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Miracles of birth and action: natality and the rhetoric of birth advocacy

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Miracles of birth and action: natality and the rhetoric of birth advocacy

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MIRACLES OF BIRTH AND ACTION:
NATALITY AND THE RHETORIC OF BIRTH ADVOCACY

by

Beth L. Boser

A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(COMMUNICATION)

December, 2013

Copyright 2013 Beth L. Boser
ii

‘Ama

In every origin myth
mi ‘ama, my mother
does not scream
or cry.
‘Ama takes pride in the way she brought
four children into this world.
In doing it the way she thought
labor should be done best.
The way she cleans strangers’ homes,
the way she loves their children;
quiet, through the pain, quiet.
As a child, leafing through mythology books,
I imagine this is how she must
have done this work.
Like Echidna,
in a Stygian darkness.
Like Demeter,
waiting for a particular kind of loss.
Perhaps
she was born this way;
the old way.
Athena, stoic,
punching through the skull of a doomed god
and always the promise of wisdom
and war.

--Jesus Valles

iii

ACKNOWLEDGEMENTS

My experience earning a doctorate at USC Annenberg, which culminates with this
project, has been shaped and guided by so many individuals. First and foremost, heartfelt
thanks to my wonderful advisor Randy Lake. I am so grateful to have found a mentor
who is both Burkean and Minnesotan through and through. Thank you for sharing
lessons, wisdom, advice, ideas, three-hour meetings, and Scandinavian food. Thank you
for helping me maintain perspective, and for showing me how to be a scholar.
Thank you to Tom Goodnight for stretching my mind in ways I never imagined
possible, and for unending enthusiasm; to Sharon Hays for being my advocate and
teaching me to be bold; and to Tom Hollihan for teaching me to think sharply and
critique strongly. Thank you to Alison Trope for being both a professional mentor and an
unfailing friend. Thank you to Soni Kim for always listening.
Thank you to my dear colleagues at the Annenberg School. Garrett, Allie, Lori,
Laurel, Julien, Martin, George, Evan; I am honored to call these folks my friends. And
thank you to Ryan, Ben, Jesus, and Eric for being my family in Los Angeles.
Thanks to my mentors and colleagues from California State University Long
Beach, for their continuing scholarly support and professional guidance, particularly
Katie Gibson, Karen Rasmussen, Sharon Downey, Craig Smith, Ann Johnson, and Amy
Bippus. And thanks to my first professor of rhetoric, Leila Brammer, for inspiring and
fostering my love of rhetorical criticism and for encouraging me to go down this path.
Thank you to Michelle Johnson, Ahmet Atay, Joan Furey, Don Goldberg, and
Denise Bostdorff, my new colleagues at The College of Wooster, for their encouragement
iv

during the final stages of this project. I am so lucky that my first job is at exactly the sort
of school I always hoped to work, with exactly the sort of colleagues I always hoped to
have.
Thank you to my father, Jack Boser, for his steadfast love and unending support. I
am also immensely grateful for the moments away from work he has afforded me, during
many conversations regarding the sad state of the Vikings. My father taught me the value
of hard work and integrity. And he has always been proud of me, no matter what; for this
I am truly thankful.
Thank you to my mother, Linda Boser, who has been my example – as a brilliant
teacher, a dedicated student, and a strong woman – for my whole life. I thank her for
teaching me how to learn with patience and teach with compassion. I thank her for
sharing with me her wisdom, humor, understanding and love. And I thank her, of course,
for my own natality.
And finally, thanks to Brandon; I feel as though this project may have been harder
for him than it was for me. I thank him for his trust and love, and for being my true
partner both professionally and personally. We have been in this together since the day
we met, on the first day of graduate school orientation. Thank you, for everything, from
the bottom of my heart.

v

TABLE OF CONTENTS

Epigraph…………………………………………………………………………………...ii

Acknowledgements……………………………………………………………………....iii

Abstract…………………………………………………………………………………...vi

Chapter One: The Eventfulness of Birth and the
Rhetoric of Beginnings……………………………………………………………………1

Chapter Two: Resisting the Dual Standard: The Medical Public
and the Potential for Natality in The American Midwife…….…………..………….…...74

Chapter Three: Natural Birth Narratives and Natality:
Considering Time, Subjectivity, and Biology…………………………….…………….134

Chapter Four: Birth Advocacy Online: Birth Rape, Symbol
Stealing and the Possibility of Natality………………..………………………………..186

Chapter Five: Homo Natal: Discussing Possibilities
and Futures of Birth and Agency...……….…………………….…..…………………..246

