Ed Yourdon via Flickrby Taylor Newman
Hot on the heels of its recent article profiling Ina May Gaskin, the pioneering American midwife who's still delivering babies naturally on her remote, rural Tennessee farm - a true alternative to a medical, hospital birth - the New York Times published, this past week, another piece on midwifery. This time, readers got a glimpse into the world of high-end natural birth in the central hub of status symbol one-upsmanship, New York City. In certain circles, midwives, along with other natural lifestyle choices, now represent a departure from the mainstream and entry into the world of upscale trends.
Models like Christy Turlington and Gisele Bündchen have played a big part in popularizing natural birth, breastfeeding and the notion of the glamorous natural mom; choosing a midwife to deliver one's children is no longer viewed as a 'crunchy' decision among Manhattan's affluent young moms; instead, it's seen as a respectable and conscientious - even luxury - move. Because midwives provide a personalized, high-touch quality of care (read: more face-time, less waiting room time) far beyond what even the best OB's offer (although OB's can do things midwives can't, too, like perform emergency C-sections), they can also deliver fewer babies per year. This has made securing one's must-have midwife something of a competitive sport akin to, as the Times article aptly notes, the pursuit of elite preschool enrollment in the same city.
The reasons cited in the Times piece behind the increasing popularity of midwife-assisted births (most of which take place in hospitals, although home births - Bündchen's included- are also happening) in New York echo the reasons offered by women across the country who make the same choice, from Gaskin's patients in the 1970s to a growing number of American women today: midwives offer an experience that treats pregnancy as a condition, rather than an illness, treats laboring moms as empowered people, and sidesteps some of the less appealing aspects of medical birth, including unnecessary interventions and the separation of babies from their mothers after delivery. Unstated reasons behind midwives' recent popularity among cosmopolitan women may, I'm guessing, also include this population's ability to pay for services that fall outside of health insurance companies' coverage plans (some companies do cover midwife services, but it's not a guarantee), as well as an affinity for anything highly customized; the attention that a midwife will give to a pregnant woman, as compared with a doctor, probably feels more like the brand of doting these women desire. These women want to have the best experiences available, and natural birth is turning out to be one way to go about getting those. (True story).
There's nothing wrong with this, of course; personal attention is a valid reason for anyone to seek alternatives to our nation's very impersonal healthcare system. And whatever their reasons for choosing natural healthcare, I hope that the acceptance of, and increased desire for, alternatives by an economically powerful, and, er, generally more demanding population will end up driving greater access to natural birth and healthcare options for all American moms, even within the mainstream healthcare system.
Irrespective of the big-name midwife-game in New York, it's interesting to me that natural choices are, these days, often seen as exclusive, especially since many of the more popular natural 'trends' have been adopted into the mainstream out of far less materialistic circles (crunchy 'hippies', rural homesteaders, etc… Gaskin, for example, took a vow of poverty early in her career). This is perhaps because 'greenwashing' has taken hold as an effective marketing concept, and products toted for their eco-friendly attributes tend to be more expensive than their conventional counterparts. But the truth is that choosing natural alternatives (from food, to household items to, well, fewer items in general) can be both doable and affordable, and not just for the rich and/or famous. In terms of childbirth, as one example, my health insurance covered Kaspar's birth (in New York City), but I was floored when I saw the bill - we're talking tens of thousands of dollars! And that was JUST the delivery and postnatal care. I'm sure the nine months' worth of appointments and ultrasounds leading up to it cost tens of thousands more. Yet a friend of mine here in Austin, who doesn't have health insurance, gave birth at the natural birthing center here (with a midwife), and she payed only a few thousand dollars for treatment through the entire nine months of her pregnancy, plus delivery, and post-natal care (at least one night at the center). A natural birth is definitely an alternative choice, but it's not necessarily an exclusive or aspirational one. Here in Austin, at least, it's the less expensive option.
What do you think? Is a midwife a status symbol? Does her elevation to status symbol make alternative birth more or less acceptable in the mainstream? How about available in the mainstream? (Are regular moms gonna get priced out?) Do you think natural parenting choices in general are necessarily exclusive? Has natural parenting become trendy where you live?