Community birth, doulas, and activism

The term “community birth” will bring to mind different images for different people. You may think of what birth looked like some time ago before hospitals got involved. You may visualize a home birth happening today, the family intentionally choosing to birth outside of the hospital. You may imagine birthing people coming together during pregnancy to talk about their experiences, and to ultimately build relationships with one another as they prepare for birth and embark on the path of parenthood.

“Community” is defined as, “a feeling of fellowship with others, as a result of sharing common attitudes, interests, and goals.” I live in a region, like many others, where most people are choosing to birth in the hospital. I’ve come to believe strongly that the essence of community birth can still flourish here, even with may families birthing in the hospital. And I’ve also come to embrace my role as an activist for healthy birth as being one in which I work towards building that community around birth. It won’t happen on it’s own, and the work isn’t easy. But the benefits are incredibly valuable. If community birth is realized here, it will mean that birthing people’s attitudes and goals around their birth experience will be supported and shared by others in the community, including their care providers.

Recently, I worked with other activists in my community to bring a production of “Birth, the play” to our community. The play, written by Karen Brody, is a scripted reading that sheds light on birth experiences of people around the U.S. It is meant to be a fundraiser, and we raised money for a local residential recovery facility for pregnant and postpartum mothers with substance abuse disorder.

When we had our first meeting for those interested in acting, we had three obstetricians who attended, among other birth professionals and parents. One of the OBs went home to read over the script. The next day, she emailed the organizers as well as the other OBs (her colleagues) who had been present. Her email expressed her discomfort with the play’s portrayal of medical care providers and it’s clear bias toward midwifery. She urged us to reconsider going through with the play, saying that it would not be a good way to achieve our stated goal of “building community amongst birthing people and professionals” in our region. As somebody who doesn’t love confrontation and/or ruffling feathers, I was shaken. I found myself questioning our motives, the play itself, and wondering if she was right. Luckily, this was short lived as I continued to sit with my thoughts and talk with the other organizers. There is a truth to be told about birth in our country, and telling it is uncomfortable.  It’s never going to sit well with every person. But remaining quiet is too risky. Too often, birthing people are dehumanized and mistreated, and outcomes aren’t what they should be.

As we responded kindly, with our intention to move forward, we were supported by the other obstetricians, and one of them even decided to act in the play. We prepared for the play, actively gaining community support and building many relationships. After the first night’s performance, we knew it had been right to move forward. Audience members included doulas, mothers, daughters, fathers, homebirth midwives, obstetricians, nurses, and other birth practitioners. It was incredibly well received. One obstetrician found me after the show to let me know that she thinks every OB resident should see a recording of the play during residency to help them remember, amidst all the studying, that they’re working with human beings during one of the most important times of their lives.

Weeks after the play, I was attending a birth in one of our local hospitals as a birth doula. When I walked into the room, a nurse I hadn’t met before introduced herself and asked if I’d been a part of the play. She shared that she had been in the audience and loved it. My client had been in the audience as well. We proceeded to work as a team to offer support to my client for the next 12 hours. And as she was close to birthing her baby, the midwife’s shift ended and the very OB who had acted in the play came in to attend for the birth. There we were, all four of us (the mother, nurse, OB, and me), plus the father-to-be, all connected in our desire for a respectful and loving birth experience. We had common goals and interests as part of this local birth community we’re building here. Each person in that room was valued and seen as an autonomous human.

Many questions come up when I train doulas about how to be both an activist/advocate and a doula at the same time. How do we support our clients and promote healthy birth without burning bridges or creating conflict in the birthing room? There are so many ways to do this, and it’s a long conversation. But one way to do this is to remember that our passion for birthing people can extend beyond the delivery room. We can use our voice and our presence in the community to advocate in so many important ways. We don’t have to simply wait until we’re faced with a challenging moment during a birth. And as we get involved in our communities, we build valuable relationships, and slowly we change the culture of birth for the families who will welcome babies in our regions. Community birth can be alive and well if we commit to it and work for it together.

Taylor is a birth doula, childbirth educator, birth activist, and DTI educator. She is passionate about supporting families to have respectful and loving birth and postpartum experiences in which their autonomy is a priority. She is the leader of her local ICAN chapter (International Cesarean Awareness Network) and co-founder of New Mama Project.  She has three children; one born via cesarean, one via hospital vbac, and one via home vbac.

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