Bibliography……………………………………………….…………………………...272

vi

ABSTRACT

This dissertation explores the question of agency in contexts of birth advocacy. It posits
that Arendtian natality explains action in contexts of professionalized and medicalized
birth. Analysis of artifacts drawn from key moments in the historical timeline of
childbirth in the United States over the last 120 years demonstrates the ways in which
women advocate for autonomy and a legitimate voice in the context of birth. In Chapter
One I introduce the social, rhetorical, and theoretical significance of birth based on a
review of literature. I put forth the central argument of this project by suggesting that
women’s experience of pregnancy and birth mirrors Hannah Arendt’s analysis of
modernity and action in more than just metaphorical ways. In Chapter Two, I consider
early midwife participation in medical dialogues through a late-nineteenth century
professional journal. In Chapter Three, I examine twentieth century narratives of home
birth to demonstrate how natality offers tools for resistance to professional medicine. In
Chapter Four, I interrogate how women claim power by redefining their experiences of
abuse during birth. Chapter Five synthesizes findings to suggest dimensions for a theory
of human actors as beginners.

1

Chapter One
The Eventfulness of Birth and the Rhetoric of Beginnings

Childbirth is an ordeal, at best. To hear mothers tell it, nothing rivals the
experience. The startling onset of abdominal contractions and the abrupt “water
breaking” sets in motion a pattern of arduous events, the progression of which is quite
familiar even to those who have not personally lived through the experience. Driven in
part by recounted firsthand experiences and in part by “going into labor” montages
pervasive in television and film, the popular and heteronormative image of birth is well
established. Once the realization sets in that birth is underway – if we are to believe what
we see in the movies – a state of utter panic follows closely thereafter. A frantic husband
gathers the pre-packed duffle bag, excitedly phones the doctor, and ushers his frightened
but dutifully breathing (hoo-hoo-heeee!) wife into the car. The pair then race toward the
hospital; upon arrival, the laboring woman is deposited into a wheelchair, hurried to a
sterile room, and helped onto a table. As labor intensifies, the woman feels obvious
extreme pain, as she grimaces, grunts, yells and screams at her husband, her doctor, and
no one in particular. Even the calmest birthing rooms evince an atmosphere of thinly-
veiled panic; a woman on the verge of losing her grip maintains shaky composure
through the coaching and support of her partner, and an obsessive attention to breath.
More chaotic birthing rooms resemble violent pandemonium; pain, terror, tears, anger,
turmoil, and exhaustion characterize these spaces. On top of this is indignity; the woman
is naked, legs in the air, under the clinical gaze of an emotionally detached doctor and
2

any number of residents, nurses, or assistants who may wander in and out. The popular
understanding of birth in this country is sensational.
Undoubtedly, all laboring women experience some degree of physical and
emotional pain and struggle; however, the reality of contemporary birth may, in fact, be
somewhat quieter than the above caricature. Most women likely do not threaten to
physically assault their husbands or verbally accost their doctors. Many are not likely to
scream, cry, or otherwise lose their grip on reality. Still, it is difficult to imagine how any
woman could go through pregnancy and birth in the United States without the presence of
some version of the above scenario emerging in her psyche. And, as Robert Scott so aptly
argued, what we know about any given thing is largely – if not entirely – a product of
how it is rhetorically communicated; indeed, rhetoric about birth is epistemic.
1
Hence,
birth is framed as a traumatic ordeal. Many women eagerly anticipate motherhood, but
regard the experience of birth with apprehension.
2

No other single event is understood to be so traumatic, and, at the same time, so
widely shared. Currently, in the United States, 81 percent of women become mothers by
the age of 44.
3
Globally, the total fertility rate (TFR) is around 2.5 children per woman.
4

1
Robert L. Scott, “On Viewing Rhetoric as Epistemic,” Central States Speech Journal 18, no. 1
(1967).
2
For anecdotal evidence see, for example: “Women ‘Frightened of Giving Birth,’” BBC News October
1, 2002. http://news.bbc.co.uk/2/hi/health/2288294.stm (accessed October 16, 2013); “Do You Dread
Delivery?” Fitpregnancy (blog). http://www.fitpregnancy.com/pregnancy/labor-delivery/do-you-dread-
delivery-0 (accessed October 16, 2013); Wendy Haaf, “Afraid of Giving Birth,” Today’s Parent February
4, 2013. http://www.todaysparent.com/pregnancy/giving-birth/afraid-of-giving-birth/ (accessed October 16,
2013).
3
“How Many Mothers,” United States Census Bureau Newsroom. May 13, 2012.
http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb12-ff08.html
(accessed October 16, 2013).
4
“The World’s Women 2010: Trends and Statistics,” United Nations Department of Economic and
Social Affairs (New York, 2010).
3

