celebrates Labor Day by exploiting the tragedies of women of color


I get it.

The folks at, primarily doulas, believe that the best way to promote themselves and expand their employment opportunities is to criticize modern obstetrics. As far as I’m concerned, there’s plenty to criticize. But they go a step too far when they attempt to promote doulas, natural childbirth and homebirth by exploiting the tragedies of women of color.

I found this example particularly repulsive.

ImprovingBirth gowns

Twelve hundred gowns, for the 1200 mothers who lost their lives giving birth in the U.S. in 2013. It’s a very sobering sight, thinking about what each one of the gowns stands for.

Big thanks to the people who have donated their time sewing the gowns to help honor these mothers- and to hopefully reduce the number of women dying in the future.

The implication is that these 1200 women (there is some dispute about the actual number) died because of high tech obstetrics and therefore, their deaths are an excellent marketing tool in promoting doulas, natural childbirth and homebirth.

Nothing could be further from the truth.

Here was my response:

Improvingbirth 9-6-15

[pullquote align=”right” color=””]The real tragedies? Women whose lives and babies could be saved if we had more high tech interventions.[/pullquote]

If you really cared about maternal deaths, you would do something about it besides exploit them to publicize your own organization.

There is some dispute about the actual number of mothers who died, but there’s little dispute about why they died. From the report that cited the number 1200:

“Hospitals across the USA lack a standard approach to managing obstetric emergencies and the complications of pregnancy and childbirth are often identified too late. Nationally endorsed plans to manage obstetric emergencies and updated training and guidance on implementing these plans is a serious and ongoing need.

A second factor is the increasing number of women who present at antenatal clinics with chronic conditions, such as hypertension, diabetes and obesity, which contribute to pregnancy-related complications. Many of these women could benefit from the closer coordination of antenatal and primary care – including case management and other community-based services that help them access care and overcome cost and other obstacles. In the USA, women who lack health insurance are three to four times more likely to die of pregnancy-related complications than their insured counterparts.

So these women, disproportionately women of color, die because they need HIGH TECH care. What is doing to obtain high tech care for these women?

Absolutely nothing, right? Oh, wait, that’s not true. You’re exploiting their deaths to promote an agenda that has nothing to do with them.

Apparently the folks at ImprovingBirth. org were stung … so they removed my comment. That indicates to me that they understand that they are exploiting the tragedies of women of color, want to continue exploiting those tragedies, but don’t want anyone to KNOW that’s what they are doing.

Apparently Dawn Thompson has been particularly stung by the criticism. She made this video last night:

Dawn Thompson video

Her primary claim is that modern obstetrics is rotten because, as a doula, she’s seen it with her own eyes.

But Dawn, who is so very impressed by what she has seen, can’t fathom that others, including obstetricians such as myself, have seen everything she’s seen AND a lot more.

Dawn is a privileged white woman who attends privileged white women who are creating a “birth experience.” There’s nothing wrong with that but it’s a tiny fraction of maternity care. Lots of women, particularly women who aren’t privileged, are more concerned with the literal survival of their babies and their own survival. They have serious pre-existing medical conditions; they’ve had difficulty accessing well woman care prior to pregnancy and these medical conditions have often progressed to further impair their health; they suffer from serious complications of pregnancy like pre-eclampsia and postpartum cardiomyopathy; they lack access to the most high tech care generally found only in regional medical centers … and as a result, they die and their babies die.

These are the real tragedies of modern obstetrics: women whose lives and babies could be saved if we had more perinatologists, more perinatal ICUs, more high tech interventions. Their lives CANNOT be saved by doulas; their lives CANNOT be saved by natural childbirth; their lives CANNOT be saved by homebirth. So why are their deaths being touted with stupid publicity stunts such as sewing pastel colored hospital gowns? Because the women of don’t care about deaths women of color; they care about THEMSELVES and their employment opportunities.

They are entitled to care only about themselves and other privileged white women who want to create a specific “birth experience.” But they aren’t entitled to exploit women who die in childbirth, disproportionately poor women and women of color, in order to do it.

They should be ashamed of themselves. Indeed, they ARE ashamed or they wouldn’t have deleted my comment.

Here’s how they can assuage that shame:

Stop the stupid publicity stunts like sewing pastel colored hospital gowns! Devote that effort to demanding greater access to high tech obstetric care for the women who die for lack of it!

That’s why they would do if they really wanted to improve birth, not merely improve their own employment prospects.