Midwifery Skills: On Expertise and Craft

Ever since my first Food Studies conference, I've been struck by the similarities between artisanal food makers and midwives.  And jealous of how successful the food people have been, compared to the birth folk, in making their world-view understandable to the general public.  Here's the start of my attempt to do that, published in the British MIDIRS, midwifery information and resource services.

To read MIDIRS's Facebook post about this article, click here.

To read the article itself, click here.

Yet another technological fix to a social problem.

I wrote about a very similar topic back in February, but it comes up again and again. And it probably will come up many more times, even after they stop asking me for a soundbyte. 

According to the article that the people at NPR sent me, it appears that IVF may be somewhat more effective in creating pregnancies than we thought it was.  Or maybe not.  I read the article through and through, and there were a number of different ways to interpret the data.  What do we use for the baseline?  How successful is what we used to call ‘trying’ in achieving a pregnancy?  How successful is ‘unprotected intercourse’ as they sometimes call it?  (How successful is not trying?  Ask young woman if they’ve ever had an ‘accidental’ pregnancy --   it’s not all that rare now is it?)  Anyway, reading the new studies, it seems like if we are willing to buy eggs from younger women, putting them at who-knows-what risk, opening up baby-making to yet more market-place values, raise yet more identity and relationship issues for the children we so conceive, it may indeed be more possible than previously thought for women in their 40’s and up to produce a live baby.  

 
So what if it is indeed true?  What if the IVF rates, with purchased  eggs (euphemistically called ‘donated,’ but only very rarely does an older woman have a younger woman ready to ‘donate’ eggs for her) are just as good as the pregnancy rates for young women?  What if we just stop arguing the data, and say ‘so what?’  Is it a good thing that young and healthy women who want education and good careers cannot in any way, not in time nor in money nor in energy, afford children?  Is it a good thing for children to become a mid-life project?  Is it a good thing to conquer the biological clock for reproduction if the rest of the biological clock – the one for diabetes, stroke, dementia – keeps ticking?  We’ve had older men fathering children, often second-sets of them, as lovely late-life projects.  But those men usually had young wives to mother the kids, care for them through the aging and death of the father.  These delayed-childbearing women are less likely to have young partners to pick up the reins.  What are we wishing on our children?  And what are the costs for all of the women involved, the ones who delay, the ones who sell eggs, the ones who succeed in late-life baby-making and the ones who don’t?  

To listen to the interview, click here

Human Rights in Childbirth: a conference in the Hague.

For those who care about midwifery and home birth, the Netherlands has stood as a beacon of sanity, a light in the darkness, a ray of hope.  When all over the world midwives lost the power of an independent profession and became some kind of nurse or physician-extender, Dutch midwives remained Midwives.  When all over the world, women moved into hospitals for birth, Dutch women stayed home.  The story is more complicated (all stories always are) but over and over again, those of us arguing for home birth and for midwives turned to the Netherlands.  And we still do, but.... it's getting a bit precarious over there.  The home birth rate is down and dropping, the midwives are finding the appeal of shift work and turning over all the complicated cases to the doctors, the doctors are pushing for more control, the women are watching the same television as everyone else and expecting to be in agony and rescued by epidurals.  As midwives around the world face various forms of state-control, dramatically shown in the recent case of Agnes Gereb who was arrested for doing home births in Hungary, we turn, yet again to the Dutch, and hope they rise to the occasion. 


To learn about the conference, click here.
To read my contribution to the conference, click here.

Surrogacy, Israel, Hitchens….

I haven’t written about or seriously thought about surrogacy in a long time – just not ‘my issue.’  But I remember as clear as yesterday the first time I heard about it.  A reporter called me for a response to the then-new “Baby M” case, in which a hired-surrogate, Mary Beth Whitehead, changed her mind and tried to keep the baby, refusing to turn it over to the purchasing couple, the Sterns.   The reporter said it was all brand new as a case, and I should bear in mind that they hadn’t yet done paternity testing and so it was possible that Mr. Whitehead, not Mr. Stern, was the father.   I said, without a moment’s hesitation: “I don’t care who the father is, we know who the mother is!”  Show me a pregnant woman and I know just who the mother is.

And here I stand, position totally unchanged, almost 25 years and a lot of fancy technology later.  At that point, the pregnancy was created with the equivalent of the turkey-baster:  the purchaser’s semen was placed into the vagina by a medical provider using low-tech tools.  Now, precisely to avoid the kind of case Baby M represented, a lot of much fancier technology is used, to assure that the egg does not come from the hired-surrogate.  But truly, it was not a question of ovum-sourcing that made me see Marybeth Whitehead as the mother of the baby she’d carried and born. 

