Performing privilege in pregnancy


The natural childbirth industry — midwives, doulas and childbirth educators — have a firm idea of what childbirth should look like: an unmedicated vaginal birth, supervised by a midwife and supported by a doula, complete with elaborate birth plan (she’s “done her research), immediate breastfeeding and 24 hour rooming in with the baby.

They appear to have no idea how much privilege is required to meet their expectations.

Natural childbirth advocates aren’t superior mothers, just white, well off women who are oblivious to their own privilege.

What is privilege?

According to a New Yorker article, The Origins of “Privilege”:

…[T]he concept really came into its own in the late eighties, when Peggy McIntosh, a women’s-studies scholar at Wellesley, started writing about it. In 1988, McIntosh wrote a paper called “White Privilege and Male Privilege: A Personal Account of Coming to See Correspondences Through Work in Women’s Studies,” which contained forty-six examples of white privilege. (No. 21: “I am never asked to speak for all the people of my racial group.” No. 24: “I can be pretty sure that if I ask to talk to the ‘person in charge,’ I will be facing a person of my race.”) …

As McIntosh explained in her paper:

I think whites are carefully taught not to recognize white privilege, as males are taught not to recognize male privilege. So I have begun in an untutored way to ask what it is like to have white privilege…

I have come to see white privilege as an invisible package of unearned assets that I can count on cashing in each day, but about which I was “meant” to remain oblivious. White privilege is like an invisible weightless knapsack of special provisions, assurances, tools, maps, guides, codebooks, passports, visas, clothes, compass, emergency gear, and blank checks.

In the setting of childbirth, privilege is also a set of assets a woman can count in on cashing in, and to which she is by and large oblivious. Indeed, it would be accurate to say that natural childbirth is basically performing privilege in pregnancy.

McIntosh lists 46 assets of white privilege to which most white people are oblivious. I’ve created a list of 25 assets of pregnancy privilege to which the natural childbirth industry and its advocates are equally oblivious.

1. My pregnancy is planned and wanted.
2. I am healthy.
3. I have health insurance.
4. I have a choice of healthcare providers and do not have to rely on a clinic.
5. I can access a hospital that has excellent statistics for neonatal and maternal outcomes.
6. I can be sure that the majority of my caregivers belong to my racial and demographic group.
7. I speak English.
8. I am married or have a reliable long term partner who is available to care for me when needed.
9. I have easy access to and can afford healthy food.
10. I can afford books on pregnancy.
11. I can afford to take childbirth classes.
12. I may have to sacrifice, but if I wish I can afford a doula or midwife.
13. I can hire a birth photographer.
14. I can afford weeks or months of maternity leave from my job.
15. I have easy, reliable access to the internet so I can share information with other pregnant women.
16. I can write well enough to create a birth plan.
17. I am not a victim of domestic violence.
18. I am not addicted to alcohol or drugs.
19. If I have older children, I have family or friends to care for them when needed.
20. I can create a baby registry on the assumption that I and my friends can afford to purchase new baby items.
21. I can afford a breast pump.
22. I have a job that offers both privacy and time to pump without loss of income.
23. I have a spouse or partner who is supportive of breastfeeding.
24. I don’t face a dramatically increased risk of premature birth.
25. I don’t face a dramatically increased risk of maternal death

McIntosh writes about her reluctance to acknowledge white privilege:

… The pressure to avoid it is great, for in facing it I must give up the myth of meritocracy. If these things are true, this is not such a free country; one’s life is not what one makes it; many doors open for certain people through no virtues of their own. These perceptions mean also that my moral condition is not what I had been led to believe. The appearance of being a good citizen rather than a troublemaker comes in large part from having all sorts of doors open automatically because of my color.

The refusal of the natural childbirth industry to acknowledge pregnancy privilege (a combination of racial/economic/educational privilege) comes from a similar place. If pregnancy privilege exists, natural childbirth advocates’ moral condition is not what they wish to believe. The appearance of having a “good” birth come not from merit or hard work, but merely from having advantages that other women don’t have. They aren’t superior mothers; they are merely white, well off women who are oblivious to their own privilege.


  • Montserrat Blanco

    Fine. I knew I am privileged but I did not know exactly the extent of it.
    I tick all the boxes. In my discharge, quite a few of them are due to universal health coverage in my country and social benefits that all the women in my country enjoy, but yes. All of the boxes.

