transcending
silence... 2008 Issue
Birth:
Eight Women Tell the Truth about Birth in America
Elizabeth A. Becker
Abstract
Every year during the month of September, community groups throughout
the US present Birth, A Play by Karen Brody to honor BOLD
(Birth on Labor Day). BOLD is a critical theatre project that Brody
created in 2006 that is committed to consciousness-raising about
birth as a woman’s reproductive right. This essay is the
revised version of a sociological/anthropological fieldwork report,
originally written for the Women’s Studies capstone course
entitled, WSS490Z: "Research Seminar in Women's Studies," at
the University at Albany. The purpose of this essay is: 1) to critically
analyze BirthNet’s production of Karen Brody’s play, Birth,
through a close "reading" of the event(s) and 2) to act
as a reflection on the process of participant-observation. For
these reasons, descriptive and analytical notes gathered during
the field experience are provided in order to offer perspective
on the process of data collection and analysis. This essay examines
the audience, the content of the play, a silent auction, and a
talkback panel, analyzing how consciousness-raising about birth
politics "plays itself out" through live media. In many
ways, this essay functions as an entrée to a much larger
body of work and a growing advocacy project.
________________________________________
Sections
Field Notes: Observations
Field Notes: Analytical Notes
Analytical Essay
The Setting
Gaining Access
My Role as Researcher
Data Collection
Data Analysis
Endnotes
Bibliography
Field
Notes: Observations
Birth, "Eight Women Tell the Truth about Birth in
America"
-- September 30, 2007
- play written by Karen Brody
- sponsored performances in 30 US cities and Amsterdam
- trying to raise awareness about mother-friendly maternity care
- donation of a section of Safe Motherhood Quilt by Ina May and
Steven Gaskin
- event sponsored by BirthNet, local consumer/midwifery advocacy
organization
- performance space donated by Russell Sage College in Troy, NY
- silent auction featuring local artists and giveaways held during
intermission
- discussion with cast and BirthNet organizers to follow performance
Performance setting & notes:
- dimly lit, cozy theatre.
- well-attended evening performance; there are a few women alone,
no men alone.
- boisterous chatter, good audience energy, positive vibes.
- snacks and drinks served; baby-friendly environment.
Memorable character anecdotes:
- "Can I really get what my dog got?"
- (Amanda) "My Body Rocks!"
- "Empowering Epidural"
- "A woman doesn't have to be rescued from pain."
- "I had never been a part of women caring for each other
before this."
- "My body is not a lemon."
- "Butt Pain."
- "Nooo! Don't cut me!" -- forced, in-hospital episiotomy.
- "Planned C-section."
- (Lisa) "Don't I matter?"
Intermission:
- silent auction with local artists and businesses auctioning off
goods and services.
- natural and organic foods and beverages offered for purchase.
Panel discussion:
- sensitivity issues surrounding childlessness and motherhood;
alternative forms of mothering/nurturing/care-work.
- evidence, science, data as opposed to the "cultural pendulum";
choice based in real information, evidence-based practice.
- a mother is born, when her baby is born. ("A father is born
-- if there’s a father," said a panelist.)
- "The oldest profession is not prostitution, it’s midwifery!"
-- Anonymous panelist.
Nurse from Germany speaks about midwives in the "old country";
points to irony of the state of American healthcare -- highly medicalized,
technological birthing practices do not protect against (and often
lead to) higher infant and maternal mortality than in other industrialized
nations that utilize midwifery care.
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Field
Notes: Analytical Notes
performance setting:
- theatre was well-heated and dimly-lit, giving the audience a
sense of coziness, a womb-like atmosphere.
- 80+ member-audience made up almost entirely of women with friends
and children, some men in attendance (8 or 9) who look like partners,
husbands, fathers and one or two friends; men are attached to the
women, implicitly understood as a "women's event."
"Can I really get what my dog got?" -- All eight women
ask this question in conjunction with a story told by one about
her dog giving birth in a very warm, calm environment. Her dog
is able to keep her pups with her as soon as she gives birth to
them and it is understood by all that one should not "intervene" in
this natural process. These women ask why humans (particularly
women) must settle for less.
(Amanda) "My Body Rocks!" -- Amanda, played by a good
friend of mine, is a character who recognizes her self-worth through
motherhood and the process of giving birth. She repeats her mantra,
encouraging the audience to participate as she acts out giving
birth on stage.
