Alternative Childbirth and Food Options of Today

Find meaning in life by bringing birthing and cooking back home in a society of commercialized choices.

baby

Some women choose a home water birth for their labor and delivery.

Photo by Getty Images/mshallenbery

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A Bun in The Oven (New York University Press, 2016), by Barbara Katz Rothman, an internationally recognized sociologist turns her attention to the lessons to be learned from the food movement and parallel forces shaping both of these consumer-based social movements. In both movements, issues of the importance of ‘meaningful’ and ‘personal’ experiences offset discussions of what is sensible, convenient and safe. The following excerpt is from chapter one “A Tale of Two Social Movements.”

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There are people dedicated to improving the way we eat, and people dedicated to improving the way we birth. Both movements move back and forth between the intimately individual — the kitchen and the bed- room, the mouth and the womb — and the larger systems in which intimacy is housed, agribusiness and the biomedical industry. The people at work in these social movements seek change through individual education, but also, in larger ways, they are doing more. They are working on social systems, working with the checks and balances on medical and agricultural monopolies. They are seeking ways to change how the economy structures the “choices” that are available to individuals.

For both of these movements, one could say it is the best of times and it is the worst of times. It is the age of wisdom, it is the age of foolish- ness, it is the age of organic kale chips, it is the age of McDonald’s, it is the epoch of belief, it is the epoch of incredulity, it is the moment of the unattended water birth, it is the moment of the elective cesarean section, it is the season of light, it is the season of darkness, it is the time of the rising of the star of the master chef, it is the time of ubiquitous processed corn, it is the spring of hope, it is the winter of despair.

I’m jealous. My movement, the one I’ve labored in for almost forty years, is the birth movement. The food movement, for all of the despair, incredulity, and foolishness, has had clear successes, while mine — sadly, not so much. The word “birthies” gets marked in red by my spell check, but “foodies” has made it into the vocabulary. And therein lies my problem. Basically from where I sit, the food movement is making strides on a dozen fronts: the need for a more natural, more organic, and tastier diet is acknowledged everywhere. Vegetable carts bring fresh fruits and vegetables to poor neighborhoods. High-end kitchen appliances are hot items even for people who mostly microwave. Exotic-food trucks ply the need improving. People who don’t really have the slightest interest in or knowledge of cooking watch cooking shows. Julia Child is some kind of a national heroine — played by Meryl Streep! Can you be more successful than that?

And my movement? The birth movement? Well, people might know there is one. They’ve probably heard of “home birth,” which is some kind of progress from forty years ago. They cannot pronounce “midwifery,” but they’ve heard of midwives. We got one movie out of it that maybe somebody heard of: The Business of Being Born. Thank you, Ricki Lake. I’m forever grateful, sure, but I’d way rather have Meryl Streep playing Ina May (oh, sorry, you probably never heard of her either — the mid- wives’ Julia Child. Ina May Gaskin’s book Spiritual Midwifery didn’t make the splash that Julia Child’s TV show The French Chef2 did, but it got some popular attention to the movement — more on that later).

I’ve been involved in the birth movement since 1973, starting with my first pregnancy, when I decided I wanted a home birth. It was at a moment when home birth was pretty much unheard of in my world. Ordinary people went to doctors, who sent them into hospitals in labor and sent them home with babies a few days later. In seeking services and providers, I very clearly aligned myself with the outsiders. Outsiders are what make a social movement.

Foodie Movement

And food? When did I become part of a food movement? What constitutes being an outsider in the world of food? When I first baked bread? Bought a 1960s gourmet guide to New York? Went into China- town restaurants down dark strange alleys and pointed to the next table to order? Proposed a little study (which I never finished) on older women’s memories of food and cooking in their lives? Or was it the moment when Jon Deutsch, then my colleague at the City University of New York, and an important figure in the world of food studies, called me, asked me about that unfinished work, and introduced me to the world of food studies? Most definitively it was when Jon and I introduced a food studies doctoral concentration into the CUNY Graduate Center — a PhD in food! Not food science, laboratory coats and agriculture, but a doctoral concentration in the social, political, and cultural relationships that make food what it is in our lives.