Most women will birth at least one child sometime during their life. It is, perhaps, the
universality of birth that makes it most remarkable; across time, across distance, and
across culture women share the experience of birth in common. Even women who do not
give birth themselves must grapple with its implications in some way or another, as they
choose not to have a child, negotiate the social consequences of that choice, or deal with
the pain of infertility or the loss of a fetus.
Birth – or even the potential of birth – is a shared reality that binds women
together, a unique source of power in a world still otherwise governed by men. And yet,
we abhor the experience. This may be attributed in part to the desire to avoid bodily pain.
Indeed, most would heartily agree that not feeling pain is preferable to feeling pain.
However, mothers’ accounts suggest that the negativity associated with birth may be
related less to pain than to poor treatment received at the hands of the medical
establishment.
5
Women are routinely devalued at the hand of medical professionals. They
are typically given little if any control over how their birth will proceed, and their needs
are always subordinated to hospital routine and the looming threat of an unhealthy baby.
My own mother recalled that, after my birth, she had “no scrap of dignity left.”
6
If my
mother is not alone in this feeling – and subsequent chapters of this study make it very
clear she is not – then it is unclear why more women are not outraged.
The answer, it seems, has precisely to do with the question of why birth is so
traumatizing. It cannot be explained by the pain alone; indeed, drugs provide women with
opportunities to opt out of much of the pain. Rather, it is the assumption of this project

5
This phenomenon will be explored in detail in Chapters Three and Four.
6
Linda K. Boser, email message to author, June 28, 2013.
4

that much of the negativity surrounding the contemporary experience of birth in this
country is a consequence of professionalized medical birth care.
Prior to the mid-twentieth century, women faced the very real possibility that
either they or their child would not survive birth. In the United States in the year 1900,
approximately 850 mothers died from pregnancy-related complications for every 100,000
who gave birth,
7
and approximately 100 of every 1000 infants born died before one year
of age.
8
During this period, the rapidly professionalizing field of medicine snatched birth
away from midwives and moved it from the home to the hospital. Physicians took pains
to articulate the reasons behind this move in the medical journals of the time. Whereas
the sanitary conditions of any given home could neither be predicted nor guaranteed, the
hospital facility promised a sterile, aseptic environment to stymie the spread of deadly
infection. The hospital also guaranteed care by a well-trained, professional, physician.
Furthermore, the hospital offered the birthing women a safe environment in which to
recover, insulated from the burdens of the home. At least on the surface, doctors seemed
to present a strong case for safer – and thus better – birthing experiences.
By contrast, in the United States today, childbirth is occasionally complicated but
rarely life-threatening. In fact, the maternal mortality rate is now only twenty-one per
100,000 live births,
9
and the infant mortality rate is only six per every 1000 born.
10
Most

7
Robert L. Goldenberg and Elizabeth M. McClure, “Maternal Mortality,” American Journal of
Obstetrics and Gynecology 205, no. 4 (2011): 293.
8
“Achievements in Public Health, 1900-1999: Healthier Mothers and Babies,” Centers for Disease
Control and Prevention Morbidity and Mortality Weekly Report. 2001.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm (accessed March 17, 2013).
9
“Country Comparison: Maternal Mortality Rate,” Central Intelligence Agency (CIA) World Factbook.
2010. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2223rank.html (accessed
October 16, 2013); even despite this low rate, the U.S. comes in 137 out of 184 countries ranked; we tie
with Iran and Hungary.
5

women in the developed world need not fear death during birth; despite this, simply
“living through” the experience of birth remains the purview of childbirth professionals.
In the latter part of the twentieth century safety during birth improved dramatically, due
as much to improvements in sanitation and general public health as to hospital practices.
Although a decreased need to worry about keeping mothers and babies alive seems to
merit more freedom for mothers, this has not been the result; hospitals responded by
becoming more rigid in their procedures, not less. If mother and baby are almost
guaranteed to come through birth unscathed, should not the mother be able to give birth
however she pleases? Apparently not; in the mid-twentieth century, women became
subject to a series of “routine interventions” – including anesthesia, episiotomy, and
forceps – which were applied whether needed or desired or not.
11
The hegemony of the
hospital birth firmly established, most mothers did not question why they were not able to
maintain more control of their birthing experience and instead allowed themselves to be
carried along on the medical conveyor belt.
Today, hospital practices, procedures, and routines – which protect against a
danger that has mostly not existed since the early twentieth century – are so entrenched
that any meaningful change from within the system seems hopeless. Now, for the sake of
efficiency, women must surrender their autonomy, individuality, dignity, voice,
intelligence – in general, their humanity. Any “choice” granted to women within the
walls of the hospital is so firmly ingrained within the larger system of efficiency as to be