"Empowering Epidural" -- This character, a second wave
feminist, recounts her experiences with the birth of her first
child. Originally she plans to give birth in a birthing center
by a group of "granola" midwives, but ultimately she
cannot endure the pain of the labor and she transfers to a hospital
where she begs for an epidural, which she later names her "empowering
epidural."
She implies that she felt empowered because she was able to "overcome"
the pain of the event.
- "A woman doesn't have to be rescued from pain." --
a realization during a subsequent pregnancy: a refusal to live
in fear of pain; to allow others to control reproduction through
pain management.
- "I had never been a part of women caring for each other
before this." -- a remark after attending a home birth for
the first time; feeling connected to womanhood and motherhood in
a powerful, primal way.
- "My body is not a lemon." -- to be squeezed and poked;
it is not a broken thing, a sour thing.
"Butt Pain" -- A memorable remark about the way that
giving birth really feels. The character said that it's "a
pain that you don't forget," "not even with an epidural."
According to her, it feels like the baby is "coming out of
your butt" and "you don't forget that!"
"Nooo! Don't cut me! -- forced, in-hospital episiotomy; this
is a particularly poignant line because it resonated with the entire
audience and spoke to the importance of a mother’s agency
in birth, addressing the systemic neglect of women and mothers
within American medicine. Speaks clearly to issues of reproductive
control; e.g. socially accepted forms of female genital mutilation.
"Planned C-section" -- a take-charge, urban businesswoman
opts for a planned c-section because she does not want the birth
to interfere with her busy schedule and she wants to make certain
that everything goes according to plan; she wants it to run like
an elective surgical procedure. The ability to choose this as an
option can feel empowering for some economically privileged women
because, while they surrender control of their bodily functions
to their physicians, they feel that they retain the ability to
plan the event (everything from choosing the date and time to electing
for cosmetic surgery), thereby remaining in control of their own
destinies.
(Lisa) "Don't I matter?" -- another emergent theme throughout
the eight narratives; Lisa’s plaintive cry speaks to the
powerlessness often felt by laboring mothers in highly medicalized
settings, while at the height of labor.
Additional emergent themes:
-Empowerment, privilege, womanhood, identity.
-Abortion: "dissociation" -- the baby-mother split --
technological intervention; medical "gaze" -- Medicalized
birth
-Facing issues of modernity, familial/societal expectations of
birthing decisions/practices.
-Further questions of the "empowered consumer": What
are the social and political implications of using the term "consumer"
to frame agency and choice within public discourses on reproductive
justice issues?
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Analytical Essay
The Setting
I chose to review a local performance of the play Birth,
written by Karen Brody and presented by BirthNet at Russell Sage
College in Troy, NY. [1]
The event took place all day Sunday, September 30th with an afternoon
and evening performance, a "Red Tent,"[2]
a silent auction, and a talkback panel following each performance.
While I would have liked to capture the entire day’s events,
I was only able to attend the evening performance, the silent auction
and the panel discussion. As it turned out, these three parts of
the event provided a wide range of data to analyze. The play is
performed annually during the month of September in 30 U.S. cities
as well as in Amsterdam, The Netherlands. The popularity of this
play is due in large part to the continued organizing and mobilization
of community theatre groups and activists through Brody’s
organization Birth on Labor Day (BOLD). [3]
The performance that I attended was put on by BirthNet, a local
reproductive rights advocacy group, and the cast was made up primarily
of local birth professionals and activists. The performance space
was donated to BirthNet by the Theatre Department at Russell Sage
and the profits earned through the performance will be used to
benefit BirthNet's future education and advocacy efforts within
the community. Additionally, donations were collected to benefit
the family of a mother who recently died in childbirth in the Capital
District.
I chose to analyze this particular event because it represents
a bridge between theorizing and community action, between practice
and community education within the reproductive rights movement
in the United States. By performing and attending this play about
birth in America, these women (and men) came together to discuss
and raise awareness about reproductive rights issues and to support
one another in their continued efforts through a variety of methods.
The play addresses the paucity of contemporary accounts of American
women's birthing experiences and offers many different perspectives
on natural birth and reproductive rights. The event provided a
relaxed and enjoyable space in which to discuss these important
issues.
