Playful, elegant, and not above the judicious use of the word “shit."

The women who inspire me to run

On November 8th I’m joining a team of 25 runners to navigate the 13.1 miles of the Golden Gate Half Marathon in San Francisco in an effort to raise funds and awareness for Every Mother Counts, a maternal health nonprofit that I have been heavily involved with for over 4 years (as most of you know). 100% of every dollar I raise (you can donate here) goes directly toward programs on the ground, none of it to administrative costs. For instance, $5 will give a woman a ride to a health facility in Uganda for prenatal care, delivery, or a post natal visit:

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(click on graphic to see a bigger version)

Your daily coffee will give that to a woman.

I should have run five miles yesterday morning, but what I thought was a nasty head cold a week ago turned into a raging case of strep throat over the weekend (at first the doctor thought I might be patient zero for the flu, a crown I did not want to wear because of that still image of Gwyneth Paltrow in Contagion). Marlo woke up at 4AM on Monday morning, heat visibly rising off of her head, and spent the rest of the night tucked under my arm shouting and moaning with fever dreams (she caught strep from me). And even though I never got back to sleep I was pleasantly reminded of those months I spent in bed at night with her exactly like that, shifting her from one side to the other every few hours to breast feed, my bald and dimpled and perfect infant nestled into the warmth of my body.

How lucky we were then, and how lucky we are now that in the throes of sickness we have each other. Lucky and privileged and did I mention privileged? We have so many options that so many women across the world and in this country cannot fathom due to a series of barriers and circumstances that make these options an impossibility.

A new study reports that the US is one of only eight countries where maternal deaths are rising, placing the US at #60 behind 59 countries with better maternal health outcomes.

The USA spends more than any other country on healthcare, and more on maternal health than any other type of hospital care. And yet, women in the USA have a higher risk of dying of pregnancy-related complications than those in 49 other countries, including Kuwait, Bulgaria, and South Korea.

That is totally inexcusable.

In May I joined a few members of EMC to visit a facility in Los Angeles called The Community Birthing Center located along a tiny stretch of La Cienega Blvd that I used to drive by every morning on my way to the job that would eventually fire me because of this website, a job that provided such excellent healthcare that it would have covered the costs of any number of doctors and facilities should I have chosen to have a baby during that time.

Back then, however, I don’t think that I would have known that I’d had options. I didn’t even know I had options when I was pregnant with Leta. A privileged, educated white woman didn’t know she had options.

This is a failure in our system.

When I had Marlo drug-free in a hospital setting, I was the first woman to have done so by choice in that facility which had been open for over 18 months. THE FIRST. The doctor who delivered her had never been present for an unmedicated childbirth. Nurses and doctors passed through my room for the next 24 hours in such droves to see “the woman who didn’t get an epidural” that I chose to go home early.

HELLO. THIS IS AMERICA.

The Community Birth Center is free-standing birth center founded by women who are determined to provide an alternative—an option—to the birthing experience that happens inside most hospital settings. They serve the women and families of Los Angeles who want an unmedicated childbirth, whether in the comfort of their own home or inside the tranquil walls of the birth center. These services include a variety of hands-on prenatal, delivery and postpartum care (including what they call Free Friday, a clinic held once a month for anyone and everyone who wants reproductive care), all so personalized and compassionate that we got to meet several members of the ever-growing family who return often to nestle in the warmth of Clinical Director and Owner, Racha Tahani Lawler.

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Racha is the granddaughter, great‐granddaughter, great niece, and second cousin of midwives. As a Certified Professional Midwife and Licensed Traditional Midwife she is committed to providing midwifery care to all who seek it regardless of race, socio-economic status or gender. She has dedicated her life to help erase the many gaps that exist in our healthcare system that make it so hard for so many women to receive the services they need:

– discrimination
– financial and bureaucratic barriers to care
– lack of information about maternal care and family planning options
– lack of active participation in care decisions
– inadequate staffing
– a lack of accountability and oversight

She led us on a tour of the quaint yet beautifully-appointed facility (gorgeous artwork, private rooms, a birthing tub, private shower, birthing stools, etc.) and immediately her disposition and sense of humor made us feel like we’d known her and all her deepest held secrets for years.

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Racha employs Tanya Smith-Johnson, a student midwife who is also pregnant with her fifth baby, and Eva Zaueta-Lara, a nurse practitioner and student midwife from Sonoma County, doing clinical work in LA. Together they deliver six to seven babies a month.

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Over half a million women give birth each year in California—that’s almost one of eight births nationally—and 33% of those births are c-sections.

One-third.

Currently there are about 400 licensed midwives in California. However, less than 20 of them are women of color. This disparity coupled with the fact that nationally, African-American women are nearly four times more likely to die of pregnancy-related complications than white women (a statistic that has not improved in more than 20 years) perfectly illustrates the power structure in this country that values the lives and the quality of it of white people over any other.

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Joining us on our tour was the inimitable Jennie Joseph, Executive Director of The Birth Place, a birthing center and maternity medical home in Winter Garden, Florida that she founded as an outreach clinic for pregnant women who are at risk for not receiving prenatal care. She, like Racha, is striving to offer solutions to the gaps in our healthcare system experienced especially by those in low income and uninsured women. She offers these women choices: where to receive care, who should provide it, and how they’d ideally like to deliver their child. She then brings in family members to be a part of a team engaged in helping these women achieve a healthy, full-term pregnancy.