    Healthcare is free, most of the prenatal and intrapartum care is provided by CNMs. I can choose providers (for free). Prenatal vitamins are almost free (one euro per month aprox.), produce and fresh meat and fish are cheaper than processed foods (1 kg of chicken is about 2 euros, one individual pizza also 2 euros, fruits in season for about 2 euros 1 kg, etc), and the social security system pays for 4 months of maternity leave 100% salary and 1 month of paternity leave, plus 1 hour for lactation until the baby is 9 months old, not to count the one month a year holidays.

    It is true that if you have an unqualified job and get only minimum wage things like breast pumps, lots of things for the baby, etc, etc are not covered, but those people at least have free healthcare, can choose healthcare providers and have paid maternity and paternity leave.

  • Who?
  • BeatriceC

    OT: I’m still reeling from shock and horror. One of my parenting groups lost a member yesterday in a horrific fashion. There are so many societal issues involved in creating the perfect storms that lead to things like this. I get so fucking angry. We’ve got bullshit like the WHO and various national health organizations spending billions of pounds, euros, and dollars on bullshit like breastfeeding with trivial population level benefits and even population level harm as current policy is instituted, when we could be spending money on mental health needs and addressing the societal issues like toxic masculinity and devaluation of women that lead to these horrific crimes.

    • Empress of the Iguana People

      Does put this nonsense in perspective.

    • How awful! I’m sorry.

    • fiftyfifty1

      I am so sorry!

  • Amy

    Spot on. I will never forget a user on Mothering telling women that they should be prepared to take out a second mortgage to pay for a homebirth midwife if necessary.

    • Steph858

      #26: Can take out a second mortgage (i.e. not living in rented/shared/hostel etc accommodation).

  • Cat10

    OT (sorry) but I just saw this: Woman gives birth in Red Sea! Yes to natural birth in dirty water!

    • kilda

      ah, the natural beauty of pushing your child out at the beach while a random stranger takes photos from their balcony! I thought women needed privacy to give birth. Isn’t the cervix supposed to slam shut like a frightened turtle unless perfect conditions of privacy are observed?

    • Lilly de Lure

      Dirty water that is also home to a wide variety of shark species (including Tigers and Silkys both of which are known to attack humans on occasion). Dolphin-assisted birth is clearly just not radical enough these days!

      • kilda

        it’s ok. Sharks are natural, and therefore good for you! I mean, if sharks were so dangerous, how would we all still be here?

        • Lilly de Lure

          Having had a look at this story further, never mind the sharks, it’s the older man in the photos I’d be worried about. His name is Igor Chartovsky, he pioneered the modern approach to water birth and is famous for . . . shall we say an eccentric approach to the safety and welfare of the children and babies in his care:

          • Kelly

            He is almost water boarding those poor babies. I can’t believe a parents stands around and thinks that is OK. I get that we have to put our kids through trauma and pain in order to make them well sometimes but this is straight up torture.

          • ukay

            Holy sh**, that is a whole new level of insane! That is scientology level bonkers.

        • Lilly de Lure

          Mother nature will never let her toothy children harm a true warrior mamma – they’re just popping by to bask in her magic birthy sparkles.

        • momofone

          Thank you for being the voice of reason!

    • Zornorph

      Of course, the sea wasn’t Red until she gave birth in it! But what makes you choose the Red Sea? I could see if somebody wanted to do it in the Jordan River (just as stupid, but somebody might think it would make the baby closer to Jesus or something) but other than drowned Egyptian soldiers, what else is the Red Sea famous for?

      • Jordan River is mostly too shallow. It’s really just a creek.

  • MWguest

    <3 <3 <3

  • OT: An overdue friend of mine is waiting until 41+6 days for her induction, because “She’ll come when she’s ready. I’m not in any hurry to force something my body isn’t ready for (because it often makes for a more difficult delivery).” Do I say something??

    • EmbraceYourInnerCrone

      Yes you should, placenta’s DO have expiration dates. My mother knew I was quite overdue (my father traveled and she knew when she got pregnant with me), but it was 1961 so no ultrasounds, etc. She said when I was born I was small and skinny. Who knows, maybe the placenta in my case had issues anyway, but as a neinate I certainly did not “know” that I was in danger of starving if I wasn’t born soon….

      Stillbirth rates went up after hospitals instituted the no inductions before 39 weeks rule:

      “The risk of stillbirth at term increases with gestational age from 2.1 per 10,000 ongoing pregnancies at 37 weeks of gestation up to 10.8 per 10,000 ongoing pregnancies at 42 weeks of gestation.”

      • Gene

        This is why, when I had my last at 40y, I was thrilled that elective induction was anytime after 39w. Last was induced and arrived that day.