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Gaining Access
Gaining access was not difficult. Since the event was open to the
public and designed to inform as well as facilitate discussion
of the issues, it was very easy to collect information without
disturbing the ambiance. I was able to observe and participate
seamlessly. I had the added benefit of being a friend of one of
the cast members as well as an avid supporter of BirthNet. Also,
the cost of attendance ($5-10) was very reasonable, with a sliding
scale for seniors, students and adults. Being a single woman in
college, I am a member of one of BirthNet's target audiences, as
they intend to involve young women--who have not yet decided to
have children--in discussing American birthing practices. By including
women like me, they are opening the discussion to proactive solutions
for the future of American birth, in addition to recounting personal
histories and analyzing past and present circumstances.
At this event, women outnumbered men by about ten to one. Perhaps
the topic itself is an implicit gatekeeper? The men played supportive
roles, as friends, partners, husbands, or (sometimes) fathers,
whereas the overwhelming majority of the women were mothers themselves.
Consequently, women played a particularly active and dynamic role
in this space.
Interestingly, the issue of childlessness was a source of conflict
during the panel discussion. A woman in the audience pointed out
how discourses on childbirth and motherhood have tended to marginalize
those women who either choose not to or are unable to have children
themselves, often altogether discounting their mothering capacities
and relevant carework within their communities. Panelists and other
members of the audience were receptive to her critique, but quickly
pointed out that this event was created to celebrate carework in
many forms. One of the panelists even encouraged her to write a
play addressing these issues herself. I felt the tension between
these women as they earnestly tried to find a middle ground and
respect one another’s points of view. However, I think that
they eventually lost confidence in each other as the critiques
and suggestions that they traded appeared to fall on deaf ears.
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Data
Collection
I took notes openly and freely over the course of the three hours
that I was there. I also recorded the first half of the performance
with a digital voice recorder. It was a useful tool for jogging
my memory about details and identifying poignant moments such as
laughter, applause and silence during the performance.
Despite the ease of access and because I went to the event alone,
I felt somewhat isolated in a particular way: nearly all of the
women and men at the event had arrived as part of a group or a
couple. Even the other students had come with friends or partners;
so I did appear different from the rest of the group. I also kept
to myself more than if I had come with a friend, as we likely would
have mingled and discussed things with others. In retrospect, I
wish that I had used the opportunity to interview more of the event-goers,
participants, and organizers; like a cultural anthropologist, I
had wanted to keep a low profile and keep from disturbing the flow
of the event with my questions. I kept my participation to a minimum
and only discussed my research with people who asked me directly.
Otherwise, I went about just like everyone else. Yet again, I feel
in retrospect that this may have been an opportunity wasted to
compile even more valuable qualitative data about the demographic
of the participants and the event itself.
I did receive, however, a wealth of information from analyzing
the critical issues and power relations that I was able to perceive
at the event. In addition to the playbill, each of the audience
members received a small parting gift for attending the performance.
Each was wrapped in a shimmering lavender satchel and tied with
a violet satin ribbon. Each one included a compact rolling back
massager, three packets of "mother-and-baby-friendly" tea
(chamomile, mint, etc.) and a vanilla-scented candle. While none
of these objects were specifically gendered--other than
the tea which proclaimed its mother-friendliness right on the label--I
think it is safe to assume that the gift was intended to tap into
the feminine.
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Data Analysis
This event was structured entirely around the performance of Birth, A
Play by Karen Brody. Great attention to detail was taken to create
both an event and a space that was warm, inviting and comfortable
for participants to share their ideas, their emotions and their
stories about being women and being mothers. For this reason, the
event was designed to put women at the center of the discussion.
The organizers have been able to bridge differences between diverse
groups of women by focusing on and organizing from perspectives
on motherhood and carework, in which arguably, women everywhere
on earth are at some time and in some way involved.
This is, however, a contentious point from which to form an analysis--especially
a feminist analysis--of women’s lives. There is deep disagreement
surrounding the history and liberating potential of motherhood,
due in large part to extensive evidence that societies worldwide
do not value motherhood and carework very highly, despite the fact
that they pay and have paid them lip service when it suits the
status quo to do so. In fact, both motherhood and carework are
marginalized forms of labor because of their reproductive qualities
and the difficulty of accounting for this labor in our current
economic systems. [4]
Many scholars and activists have been deeply invested in arguing
and acting from this theoretical position, while many others have
been deeply critical of the liberating potential of this argument,
acknowledging that not all women choose or want to choose motherhood.
