Sunday, February 21, 2010

Demographics of Home Birth

In the second chapter of Blessed Events, “Cultural Contexts of Home Birth,” Klassen describes the demography of home birth in the United States, tells a brief history of childbirth practices in America, and frames home birth in the context of anthropological studies on the meanings of childbirth. The demographical sketch confirmed my observation that most home-birthing women are well-educated, middle-class, and white. They are more likely than hospital-birthing women to be married, and less likely to smoke or drink while pregnant.

But what surprised me is that home-birthing women cluster in two groups. To quote Klassen, who cites a 1995 study, “The first group is the ‘older or more formally educated mothers who are likely to prepare themselves prenatally for a home birth.’ The second is made up of ‘those who are younger or have less formal education for whom home birth may be a result of lack of planning or other manifestation of problems with health care access.’” Race plays a big role in the distinction as well. According to Klassen, African-American birth-birthers tend to have less formal education and poorer birth outcomes than other African-American women. They struggle for access to good quality health care. In situations where women birthing at home have to be transported to a hospital, white women are “much more likely to know that they have adequate insurance that will both pay for their hospital stay and grant them access to health care that they need, and they are much less likely to suffer from racism in the hospital environment.” Klassen reminds us that choice is a privilege that only some people have.

There are people working to make birthing options a right, not a privilege, for all women. Miriam Zoila Pérez, a self-proclaimed “radical doula,” keeps a blog that deals with issues like access, choice, birth activism, and reproductive rights. The Doula Project is an organization in New York City that “provides free compassionate care and emotional, physical, and informational support to people across the spectrum of pregnancy.” I have heard that many doulas are willing to charge clients on a sliding scale. I have one friend who is going to be a volunteer doula. Once I become certified and get more experience, I definitely hope to make my services accessible.

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