So for me, nothing’s changed, my position remains solid.  But out there in the world, a lot has changed: Surrogacy is a growth industry.  And like many industries, it profits from globalization:  outsourcing pregnancies to India, once as unimaginable as anything I could now imagine, is routine, fully industrialized and normalized.  And sadly too, like many industries, it comes with its own set of scandals.  A well-known ‘reproductive law specialist,’ popular on the media circuit, has just been sent to jail for what amounts to an even-more direct form of baby selling than is surrogacy.

But still, I’ve been happy to take a back seat, watch, sadly wag my head back and forth and sigh dramatically once in a while.  And then I was asked  to review a book by Elly Teman on the surrogacy industry in Israel. You can read the review here.  Or better yet, go read the book -- obviously Teman and I disagree about surrogacy, but she does write well.  That book got me way past sighing – it made me cry, made me throw things, made me seriously think about cancelling my big annual Passover seder.  I’m not religious enough to have a crisis of faith – but this created a bit of a crisis of identity for me.  That Jews, as Jews, in a Jewish state, applying the logic of Jewish patriarchy, could come up with the system they did – well, do I want to be any kind of a part of that? 

I rescued Passover – my hagaddah is something I’ve developed with family and friends over many years, reflective of our multinational, multiethnic identities, celebrating a human desire to be free of oppression.  And Surrogacy, as practiced in Israel, as practiced in India, cannot be understood as anything but a form of oppression.  Not to my thinking, anyway. 

And then, the review just published, a few letters and comments trickling in in response, I was pulling out my own copy of RECREATING MOTHERHOOD, the one place I did write about surrogacy, and an old review slipped out.  I looked at the photo of a young me, and looked too – with quite a bit of surprise – at the photo of the reviewer: Christopher Hitchens!  I’d forgotten that.  I read it again (and you can too, here), and saw that yes, that was a smart guy, yes he did get what I was saying, and oddest of all, he too connected  it to Israel , even if calling it a digression to “another contemporary controversy, the ‘Who is a Jew?’ debate”   It wasn’t a digression: it showed a true understanding of what this surrogacy business is all about.  Like traditional fatherhood in any patriarchy, the point of baby-making is for people of power to use oppressed people to grow their seeds into their progeny, do the labor, the dirty work, the hard work, and create a child who will bear the name and carry on the life and work and values of the oppressor.  Whether it is in the most traditional, religious framework in which the seed of Abraham can grow through any woman’s body, or in a post-feminist capitalist state in which rich women can hire poor women to be their ‘surrogates,’ this is an ugly business.  Hitchens was left with the ‘strong conviction that the argument could be more civilized if the profit motive could be eliminated from the process of conception. “ 

He said that showed what a naïve utopian he was – to me, it sadly showed how smart and how prescient he was. 
Maybe I’ll write more, maybe I’ll just go back to heavy sighing.  I’ll decide after Passover. 

Creating Eggs for Older Women: And for what problem is this the solution?

Another news headline out of the repro-science labs: they can --  maybe eventually, sorta, possibly -- get viable eggs from postmenopausal women.   Asked to chime in on the 'social implications' I have to first wrap my head around why women would want to become mothers in their 50's and 60's.  Is it because we've made it so hard to have kids in our 20's and 30's, when our bodies are most ready for it?  So -- call me crazy -- but might it not make more sense to solve that social problem rather than try to introduce a technological fix?

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Whole Mother

Radio interview in Houston.

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Talk: Splashing in New Waters: Beyond Second Wave Feminism

The first-ever joint conference of the Midwives Alliance of North America, the Canadian Association of Midwives and the American College of Nurse Midwives took place in Niagara Falls in November 2011.  I was present at the first-ever MANA conference (still have the t shirt!) and have been at most of the ones since.  It is one of the great honors and joys of my life that I was invited to do a plenary presentation at this meeting.   Talks are flexible, things come up, and I never could or would give a written-out version of a talk.  But here's the gist of what I had to say. 

click here to read the talk

Article: On Markens

This short article is from on a panel in response to a new book on Surrogacy by Susan Markens.  The book has the greatest cover -- a pregnant belly, barcoded.  It's a white pregnant belly on that cover -- the dark ones are cheaper.  Googling for Surrogacy to find the image, ads popped up first -- how to hire a surrogate, how to get work as one.  It's a business, and like so many American businesses, increasingly outsourced. 

