I can’t stop thinking about Savita Halappanavar, the 31 year old dentist from Galway who died three days after being admitted to the hospital for a miscarriage at 17 weeks. Her death could have been avoided with a simple medical termination to remove what doctors admitted from the beginning was a non-viable fetus.

Instead, they pulled out the “This is a Catholic hospital and a Catholic country” line…and recklessly let her suffer over the next three days until she died of septicemia. Words can’t even express my anger that something like this could still happen, is still happening. In essence, they were telling her, “We value your non-viable fetus more than you.” They refused to perform a medical termination because the fetus still had a detectable heartbeat.

I know that as a future midwife, people will ask me how I can defend my pro-choice stance, how I can joyfully work with women carrying wanted pregnancies and catch their babies, while at the same time, finding great satisfaction in supporting women who decide to end their pregnancy.

The answer is simple:

Women are the ones who should be making decisions about their bodies, their health care, and their lives.

It is not my job to insert my personal preferences into my work as a health care provider. It is my job to protect the health and safety of each woman I work with, regardless of whether I agree with her decisions or not.

And further: I know what will happen if we lose access to safe, legal abortions. The costs–physically, emotionally, and financially, will be enormous. Women have always sought ways to control their fertility, and will continue to do so, no matter what the law says.

As a future midwife, it is my calling to be with woman. That doesn’t mean only when I agree with her. It means always. It means in the middle of the night when she’s been laboring for 30 hours already, and when she comes to the clinic, confident in her knowledge that ending a pregnancy is the best choice she can make for herself, no matter what the circumstances. Being with woman requires recognition of the full spectrum of a woman’s life, seeing the interconnections among pregnancy, birth, abortion, adoption, infertility, and loss. Being with woman means unequivocally supporting and demanding women’s full agency and participation in their own health care.

I feel incredibly lucky to live in a state where nurse-midwives legal scope of practice includes abortion care. Having spent over 200 hours volunteering as a patient support advocate for abortion patients at Planned Parenthood, I have witnessed first-hand that the women who come into the clinic are just like you and me. They are your mother, daughter, sister, cousin, teacher, student…they are 1 in 3 of us.

And, I have witnessed the power of receiving compassionate abortion care from skilled nurse-practitioners and nurse-midwives. They bring a unique sensitivity and understanding to their work, and I have been deeply inspired by the advanced practice nurses I have had the privilege to work with. I aspire to someday to join them. I will be doing it for Savita, and for the 22 million women each year who have to endure unsafe abortions. I will be doing it for all of us.

The Big Picture: Disparities in Maternal Health in the US

This will be a short post…I accidentally cut my finger while chopping onions for dinner last night, and typing with a bandaged finger is not super compatible with long posts.

Things I’m thinking about:

The Importance of Understanding and Reversing Disparities in Maternal Health Outcomes

This is a great overview article by  Christine Morton, PhD,  a medical sociologist who has researched, worked and written about disparities in maternal health for many years. Read the whole thing over at Science and Sensibility.

She starts with a shocker:

Maternal mortality is associated with the widest and most persistent disparity (inequality) in all of public health.  African American women have a three to four-fold greater chance of dying as a result of pregnancy than women in any other racial-ethnic group.1The gap between maternal mortality in African American women and women of other racial-ethnic groups is greater today than it was in the 1940s.2

And this:

Some suggestive work in this area was published by Tucker and colleagues from the CDC (2007), who examined the prevalence of five conditions considered major causes of mortality occurring during hospitalization for labor, birth and postpartum. They found that African-American women did not have a higher prevalence of these conditions (preeclampsia, eclampsia, abruption placentae, placenta previa and postpartum hemorrhage) compared to other racial/ethnic groups, but were more likely to die from them, suggesting either a possible difference in the severity of the disease or the quality of care provided during hospitalization.

Which is why I’m supporting this:

“I promise, I will do something this time”: Scholarships for ICTC’s Black Midwives and Healers Conference 2012

And if you need any more inspiration to contribute to this fund…please read my friend K. Heron VIehmann’s powerful words from her graduation speech, given earlier this summer from Birthwise Midwifery School. In fact, you should read the whole blog anyway. It has the best name ever (Bloody Show!) and as she describes it, it explores the intersections of health and race, class, sex, gender, sexuality and disability.

We need more midwives who are willing to tackle the unconscionable disparities in birth outcomes in this country. I’ve been so inspired by her journey, and look forward to walking that path and someday calling her colleague as we work to find creative solutions to improving maternal and infant health care in this country.

What Does Inclusive Really Mean?

As a doula, I’ve thought long and hard about this, because I am committed to making my services as inclusive and accessible as possible. I may not connect emotionally with every possible client I meet, but I want to make it clear that I believe that doula care and midwifery care should not exclude anyone on the basis of race, gender, sexuality, etc.

This was a great article to wake up and read this morning…Sharon Muza, a doula and educator in Seattle, is guest blogger today on Science and Scnsibility, and shares the experiences of Cathy Busha.  Cathy is a MSW, and she and her partner are expecting their first baby in July.  As the non-carrying parent in a lesbian couple, she has experienced all kinds of subtle and not-so-subtle hints that the childbirth ed world still hasn’t quite made the shift…and it hurts.

As I’ve explored books and blogs and birth websites, it seems the birth world, like the rest of the world, is hyper-heterosexist with rigid gender roles. Heterosexism assumes that everyone is straight: there are no pictures or stories of lesbian births on mainstream birth websites. At best, the word ‘partner’ is used, but all images, examples and stories are of straight couples.  I have grown weary of having to translate my role (non-biological mom) from mainstream books, videos and materials that assume all families are one man, one woman.

As for gender roles, on birth websites, women are portrayed with long hair, flowy white dresses, surrounded by flowers, brimming with nurturing instincts. Men, on the other hand, are described as bumbling, strong, masculine providers who may or may not know how to hold a baby or change a diaper, but patiently suffer through their wives’ crazy cravings and mood swings. I don’t identify with either of these paradigms and wondered how I would fit into the birth class we had chosen to take.

Language is important, and can make a world of difference in ways that those of us in positions of privilege would never notice. Imagine going through your entire pregnancy feeling invisible in your childbirth ed class because the language used never acknowledged, affirmed, and celebrated your presence. For any birth professional, this is a post well-worth taking five minutes to read and ponder…and then take some more time to consider simple ways that you can make your language more inclusive and affirming of families of all kinds.