Trying to think through my own relationships to these two movements, I put on my sociological lens and start thinking about just what makes a social movement. Movements, people say, make waves, which is a good way of thinking about them. Picture a lovely, still body of water. Then picture a lone person splashing — a little ripply thing happens. But picture hundreds of people swimming along in a coordinated way, and the waves that can make. That’s how I think of social movements, a few people splashing at the edges, more and more joining, and eventually big waves. Social movements make more than waves, though — they change things. Of course we think of the big social movements, like the French Revolution, the ones that gave us the very word. Grand, sweeping social movements make — or aim to make — enormous societal changes, redefining societies, moving from a dictatorship or monarchy to democracy; or redefining membership in society, like the civil rights, feminism, disability, and LGBT movements. Social movements push at the foundations of society, are collective political challenges to the powers that be.

Charles Dickens was writing his books — including A Tale of Two Cities and Great Expectations — in response to the great social movements of his time, the legacies of the Industrial Revolution, and the nascent workers’ movements that it produced. His work exposed the horrible treatment of workers. We are in another era in which workers are very badly treated, and we see the rise of new workers’ movements, including the work going on in the fast-food industry and in my own world of exploited adjunct labor in universities. The food and the birth movements, while they certainly include workers in those fields, are focused more on the consumption than the production end of industrialization. The first industrial revolutions remade the way we produce things; this one is remaking the way we produce ourselves, our lives as human beings. The worlds Americans think of as private and outside work, worlds of family and home, are increasingly usurped by industrial products and thinking. What are available to people in private spaces — the dinner table, the birthroom, the deathbed — are all being controlled more and more under industrial rubrics, with profit a core value. It was hard for workers to be taken seriously as political and moral actors; it is similarly hard for people as consumers to be taken seriously.

How can one even begin to organize consumers? There is the use of the boycott, a consumption strike, like the segregated bus boycotts of the civil rights movement; the Nestlé boycotts of the 1970s, responding to the company’s aggressive marketing of infant formulas in countries where women could not afford not to breastfeed; or the lettuce and grape boycotts organized by United Farm Workers in the same years. But boycotts are only one form of social action consumers take. It is harder to see the work of the food and birth movement as political — too often it is dismissed as elitist, consumerist choices only those with lots of choices could make. But the food and the birth movements are filled with people who are working as consumers and as consumer advocates, working with committed providers to create an alternative to what industrialization offers, and to make that alternative widely available, available to all. That work, those attempts to deindustrialize the way we eat and the way we birth, are what I mean by these two movements.

Is it reasonable to even talk of our shifting relationship with food or with birth as a social movement? You can read a lot of textbooks on social movements and not see much on either of these. Jon and I have commiserated repeatedly about how our interests are seen as trivial within the academic and political worlds in which we move. If we want to study “access” issues, that’s worthwhile — suffering and death, those are not trivial, and issues of food and birth can lead to either. Think starvation, malnourishment in impoverished countries or our inner cities; think of maternal mortality — though there we are encouraged to think of it only in impoverished places and not close to home. Think of infant mortality, a point of overlap for our two movements, as lack of access to good maternity care and to a good and healthy diet causes babies to die. The infant mortality rates across the United States, by race and by class, are as clear a map to our inequality as can be found.

It is not only about access issues. Even for people who can get to a supermarket and generally meet nutritional needs, for people who can get to standard medical services and have obstetrical care provided, infant mortality rates still reflect our race and class disparities. For those people, and yes, for wealthy people too, for all people everywhere, food and birth involve life and death. The relationships are more complicated to study as you go up the racial and socioeconomic ladder. The obesity epidemic, type 2 diabetes, and high blood pressure in children, like the same conditions in women in pregnancy, along with the epidemic of cesareans, are all issues of safety, health, life, and death.

I do care about and study those things. I also want to go beyond that and look at the parts of birth and death that deal with life not as measured in years, but life as measured in joy and sorrow, in liveliness. Are the pleasures and joys people experience with birth or with food to be dismissed as trivial? I don’t think so at all. Talk to people about their dinners or their births. You will hear stories of humanity, connectedness, social life, the sense of the body — stories about what life is about.

Birthies Movement

It is so easy to make fun of these movements, to see them as “first world problems,” the concerns of middle-class white women. I want a movement of birthies, but know full well that “foodies” is itself a trivializing term, objectionable to many within the food movement. Maybe I’m just being contrarian, but I am going to stick with those terms. They capture something I cannot otherwise express. I heard the word “birthies” long before what we now think of as a food movement. It was a kind of joking term we used for the hangers-on in the birth world, those of us who weren’t midwives, weren’t doing births as our work, but were somehow drawn to that world. My role as a researcher-scholar was anomalous. But there were others who were attending midwifery meetings who were not midwives. We joked we were “midwife groupies,” roadies on this tour. We were drawn to birth, just as some of us are drawn to food. We’re not chefs, we’re not nutrition scientists, we’re not making this our life’s work. But we think about it, care about it, read about it, and, these days, watch videos about it.