 

The very concept of surrogacy continues to infuriate me -- Every pregnant woman is the mother of the baby in her belly.  I will stand by that no matter what technologies we develop, no matter whose genetic material is involved, no matter what she was thinking or planning (or not) when she got pregnant, and no matter what that woman chooses to do with that baby after it has left her body.  If she wants to stop being its mother at birth, place it for adoption, I'm as supportive as only an adoptive mother can be.  If she wants to sell it -- well, let's think about that.  I'm still not ready to endorse baby-selling, but there's an argument to be had.  But for me -- don't tell me it's not her baby while it's in her belly. 

Click here to read the article

Frau Dokter Katz Rothmann

For reasons I've written about, (see "Jews, Germans and Clones")  I've come to have a German audience.  A year or so ago, Hildburg Wegener, a feminist theologian, approached me about coming to give a talk on the occasion of the 25th anniversary of the publication of The Tentative Pregnancy.  25 years? seriously?  Did the math and yes, indeed.  I went to that meeting, met Germans who are still working hard on issues around prenatal testing, who are still worried about eugenics slipping in what Troy Duster called 'the back door,' the medical-testing route. 

After a really fascinating conference -- made all the more so because my son, Daniel Colb Rothman, joined me and was able to help me see, reflect, think about what was happening -- Hildburg spoke to me about doing a book aimed particularly for German audiences.  We went through just about all of my published work, articles, chapters in my own and others' books, essays, presentations, and Hildburg chose the chapters that would speak to Germans.  She's almost done with the translating, guided me through the editing, and the book is going to come out soon.  The jacket here is not quite the final version -- they have (charmingly) done what Germans seem to always do with my last name, and bestowed an extra n on Rothmann.  I've become rather fond of my German personna, Frau Doktor Katz Rothmann. 

Forthcoming, SCHONE NEUE WELT DER FORTPFLANZUNG: TEXTE ZU SCHWANGERSCHAFT, GEBURT UND GENDIAGNOSTIK, Mabuse-Verlag, Germany  Translation by Hildburg Wegener 

In the news: Huckabee's attack on Natalie Portman

Motherhood issues just never cease to fascinate the conservative politicians and the media.  At least Huckabee picked on an actual woman's "unwed motherhood" unlike Dan Quayle's attack on a fictional character's.


Read the article here.

Article: Breastfeeding

(See below for link to article)

I wrote this article first as a talk – and probably it ‘reads’ better as a talk – for a conference called “Feminism and Breastfeeding.” It feels to me like we’ve been trying to put those two things together for a long time, without great success.

The standard American version of feminism argues that women can do everything, just everything, no limits. Which means women can be all that men are: engineers and firefighters and physicians and soldiers and Supreme Court Justices and airplane pilots and Presidents. All of it. Yes we can.

If that’s the feminism that you are pursuing, then almost inevitably anything that is ‘unique’ to women seems like a barrier we have to overcome. Yes, even with our big breasts and smaller shoulders, we can be firefighters! Yes, even with our menstrual hormones we can be airplane pilots! Yes, even with our emotional depth and our empathic qualities we can be oncologists! Whatever – nothing about our female bodies will interfere with our real achievements.

That is, of course, overstating to the point of being silly, but I do think that’s the basic argument of American feminism: women can be just like men. It doesn’t give us a lot of space for the things that women’s bodies can do that men’s cannot – like being pregnant, giving birth and breastfeeding.

There are other feminisms, other places to stand when talking about a better world for women. It is possible to actively value women’s potential, the bodily capacity to create and nurture the next generation. But it’s hard to do that and not fall into the anti-feminist trap, the argument that women ought to be doing the nurturing and leave the rest of the world to men.

That’s the tricky place I’ve been standing all these years: trying to value what women do as women, trying to make space for men to be more like women, more nurturing, more care-giving, doing more of the mothering of their children and the children of the world. But it’s not an easy argument to be making in a society that basically views the care of young children as unskilled labor.

And so we end up with a fraught relationship with our ability to breastfeed our babies: if we celebrate it, we tend to fall off into the anti-feminist side, asking women to spend their time being traditional mothers. But there is something there to celebrate – it’s really quite a lovely and interesting system for baby feeding. A recent article by Hannah Rosin in the Atlantic, (April 09) “The Case Against Breastfeeding,” revisited the issue. She did a hard backlash against all the ‘breast is best’ propaganda, and some of her points are well worth thinking about. But – and I found this charming – she ended her article by saying she would continue to nurse her baby basically just because it’s a lovely thing to do.