10
“Mortality Rate, Infant (per 1,000 Live Births),” The World Bank 2013.
http://data.worldbank.org/indicator/SP.DYN.IMRT.IN (accessed October 16, 2013).
11
Richard W. Wertz, and Dorothy C. Wertz, Lying-In: A History of Childbirth in America, (New York:
The Free Press, 1977), 141.
6

rendered virtually meaningless. It is no wonder that many women are wheeled away from
birth wanting to forget the experience.
Furthermore, with such emphasis placed on safety, it makes sense that nearly
without exception, merely “ending up with a healthy baby” comes to define satisfaction
with the birth experience. After recounting how she endured an episiotomy and unwanted
forceps, and suffered terrible emotional pain when she was separated from me for long
periods of time and not allowed to hold me, my own mother summed up the experience
with a statement of satisfaction: “We both came through like champs but we did it the
hard way!”
12
Women are so strongly encouraged to recognize a successful birth as one
wherein the baby does not die, that expressions of dissatisfaction with some other aspect
of the experience seem like baseless grousing and need to be qualified with an assurance
that everything was alright in the end. Mothers deserve better than the self-denigration of
their own wants and needs.
In light of the rigidity of hospital procedure and the compulsory demands placed
upon women to accept that a successful birth equals nothing more than a healthy baby,
women who wish to exercise autonomy over the birthing experience have no choice but
to opt out of the medical system. However, few choose to do so. In 2010, a total of
3,999,386 births took place in the United States; of these, 98.8 percent took place in
hospitals.
13
More than 33 percent of these ended in Cesarean section.
14
Childbirth is by

12
Linda K. Boser, email message to author, June 28, 2013.
13
The discrepancy between the percent of women giving birth in-hospital and women giving birth at
home is accounted for by small numbers of women who attend free-standing birth centers not affiliated
with hospitals, or who give birth at clinics not attached to hospitals.
14
One of the biggest pitfalls of the contemporary hospital birth is the constantly looming possibility of
Cesarean-section, and women’s too-frequent lack of control over whether they will have one. Some C-
sections are medically necessary, but the World Health Organization has consistently maintained that the
7

far the most common reason for hospitalization, and accounts for about 10 percent of
hospital stays overall.
15
Despite the almost total dominance of the hospital birth, recent
significant increases in the numbers of women choosing alternative paths have garnered
some attention. Small yet growing numbers of women are giving birth outside of
hospitals, and most publicity centers around those who choose to birth at home.
16
In
2012, the Centers for Disease Control and Prevention’s National Center for Health
Statistics released a report citing a 29 percent increase in home births in the United States
between 2004 and 2009. This increase, which translates to a total of 0.72 percent of total
births taking place in the home, results in the highest rate of home births since 1989,
which was the year the CDC began gathering data on home birth.
17
In 2010, the rate
increased even more, to 0.788 percent.
18

Parsing these statistics a bit more finely paints a fuller picture of contemporary
birth in the United States. In 2010, the total rate of not-in-hospital birth was 1.18, while

recommended upper limit for C-section in any country is 15 percent of total births. The general
undesirability of a C-section birth is well-established: C-sections can lead to a more difficult recovery for
the mother including longer-lasting postpartum pain, greater rate of postpartum exhaustion, greater instance
of bowel problems, increased likelihood of hospital readmission for complications, later initiation of
breastfeeding, and less satisfaction overall with the birth experience. C-sections also tend to be more
expensive.
15
Anne Pfuntner, Lauren M. Wier, and Carol Stocks, “Most Frequent Conditions in U.S. Hospitals,
2010,” Healthcare Cost and Utilization Project. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb148.pdf
(accessed October 19, 2013); 1.
16
See, for example, Steven Reinberg, “More U.S. Babies Born at Home: CDC,” U.S. News & World
Report. January 26, 2012. http://health.usnews.com/health-news/family-health/womens-
health/articles/2012/01/26/more-us-babies-born-at-home-cdc (accessed October 19, 2013).
17
Marian F. MacDorman, T.J. Matthews, & Eugene Declerq, “Home Births in the United States, 1990-
2009,” U. S. Department of Health and Human Services, Centers for Disease Control and Prevention,
National Center for Health Statistics, NCHS Data Brief, No. 84, January 2012.
18
Joyce A. Martin, Brady E. Hamilton, Stephanie J. Ventura, Michelle J. K. Osterman, Elizabeth C.
Wilson, T. J. Mathews, “Births: Final Data for 2010,” U. S. Department of Health and Human Services,
Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics
Reports, 61, No. 1, August 28, 2012; 53.
8