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Jennie is a force (and also one of EMC’s grantees) who has given countless briefings (including one on Capitol Hill) to discuss statistical data, quantitative and qualitative studies, and practical solutions regarding racial and perinatal disparities in the US. Midwifery is her life, the pump that pushes every molecule of blood through her expert hands and mind, and to be in her presence you have to be prepared for the power with which that dedication radiates from the posture of her body, from the emphasis in every word that she utters. She does not turn any woman away.

These are the faces of women who have set out to improve maternal mortality rates in this country, and they are chipping away at that goal one woman at a time. They know that this is at best a life-long, uphill slog, and yet, they go about it anyway.

It’s these women and these types of programs that compel me to run these races for Every Mother Counts, despite broken ankles and pulled hamstrings, and weekly visits to a chiropractor. It’s certainly the least this privileged white woman can do to dismantle part of the system that has at every turn given me more choices than I even knew I had while at the same time barring care and life-saving options for those women who need it the most.

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……

Check out the trailer to EMC’s upcoming documentary series, “Giving Birth in America”. The full series, coming later this year, explores the biggest challenges pregnant women face in the U.S. when accessing maternal healthcare.

Giving Birth in America Trailer from Every Mother Counts on Vimeo.

  • Jasmine

    run it boo, run it!

  • RzDrms

    You mention that Racha is “committed to providing midwifery care to all who seek it regardless of…gender.” Genuinely curious what kind of midwifery services men need?

  • REK981

    I love this and the mission that EMC is running for. Thank you!!

  • Amanda

    beautiful. looking forward to the documentary series!

  • Peggy Elliot

    Transman/Transgender Man/AFAB Man (Assigned
    Female At Birth): A man who was thought to be a girl when he was born.

  • Heather Armstrong

    Racha has worked very specifically in the transgender community to provide home births, thank you Peggy for the explanation.

  • Abby

    This is a lovely focus given to very important work, thank you.

    One thing I was wondering — I know they’re just words, and this audience generally knows what you mean, but is there a reason to use the term “natural birth” instead of “vaginal” or “unmedicated” (huh, actually, I guess in this particular case, I *am* a little unclear which you mean in each instance!)? I certainly believe that our approach to maternal health in the U.S. seems pretty wrong-headed, and commend those who work towards providing more knowledge and options. When a mother has a medically necessary c-section though, especially if she didn’t want to initially, or when a mother opts for medication for her labor… it’s certainly not an unnatural birth, regardless of what her personal guilt may tell her?

    Thank you also for the extra info on donating to EMC — going there now!

  • Steph Schmidt

    Our first born was delivered by C-section, our second and third were delivered vaginally. I asked my ob dr. at my six week check up if any other children would have to be caesarean and he said.. no, we encourage you to try vaginal as long as the surgery was not related to a medical condition. I truly believe the doctors here need to wake up and quit scheduling unnecessary C-sections, not only is it dangerous it is way more expensive. Thank you for sharing this information!

  • Heather Armstrong

    Thanks for bringing this up. That was laziness on my part, and I’ve changed the language in the post. When I was talking with Racha we were using “natural” to mean with as little medical or technical intervention as possible. But you’re right, “natural” can make women who opt for an epidural or a c-section feel as if the delivery of their child is somehow not as valid.

    They are just words, but words are important. And my goal here is to honor all women and the choices they make for themselves, and sometimes a “not-choice” when medical intervention is necessary.

  • Kimberly Wydeen

    This sounds like a wonderful program.

    But I would like to make a comment about this post from a different perspective. On June 4, 2015 I gave birth to a still born son. He died from a placenta abruption near the end of a routine, textbook pregnancy. He was 5 pounds, 10 ounces, and 18.5 inches long.

    I had a c-section for a variety of mental and physical health reasons. And sometimes when mothers start talking about their unmedicated births, or how strong they were to not have a c-section my blood just boils.

    Yeah, Heather, you were strong to not have drugs when you gave birth to Marlo. Absolutely. But you know what? I’m strong, too, even though I had a c-section. I’m strong even though this happened to me and I don’t fit into any demographic that typically elicits sympathy.

    I think this is a wonderful cause and I donated to it today, as maternal and prenatal health is obviously important to me.

    But I don’t really like the framing of this issue as if getting an unmedicated birth or a c-section isn’t a positive outcome. A healthy mother and child is the important outcome, not how it comes to be.

  • Heather Armstrong

    I am so sorry for your loss. Please see my response to Abby below. Of course a healthy mother and child are the most important outcome. That’s the basis and purpose of this entire organization. This post is about informing women that they have options when so many of us do not know.

  • Kimberly Wydeen

    Thank you.

    I know your writing style has a lot of exaggeration. But I kind of find it hard to believe that so many people came to see you after not having an epidural. Or that you were the first patient in 18 months not to receive one. When I was in the hospital, there was no communication about other patients and their treatment, so I would be surprised anybody was even talking about your medical choices enough to even have that kind of attention. Patient privacy is usually a pretty big deal.

    I agree that all women should have choices and education about those choices. But I think you could have written this post to reflect that more clearly, as it came off to me as another installment in the Mommy Wars of who gave birth in what way. Believe me when I say I think we could all use less of that.

  • Kimberly Wydeen

    Thank you.

    I know your writing style has a lot of exaggeration. But I kind of find it hard to believe that so many people came to see you after not having an epidural. Or that you were the first patient in 18 months not to receive one. When I was in the hospital, there was no communication about other patients and their treatment, so I would be surprised anybody was even talking about your medical choices enough to even have that kind of attention. Patient privacy is usually a pretty big deal.

    I agree that all women should have choices and education about those choices. But I think you could have written this post to reflect that more clearly, as it came off to me as another installment in the Mommy Wars of who gave birth in what way. Believe me when I say I think we could all use less of that.