    • Lilly de Lure

      I would – at the very least ask her to check if baby’s heartbeat is being regularly monitored and she’s checking her movements (any change – straight to hospital: do not pass go, do not collect £500 and do not listen to anyone who say “babies often slow down just before birth” – they don’t unless there is a problem). Placentas can and do degrade and babies can and do get too large for the placenta to continue to supply their needs. “Forcing” things along via an induction/c-section certainly might make things seem more cold and clinical, particularly if the mother is wedded to an all-natural birth plan – but it’s a damn sight easier than living with the memory of a stillbirth for the rest of her life!

      • It’s hard, because she’s one of those “natural” types who’s also a shill for the Plexus pink drink and talks endlessly about the gut, MTFHR mutations, and other woo-y concepts. And the risk of stillbirth, though elevated, isn’t THAT high in absolute terms. (Higher than I’d take a chance with, but not impressive to someone committed to a course of action.) I did say that my induction was my favorite labor experience.

        • Charybdis

          Is it just me, or does anyone else read the MTFHR mutation as “Mother F*cker” mutation?

          • Empress of the Iguana People

            every time

          • Mishimoo

            It’s not just you!

      • The Bofa on the Sofa

        ANY change in activity is a sign to go. Not just slowing down, but also speeding up.

        When my sister lost her first (stillborn) she recalls that he seemed especially active the day before. In retrospect, it’s probably true – he was struggling for his life. By the time she went in, he was dead.

        If my sister had been induced at 40 weeks, my nephew would still be alive. He, apparently, did not “come when he was ready.” Heidi, you can tell your friend about my sister, and ask the question: does she think my nephew was stupid or something? Why didn’t he come out before he died? What was he waiting for?

        You can tell your friend she can call my sister and tell her that her baby wasn’t smart enough to be born when he was ready and therefore deserved to die.

        • Merrie

          Oh jeez, your poor sister and nephew. How terrible.

    • Sarah

      No you shouldn’t that’s what her dr is for. Women have enough ppl telling them what they should/should not do with their bodies.

    • Amy

      My first did not come when she was ready. She was asynclitic and nobody figured that out ahead of time. Even after two days of induction at 41+4 and 41+5 (41 weeks was Christmas Eve, so we waited until after Christmas), nothing. Finally had a c-section at 41+6 and my daughter showed lots of signs of post-dates, including absolutely no vernix left and dry cracked skin as a result.

      Babies come when they’re ready……except when they don’t.

      • AnnaPDE

        I had my scheduled CS on my due date — also the house was being renovated and the 3-day non habitable time was scheduled for that date, as we’d hang out for 5 days at the hospital anyway. (Talk about convenience.)
        My cervix was not even properly effaced at that point, and kid hadn’t descended at all. So I was having qualms about us being a bit early or something.
        Turns out his head was a bit stuck in my pelvis and he had no chance of making his way down no matter how “done” he was. And yes, he hardly any vernix left and the placenta wasn’t doing all that great either, so it would have been a big mistake to wait until things start naturally.

    • Kelly

      What about the preemies? This comment always gets me because some women’s bodies can deliver term babies and some don’t. Your baby knows nothing about when the right time is.

      • Empress of the Iguana People

        A woman at a toddler group I frequent said something about her body knowing how to give birth, not 5 minutes after saying every one of her 5 or 6 kids (singletons) was a preemie. I managed to keep my teacher-tact that time.

        • Kelly

          It may know how to give birth but not when. Did she at least acknowledge that science has helped her kids live?

          • Empress of the Iguana People

            Rather doubt it, but I sort of tuned out after that comment

    • Who?

      What would you say? If she’s being induced, she’s getting medical advice. She might be choosing to have the induction late, against medical advice, or the doctors might be fine with it.

      Chances are, everyone will be fine. If they are, you will have some real tongue-biting to do when the self congratulations start, and if they aren’t, she’ll need support.

    • StephanieA

      This is a tough one, because many doctors will let a woman go to 42 weeks as long as they are having NST’s done to assure fetal well being. And obviously most babies are fine, but there’s always that chance that they won’t be. And honestly, many 41 plus inductions are difficult because of aged placenta and bigger baby. Is your friend getting regular monitoring of the baby before induction?

      • No idea. She’s seeing CNMs who deliver at the hospital I used (they have a Natural Birth Center, but it’s down the hall from the operating room). I hope they’re monitoring her properly. I do know she agreed to extra US and screening because her son has Down Syndrome, so she’s not opposed to all monitoring per se. (I don’t think she’s 35 yet, by the way.)