In this talk, I found myself arguing with all these people who – like me – want to encourage breastfeeding, but are pissing off the Hannah Rosins of the world. The arguments they keep pushing are all about how good it is for babies, how healthy, prevents this and that, healthy for mothers, yadayadayada. Not markedly persuasive – there are lots of healthy things we’re not doing, and this is short sighted anyway. They could, as I point out, create a technologically superior milk than we’ve got now, and then what?

So I’m asking the breastfeeding advocates to try to figure out just what it is that they so value about breastfeeding, to try to figure out what we’re celebrating. And realize that all our arguments, all of what breastfeeding means, occurs in a context, and that if we don’t think about that, if we don’t place ourselves in the right context, we’re not going to be encouraging women to breastfeed. And that’s sad because…… well, it’s a lovely thing to do.

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Read the article here.

At Your Beck and Piven: A Call for More Public Sociology

You’ve probably heard something of the situation by now – Glenn Beck, a Fox news ‘commentator’ is trashing Frances Fox Piven, using the kind of hateful language and accusations that have come to mark American political discourse, taking all the ‘civil’ out of it. Throw in the joys of the internet, and the level of the conversation has degraded to “Die you Cunt!” messages arriving in Piven’s email. Commentate that!

I’m not absolutist about a lot of things, but when it comes to free speech and the first amendment, you’re not going to find a lot of stronger advocates. I spent my teenage and young adult years listening to late night ‘listener supported’ radio, listened in tears as stations were attacked by right-wing, pro-war forces, felt my eyes fill as the Pacifica station reopened with the rousing chords of “Let the Sun Shine In” after a bombing. Oh those 1960’s! And in the years that followed, I watched early feminist attempts to control deeply misogynist pornography backfire, the laws quickly being used against feminist free speech. These days, I spend a fair amount of time in Berlin, a city so overfilled with its own monuments that it requires stumble stones, engraved brass cobblestones to show you where people were rounded up and sent to concentration camps. I became used to it, stumbled, sighed, nodded and walked on. But the memorial that brought tears to my eyes, the one that truly made me stumble, was the book burning memorial. In front of Humboldt University, at the law school no less, there is a memorial marking the spot where the Nazis burned piles of the books they found offensive. You stand on a square of thick glass in the plaza and look down into a small white room lined with empty white bookshelves. I stood there and cried – the books!

So what with one thing and another, I’m not going to ask for laws to cut down on freedom of speech. Not even Glenn Beck’s. I am going to defend his right to be stupid and evil. But it does require that I – and we, SSSP members – be good and smart. We have to address these vicious, personal attacks designed to silence not just Piven, but any of us who critically assess the system and dare to publicly advocate for the poor, the unemployed or the foreclosed.

An unfortunately large part of the media response supportive of Piven that I’ve seen makes a point of mentioning that Frances Fox Piven is 78. Well, as an old white woman myself, I kinda resent the assumption that one look at us and anyone can see that obviously we’re not dangerous. Partly it’s the ‘ageism’ in that, but more it’s the kind of privilege that allows some people to say things like “Do I look like a ______?” shoplifter, terrorist, radical rabble-rouser? Thus reinforcing the idea that some people – young black or Middle Eastern men for example-- do look the type. And just what is the type in question for Beck here?

Piven, a past president of our organization and of ASA, a colleague and a truly remarkable and wonderful scholar and person, may well be a model member of an intelligent minority. Beck has named her among nine people as the ‘intelligent minority’ who are also the nine most dangerous people in the world. I think I would take some comfort from a world in which the most intelligent were also the most dangerous – it would imply more power associated with intelligence than I’ve observed. But be that as it may, I’m having a hard time seeing Piven as one of the nine most dangerous – and thus in some way powerful -- people in the world. If she were, this would be a much nicer world.

It’s been noted that 8 of those 9 people Beck pointed to are Jews. Intelligent minority? We’ve been called worse I suppose. Did Beck really and truly, deliberately do a display of anti-Semitism? Is this a Goebel-like attempt to tell the big-lie, name the scapegoat, sow division, and let the people connect the dots? Or, like Sarah Palin’s recent misuse of the phrase ‘blood libel’ did he just demonstrate an appalling lack of, uh, intelligence? Or at least knowledge of history, sense of the political landscape, basic common sense or what my mother would call ‘seichel’?

So here’s what Beck says makes Piven so dangerous – she’s a public sociologist (or public political scientist -- pity but the media do consistently give them rather than us credit for her) who has recently wondered why the unemployed in America these days are not protesting, rallying and marching, why they are going so quietly into that jobless night. She compared that silence with other protests and disruptions, including the recent Greek strikes and riots. Well, people died in Greece, so it follows logically a la Beck that Piven is calling for violence.