Still other women are unable to become mothers for health or environmental
reasons, which was a topic of particular interest (as I have noted
above) during the panel discussion after the performance. For me,
the conflict that arose between the audience member and the panelists
was particularly poignant because it demonstrated how women who
are actively engaged in educating the public about issues of equity
and visibility can be insensitive to alternative or conflicting
viewpoints of other women. The most disheartening effect of this
insensitivity occurs when potential bridges between activists (and
everyday people) are not realized. This is a kind of tunnel vision,
a deadly blindness. Despite these and other limitations, the organizers
of this event were working from a good information base and a solid
theoretical framework on the issues at hand and I would like to
discuss the outcomes here.
I noted earlier that I was struck by the small number of men (roughly
10%) at this event. I observed that these few (brave) men were
in attendance to support their wives, partners and friends who
were experiencing something cathartic and energizing. However,
I believe that the men present did, in fact, get something significant
out of the experience themselves. The friend of mine who invited
me to the event, and was incidentally a leading lady in the performance,
told me that her partner had attended the day-time event, but was
now home watching their two-year old son. She related that he had
cried during the performance as it was the first opportunity that
he got to see her in this stage role and her performance sent him
back to the birth of their own child—in all of its beauty
and intensity. When she recounted this anecdote to me, I recognized
again how personal and transformative this event was for those
in attendance. The organizers were committed to sharing and consciousness-raising,
something that I think the performance communicated best.
Out of all of the anecdotes and experiences that I collected during
the event, I was most impressed by the collection of semi-fictional,
semi-biographical stories that made up the basis for the performance.
Several themes emerged from the data that I collected, dealing
with fundamental feminist concerns and concepts like empowerment,
privilege, womanhood and identity. Through their dialogues and
soliloquies, the women on stage grappled with these issues, making
sense (and making fun) of the hard facts and harder choices about
American birthing practices. Through their diary-like entries,
they each communicated vastly complex identities and decisions,
struggling with personal feelings, familial expectations and societal
norms, as well as the medical establishment, and often doing so
without any support. Something that is often overlooked about birth
in American hospitals is that women make many so-called "informed
decisions" during the course of labor, while either heavily
sedated or in excruciating pain. Combined with societal expectations
and the pressures physicians face to assist in a "flawless" birth,
laboring women are often coerced into making decisions about their
health and well-being that they would not normally have made under
less intense, high-pressure circumstances. This is due in large
part to mainstream medicine's construction of birth as "disease" or "temporary
disorder," instead of as a normal physiological process that
the female body is naturally equipped to handle. The parts of the
performance that speak most greatly to these issues dealt in large
part with the characters' perceptions and experiences of medical
intervention practices during the course of labor--whether elective
or not. I found the language and expressions that they used to
describe these processes and their resulting responses to be most
interesting and illustrative of the concepts mentioned above.
Perhaps the most illuminating character of all was played by a
woman in her mid-late fifties or early sixties who went through
one of the greatest transformation stories of any of the characters.
I coded her story, "The Empowering Epidural," after the
name that she gave to her first birthing experience in the hospital.
The phrase carries quite a lot of pain, humor and irony, which
she expressed throughout the course of her monologue. As a product
of the late-1960s' counter-culture, when she and her partner decided
to have children, she opted to give birth "the natural way" in
a clinic staffed by "granola" midwives. [5]
Unfortunately, this was her first birth and the labor was not an
easy one. She was transferred to a hospital and as soon as she
arrived, she begged the head obstetrician to give her an epidural. "Please,
please! I need one; I need an epidural! Give me an epidural! Or
else… Just kill me, take the baby and give it to my husband!" At
which point, the physician conceded and she was finally able to
relax.
At the time, she considered the epidural drugs a god-send to her,
a true relief and an absolute necessity for birth. Her polemical
endorsement of the epidural seemed similar to many first wave feminist
arguments for women’s liberation through birth control. She
felt empowered and privileged; she felt like the modern American
woman and mother. As her story unfolded, she gave birth two more
times and became increasingly unhappy with her recollection of
the experience, particulary with her inability to connect with
her body and with other women whom she knew to have had less intervention
during their labors.
She began to do research on midwifery and shadow midwives. Later,
she attended her first homebirth and felt its innate power, the
feelings that the women shared together and the satisfaction that
the birthing woman felt. When she was pregnant with her fourth
child, she decided that she had to give birth at home in order
ultimately to make peace with herself. Because of her high risk,
she gave birth not at home but in a clinic staffed by midwives.