        • Eater of Worlds

          More babies with Down Syndrome are actually born to younger mothers because more babies are born to younger mothers period. 80% are born to mothers under 35.

          • Yes; I just included her age because I didn’t want people thinking she was of advanced maternal age.

    • My friend’s baby came at 41+5 days. She pushed 3 hours and the baby weighed 10 lbs, 7 oz.

  • mdstudentwithkids

    22. I have a job that offers both privacy and time to pump without loss of income *or other negative repercussions.*

    I had to pump through third year of medical school. I ended up quitting pumping just because the loss of educational opportunities (on ob/gyn no less). On other rotations I was also concerned about what people thought about my multiple leaves throughout the day even if they said it was okay but that wasn’t what made me actually quit.

    • MWguest

      Working in hospital settings, I notice that there is a threshold that needs to be met in order to have access to pumping rooms – usually employees at the nursing staff level or above. I see RNs, MDs, administrators using the designated ‘lactation rooms’ and being awarded the necessary breaks (in addition to their scheduled breaks) to access those spaces.

      The housekeeping staff, food services workers, sterile processing workers, janitorial services, aides, rarely access those spaces, they often lack privilege and/or union representation… it became very clear from observing who accessed the ‘lactation rooms’ that breastfeeding – and lactating and pumping at work – was a privilege offered to those who already exist at the higher end of the medical system hierarchy.

      Those working at the $8-10/hr end of the spectrum were not shlepping their breastpumps to work with them and pumping breastmilk on their extra breaks.

      • Gene

        ER doc here. We have no scheduled breaks (what’s lunch?) and the “official” pump room was on the other side of the hospital and one floor up. We are “baby friendly” but when we tried to create another staff pump room, we were swiftly shot down (and told not to bring it up again). So I pumped in the family bereavement room (where we take families to give them bad news) in between patients. So much for baby friendly.

        But, yeah, other than that, I’m 23/25 (we live far from family). So I’m well aware that my minor bitching is nothing compared to other women.

      • Merrie

        I have a friend who has worked multiple low-wage jobs and she had some that weren’t pumping-friendly, but she was also getting a lot of her income through child support and benefits so when she had a job that wouldn’t work with her on pumping, she’d just quit. Not necessarily an option for everyone.

        I hit most of these, but as a retail pharmacist, my working environment isn’t really conducive to leaving my work station to pump. I made it work with my older two kids, but only lasted about 3 months with this one. The whole process drives me bananas.

      • Cartman36

        I work at a large university and the only official pumping rooms are several buildings away from mine (a good 5 minute walk each way). I am privileged enough that I have the flexibility to walk over and use them without having to monitor the amount of time I am gone but its probably similar to your situation were the same is likely not true for our entry level hourly employees.

    • nata

      I pumped as a midwifery student in a UK hospital. I had good supply and had enough days/nights to breastfeed my baby so did not bother pumping often – usually 2x during a 12h shift – at 12 and at 6 would be enough. There were no dedicated lactation rooms neither at uni nor at the hospital. At the hospital I would use one of free delivery rooms. At uni they once took me to the changing room that had like one chair and no privacy. Looking back I am thinking it was easy to do because I was a student and I could just leave my mentor to continue work while I pumped. I would not have anyone actually giving me these breaks from work if I had to do it now.

  • The Computer Ate My Nym

    I met all 25. Nearly died anyway. Pregnancy is not safe, not even an “ideal” “low risk” pregnancy.

    • Daleth

      I met 24 of the 25 (all except the bit about not having an increased risk of premature birth–mine were twins). And I nearly died three different ways.

      But fortunately I wasn’t “performing privilege,” I was in a major hospital under the care of maternal-fetal medicine specialists and neonatologists, I insisted on a prelabor c-section, and I consented without hesitation to the heplock–which is good, because it helped me not die of hypovolemic shock.

  • Emilie Bishop

    I would add “My boobs work” to that list, since you included being able to get a pump and use it at work. I meet all 25 of these more or less (being a stay-at-home mom negates the workplace ones, but it is its own privilege in many ways), but having IGT still set us up for breastfeeding drama. Those who babble on and on about how every woman can breastfeed if they just try hard enough are just as privileged as they likely have working boobs so therefore don’t know any different. Like most privileged people, they don’t realize it’s privilege until they have it pointed out by someone for whom it doesn’t apply.

  • Cartman36

    Well written! Thank you