“Activists” would probably be the more acceptable term for participants in a social movement, and for sure, there are both food and birth activists. In the birth world there were couples who handcuffed them- selves together before going to the hospital so that the husband could not be put out of the delivery room. There are guerilla gardeners, people who break the law by trespassing to plant vegetables in city lots. There are people who work tirelessly on legislation, in food and in birth. But then there are the rest of us, those whose “activism” is mostly through consumption and networking, who think carefully about how we feed our friends and family, and how we give birth, and do some conscious- ness raising around that. It is best captured in “lifestyle” issues. Lots of people who don’t think of themselves as political are drawn to the values and the art of food and birth. We want to make these better for ourselves and for everyone.

It’s not all about organic kale chips and water births with yoga chants. When I find myself talking or writing in an impassioned way about birth, there is always someone around to dismiss it as a “white girl’s problem,” first world troubles that have no meaning for poor people, for people of color. The same thing happens in the food world: start talking critically about industrial farming and production, and someone pops up to tell you that the real problem is food insecurity, just getting enough food to eat. But there are risks and threats posed to our health and our lives by the way we in America manage birth and food, and as is always the case with risks, the people who are most vulnerable are the ones who are already “at risk.”

Industrialized birth has caused enormous damage to poor women and specifically to women of color: just look at African American maternal and infant mortality statistics in the United States compared with the rest of the world. And within the United States, the work done by midwives with “at risk” communities (read poor, Native American, African American, and some Latino communities) has demonstrated that another approach can and does bring down those death rates.11 And this of course could not be more true in the world of food as well, where industrialized food has had its most striking health impacts for poor and African American people in particular, and the food movement, including work on the food stamps program and public school lunches, can save lives. Which children are showing up with early-onset diabetes, with high blood pressure in grade school? These, like infant mortality rates, reflect the race and class stratification of America. And if there are, as I will be arguing, social and emotional costs to the way that we manage birth and food in America, there too, who is going to be most hurt by those?

So what are these movements for, and what are they against? Why am I linking such seemingly disparate things?

Bear with me for a moment as I paint with a very broad brush now, details to be filled in later in this book: The course of the twentieth century saw birth and food swallowed up by science and industry. Food is produced by agribusiness; babies are born in industrialized “tertiary care” hospitals. Mass production was claimed to bring us better out- comes, better living through chemistry. Sometimes it worked — certainly in some ways it worked — but sometimes it failed us miserably. Ideas of cleanliness got twisted to mean sterile environments — while actual food production plants and actual hospitals remain sources of infection.

Science toyed with science fiction. Did we even need food — messy, unpredictable, variable cooking in our own little kitchens — at all? Or did we just need nourishment? Could we be fed like astronauts, little freeze- dried packages of nutrients? Good-bye oranges and squeezers, hello Tang! And did we need messy, painful, unpredictable, variable birth? Or could we knock women out and bring them to only when the baby was clean and wrapped? Schedule cesarean sections and let the women lie there like a car being worked on as someone else extracted the baby? Or can we skip it altogether, finally get that mechanical womb operating? Meanwhile, if food needs to be handled and babies to be birthed, can we just outsource it all, give it to the poorest of us to do? Enter the low-wage restaurant worker, enter India’s surrogacy industry.

And through the course of that century, splashing at the edges constantly and occasionally coalescing into a social movement, were people who said no. People who said that you are what you eat, that what you eat and how you make it and how you serve it and how you come together to eat it are what makes us who we are. Food matters. Foodies. And there were people who said birth matters, that it is a crucial moment in not only bringing a baby into the world but in the making of a mother, the making of family. Birthies. The food people splashed harder, I guess, their issues resonated more widely — after all, everyone eats all the time, and only some of us birth and that only a few times in our lives. The food movement has had an impact and is shaping us a bit now. The birth people — well, we’re still trying.

Part of what I am learning in looking at these two movements together is what makes a social movement work. How does it come to resonate? In sociology, we talk about that as framing a movement — how a social movement presents itself in terms of the values of the society it aims to change. Because you don’t really change from completely outside, not with the kind of social movements I’m talking about. This isn’t armed revolution — this really is about changing people’s hearts and minds.


Excerpted from A Bun in The Oven, by Barbara Katz Rothman (New York University Press, 2016). Reprinted with permission from the publisher.