Originally written for Oakland Better Birth Foundation's Better Birth Journal - December 2020 Edition 12/31/2020
As we move through holidays renowned for centering a major mother archetype, it is near impossible for birth workers everywhere to move through this season without reflecting on the reality of motherhood - and parenthood in general - in the United States and beyond. As doulas, advocates, loved ones and medical care providers, we see daily, in anguished detail, the ways American society and policy regularly devalue the Mothering individual while proclaiming “Christian family values'' as a core of mainstream U.S. culture. Outcomes vary widely, yet the repeating undercurrent is that the lived experience of a reproducing person in a position of maternal nurturing, by choice or circumstance resulting in pregnancy, is punished for transpiring in any way that does not serve white-dominated definitions of “efficient” and “convenient” capitalist personhood.
I think of Mary from the Bible, one of the few mother figures revered in white American culture, very likely a rather young woman given the historical context of her story. A teen who becomes pregnant today is rarely asked if or what she is excited and joyful about, let alone treated as if her child is valued - and while we certainly want to help people avoid unwanted pregnancies to begin with, assuming that a young person can’t also feel joyous about their fertility and the possibility of parenting is patronizing in the most classical degree. What if we granted that individual their full spectrum of human experience, and gave them compassionate space to feel whatever range of emotions they might have about an experience that, only five or ten years later, might be lauded by the same parties as the most sacred and formative of their life? What if instead of shame, pity and punishment, we met teen parents with flexible job training, culturally accessible parenting classes, and nutrition programming aimed towards thriving health for the pregnant couple and their newborn through three years of age?
How many billions of dollars in the cost of homelessness, incarceration and addiction could be avoided by comparatively few millions of up front investment in our youth? What if instead of a conversation asking, “How could you?”, we asked, “How can we support this young person’s health and effective parenting?” And what if we asked that question for young people before they were in a potential crisis situation by implementing honest, evidence-based, comprehensive sex education for all youth? What if instead of fear-factor based sex education, we taught young people about the realities of the emotional, physiological and logistical attachments that come with sex, conception, gestation, birth, infant nourishment, child development and parenting? What kind of protections might we offer young pubescent and birthing people - who suffer some of the worst preventable health outcomes - if we equipped them to manage their budding sexuality with the Grace and Peace we sing about for the Silent, Holy Nights of Christmas? And, with girls aged 15-19 globally more likely to die from perinatal complications than any other cause, what if we carried that respect and collaborative spirit into clinical settings and care systems?
On the other end of the spectrum, a woman who has been taught her whole life that she can “do anything a man can”, if she just “puts her mind to it”, establishes herself in a successful career, and, equipped with a home and private insurance, decides to become pregnant at 38. Meanwhile, her male colleagues are enabled in disrespecting and even denigrating working femme peers, making this woman’s pregnancy the subject of lewd comments, disappointment from “team” members, and dismissals in professional spaces. Particularly if she is also a Black woman, she is expected to express not an inkling of assertiveness in response, lest she be labeled antagonistic for protecting her Self and the right of her offspring to exist.
Medically, she is put into a high risk category, and having never received holistic guidance around nutrition, movement and mental health (unless she had the time and resources to seek it out individually), she is fearful and complacent in this diagnosis, with stress levels increasing each week as she faces a process that seemingly punishes her for “reaching for her dreams” - dreams that include the complexity and challenge of motherhood. Stress loads and lack of support create a perfect storm of hypertension, exhaustion and nutrient depletion, fulfilling the original estimate of pathological pregnancy. Yet this working, fully adult, willingly pregnant person is also dismissed because, well, with an income, she will surely be okay, and as an “older woman” must know what she needs already, despite never having been around pregnancy or childrearing while she was working 60-hour weeks.
Once her baby comes, likely through a highly medicalized fashion, she is asked to return to work after 6-12 weeks, and her partner is likely asked to return even sooner. Their desires to breastfeed and to witness their child’s first year of life are put aside as necessary sacrifices to maintain career, because someone younger, faster, and not-a-parent will take that place otherwise. Her partner is warned by peers that their sex life will go down the drain, and perhaps with the high level of medical intervention that accompanied labor and birth, that reality hits hard, and with little discussion, because the shame and stigma surrounding pelvic health (for all gender identities) is so insidious and pervasive that no one asks for help - how selfish it would be to seek a fulfilling sex life after waiting so long to have children! So both parents' viability as employees is determined in part by their willingness to outsource parenting, despite qualitative research in both public health and economics showing that well-supported parents with paid family leave have fewer health complications, require less time off in the long-run, and are more effective employees. It pains me to reflect that perhaps COVID-19 is one of the few moments in recent economic history in which working colleagues have become more honest about the impossibilities asked of parents across roles and industries.
Despite years of work on the ground, in clients’ homes, in institutions of learning, in hospital suites, and in the court system - despite activists’ and allies’ persistent efforts to implement actionable change for working families, maternal care patients, and the systems supposedly designed to serve them, we still suffer some of the worst maternal and infant mortality rates in the world, and we still find ourselves in a mainstream narrative that is only just beginning to inch away from the two options most often assigned to the designation of “Mother” in recent cultural history - pathological burden to society, or perfect saint-like embodiment of patriarchy’s definition of femininity. That isn’t to say that parents and Mothers don’t fail, or that all people should take on this role - nor that in private conversations do we actually refer to childbearing people in such simplistic terms. Certainly parents themselves know that they, as individuals, are more complex and nuanced than that harmful and high-pressure binary, but we do tend to heap judgement on the vast majority of people who identify as Mothers, instead of allowing them to be flawed humans-in-process who could benefit from institutional protections and culturally congruent support. Suffering, fear and inadequacy are the messages our clients receive - from marketing, from practitioners, and even from their own grieving or traumatized peers. What Peace is this? What burden does this place on our children entering a world where solidarity and collaboration is needed more than ever?
It is our fervent prayer and actionable vision that as new generations of care providers, educators, writers, lawmakers and parents start to shape the pathways and conversations around whole family health, we move away from the internalized oppression and hypocrisy, and instead stand up for inter-professional integrated care, culturally responsive resources, and the reframing of maternal and infant care as a matter of both human rights and joy, with a rightful respect, reverence - and thereby responsibility- for the power of our reproductive forces. That is a possibility we all hold stake in, whether or not we know it and no matter who we are, for a more equitable and healthier 2021 and beyond on this planet.