But that’s rather minor in her list of sins. Really what she’s responsible for is the financial meltdown and – now you’ve made even me angry Frances -- the housing crash! It seems that what really caused the economy to crash was an article Piven and Cloward wrote 45 years ago that suggested that ‘poor people claim their lawful benefits from the welfare system.” Piven and Cloward thought perhaps that would bring us to a system of guaranteed income. It didn’t actually do that, you might have noticed. But 42 or so years later, that article caused the markets to crash and that explains why I couldn’t sell my house! I am so relieved to finally understand what happened with all that.

OK, I will take a deep breath and try again to deal with this seriously. Frances Fox Piven is getting death threats, and no, that’s not funny and it is terrifying. Defending her right to enter the public discourse and try hard to steer it intelligently does not really open up ways of shutting Glenn Beck up. If she has a right to be smart, he’s got one to be stupid. But there are a lot of us, and maybe we better get out there in that public discourse too. Surely there are more members of the intelligent minority (goys welcome!) who can raise our voices alongside of Piven’s, make our calls for justice, for decent social policy, for an end to racism, an end to poverty, our calls for a better world, and make it harder for just one or two of us to be picked off, ‘selected,’ shall I say, for smearing.

Article: Who is Defending Whom from What?

This little piece is really too short to properly address the issue, but here's a quick thought on the issue of 'malpractice' as an explanation for the rise in Cesarean sections.  One thing worth noting is that the medical profession has so totally managed to place its own concerns front and center that when you say 'malpractice' most people think of the insurance, rather than the actual bad practice being insured against. 


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Read the article here

Article: Obama's Mixed Heritage - A Mother's Perspective

(See below for link to article)

I wrote this piece at a moment when I really wasn’t allowing myself to be hopeful. Hope was in the air, that ‘yes we can’ feeling was all around – but I just wouldn’t let myself believe it.

But in spite of my doubts, my “Eeyore” tendencies as a friend calls it, I made a party the night of the Democratic Convention’s nomination of Obama. Talk like Eeyore, act like Tigger my friend says – that’ll be my motto. So, Tigger-like, I made a celebratory party.

I called it a ‘Dayenu’ party – Dayenu means ‘It would have been sufficient’ in Hebrew – or so I’m told. I don’t speak any Hebrew. The only part of being Jewish I’ve really hung onto is Passover, the liberation holiday, the celebration of the Exodus, and a holiday that lends itself to endless remaking.

Passover is a home-based holiday, a formal dinner with ritual foods and readings, called a ‘seder.’ I make big celebratory seders every year. And a traditional part of the seder is the singing of “Dayenu.” Each of the steps of the Exodus are recited, with Dayenu sung:

If we had freed ourselves from slavery

And not passed through the sea in safety

DAYENU!

If we had passed through the sea in safety

And not learned to survive in the desert

DAYENU!

It’s crazy really – what good would the Exodus have done if everybody had drowned? Or wandered endlessly in the desert? But actually it’s not so crazy: the meaning to be taken out of Dayenu is that each step needs to be acknowledged, celebrated for the accomplishment it is.

And that’s what I decided I needed to do about Obama’s nomination. Celebrate it and just enjoy the moment. And if our worst nightmares came true and Sarah Palin ended up being sworn in as President a couple of years later, so be it. There’d be plenty of time to mourn -- and to organize -- then.

So I invited a bunch of people, set up all the laptops we could gather (I don’t own a TV) and opened a bottle of champagne as Obama gave his acceptance speech. I expected to be moved, elated. I was oddly flat. Conventions are so, well, conventional, you know? And not having a TV, I kinda lost the ability to listen to that standardized rhetoric. So sure, celebrate, champagne, hope, yeah maybe we can at that, whatever. I did all the steps of celebration, but pfeh. Stood there surrounded by laptops blaring speeches, feeling nothing.

And then the wives came up on stage after the speech. You’d think I’d be made miserable by that too – the old ‘farmer takes a wife’ style of the thing. But in all the ritual, a magic moment happened for me – Joe Biden hugged Michelle Obama, and – the moment! – Obama hugged Jill Biden. My eyes filled, my throat closed. I remember when a black man was not allowed to touch a white woman on television. Some scene from my childhood about Sammie Davis Jr I think it was, shock and horror, oh no, not happening. And here was a Black man embracing a white woman – and my god, it was the Presidential Nominee hugging the wife of the Vice Presidential nominee. Grab that champagne! Things do change! There is hope! Yes! We can!

And we did.

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Read article here.

Interview: Profile on BKR

Interview with Barbara Katz Rothman at Literary Mama - read here.