As she performed the monlogue, the tension in the audience was
palpable. She ended with the story of the birth of her fifth and
last child. She was ultimately able to give birth at home, surrounded
and coached by her family and friends. She had come a long way
out of fear and mistrust of her body and she found a way to lay
claim to her own experiences through birth. The most important
message from this piece was not that every woman should give birth
at home; but like in the other women’s stories, she should
be able to choose where and how she births her children. We should
acknowledge that "a woman doesn't have to be rescued from
pain." She should be encouraged to work through "her
darkest hour" and overcome fear in any environment.
At the end of the evening and toward the panelists' final
wrap-up, a German nurse raised her hand and spoke about her earliest
experiences of nursing practice in this country. She had left Germany
many years ago and came to the U.S. to work as an advanced practice
nurse. She quickly discovered that for the vast majority of women,
only obstetricians attended births in hospitals and clinics. She
was surprised by the complete absence of midwives in major medical
centers; whereas in Germany, birthing women were seen almost exclusively
by trained midwives, except in the minority of cases that required
some kind of surgical intervention to protect their life or the
life of their child. In those cases, they were attended by an obstetrician.
This comment initiated a full panel discussion of the rapid changes
that had occurred in American medicine over the past hundred years.
The majority of these changes took effect over the earlier part
of the 20th Century, precipitating an extensive takeover of birthing
practices by American physicians and resulting in the marginalization
and near extinction of American midwives. Panelists raised the
issues of racial and gender discrimination in the field of medicine
in conjunction to the ousting of American midwifery, and showed
how institutionalized forms of oppression and popular prejudices
were used to sway public opinion against practicing midwives. As
the audience members reflected on how images of women (especially
women of color) have been used throughout history to silence and
marginalize, one of the panelists noted wryly, "Despite popular
opinion, the oldest profession is not prostitution, it's
midwifery." (And guess which profession
gets more publicity these days?) At this, everyone laughed.
There is an implicit awareness and fear at gatherings of this
sort that the sacred rites and practices of midwifery--of women
and partners participating in and supporting women through birth--are
in constant jeopardy today with over-reliance on medical technologies
and widespread mistrust of women's bodies and power. In spite of
this, I am not without hope. Life, giving it and supporting those
throughout that process are very ancient rites; they predate every
institution and run across cultures, even across species. Even
as we contest teleological "master" narratives and reinvent
notions of progress, we continue to find ways to preserve our most
sacred, not simply from fear of loss, but because they are necessary
to our survival.
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Endnotes
[1] Although the play's title is officially Birth, A
Play by Karen Brody, I chose to emphasize the event’s tagline
("Eight Women Tell the Truth about Birth in America")
in my own title in order to reflect the multi-layered critical
analysis within the performance narrative. [Return]
[2] The Red Tent was designed to provide
a safe space for women to share their own mothering and birthing
experiences, whether discussing fertility issues, loss of a child,
birth experiences in different settings, the political and legal
issues surrounding midwifery practice, or anything else that bridges
the personal and political. The concept of the "Red Tent" is
based on the book by the same title, written by Anita Diamant.
[Return]
[3] Additional information about Birth
on Labor Day (BOLD) can be found at: http://www.birthonlaborday.com/.
[Return]
[4] These concepts were derived from
the work of Marilyn Waring on national income accounting, "Who's
Counting?: Marilyn Waring on Sex, Lies, and Global Economics," directed
by Terre Nash. [Return]
[5] The term "granola" is used
to describe people who live (or appear to live) a socially liberal,
environmentally-sustainable lifestyle, that is most often associated
with hippies. It comes from the stereotypic image--a granola-crunching,
Birkenstock-clad, dreadlock-bedecked, tree-hugging, peace-loving
flower child. It can be used in both a negative or a positive context,
but is intended to connote humorous undertones in either case.
[Return]
[Back to Top]
Bibliography
Brody, K. (2004). Birth, A Play by Karen Brody. Organized
by BirthNet, performed at Russell Sage College. September 30, 2007.
National Film Board of Canada, The. (1995). "Who's counting?:
Marilyn Waring on Sex, Lies, and Global Economics." (Video).
Directed by Terre Nash.
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Edited by Robin Morris and Sabrina Tabarovsky
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