the total rate of at-home birth was – as already indicated – 0.788. In other words, 1 out of
every 85 women gave birth at a location other than a hospital, and 1 out of 127 gave birth
at home. This, again, represents a significant increase. However, when race is a variable,
we find great disparity. For white women, the total rate of not-in-hospital birth was 1.75,
and the total rate of home birth was 1.19. So, 1 of every 57 white women avoided the
hospital, and 1 of every 84 gave birth in her home. These above-average rates are made
up for by low rates for women of color, for whom the percentage of home births has
actually decreased since 1990.
19
For Black women, the total rate of not-in-hospital birth
was 0.477, while the total rate of home birth was 0.317. In other words, 1 of every 210
Black women gave birth outside of the hospital, and 1 of every 315 gave birth in her
home. For Hispanic women, the total rate of not-in-hospital birth was 0.408, and the total
rate of home birth was 0.228. In other words, 1 of every 245 Hispanic women gave birth
outside of the hospital, and 1 out of every 439 gave birth in her home. Therefore, if
scholars of birth are correct that women are able to exercise more autonomy over the
birth experience outside of the hospital setting, some groups of women are doing far
better than others.
This state of affairs is ripe for study and critique, and I contend that it is best
understood from a rhetorical perspective. Historical discourse and debate over best
practices for birth have shaped a professional status quo so thoroughly presumed that
dissent can seem ludicrous: Birth is dangerous—any number of things can go wrong—so
of course it belongs in a hospital.
20
As with any other part of a living system, sickness or

19
MacDorman et al., “Home Births,” 2.
20
Using a chain saw is also dangerous; 36,000 users wind up in the emergency room every year!
However, despite the perils of the chainsaw, we do not presume that its user should begin in a hospital.
9

disease may accompany pregnancy or birth. However, birth itself is not a disease. In other
words, some advocates claim, birth is physiological, not pathological.
21
Becoming
pregnant and giving birth is a process of a normally functioning and healthy female body.
Yet, its almost total confinement to the hospital and the degree to which it is treated as an
emergency requiring medical intervention place birth in the category of pathology. Birth
did not come to be regarded in this way by accident; its migration from physiology to
pathology and the ensuing dominance of the hospital birth were rhetorically shaped.
Of course, in the face of near-total hospital dominance, resistance has been
waged. As Kenneth Burke reminds us, identification always invites division.
22

Accordingly, systems of near-total compliance invite acts of resistance. For more than
100 years, groups of women have engaged in various forms of strategic opposition to the
dominant paradigm of birth. Such acts of resistance represent important moments in the
larger struggle for women’s reproductive equality; and yet, they have received little
attention. The reasons for this are unclear; women’s rights with regard to birth have
always directly affected more women than any other single reproductive issue. However,
rhetorical scholars choose to focus almost exclusively on social protest and legislation
centering on abortion and contraception. Make no mistake, these are vitally important
concerns and I by no means advocate attending less to reproductive freedom with regard
to abortion access and birth control. However, I would also submit that the large number

21
It is worth nothing that a distinction exists between giving lip service to this notion and actually
enacting it. From an advocate’s perspective, a doctor within a hospital claiming that birth is a normal bodily
process who then proceeds to act as if it were pathological is not sufficient.
22
Kenneth Burke, A Rhetoric of Motives (Berkeley: University of California Press, 1969), 25.
10

of women who elect to carry their pregnancies to term
23
and must navigate the often
demoralizing process of birth in this country merit some attention as well.
In sum, birth is complicated, and presents a complicated set of exigencies which
necessitate both rhetorical response and study. A dominant social image of birth exists,
which may diverge from material reality and yet captures the essence of women’s
apprehension toward birth. At the forefront of this image is the modern hospital: sterile,
bright, organized, efficient, cold, unfamiliar, and uncomfortable; where one patient is just
like the next and necessarily so. The modern hospital and professional medicine
encourage women to judge the success of the birth experience by the outcome of a live
infant and little more. Thus, any woman feeling alienated, mistreated, abused, or
dehumanized has little recourse; the context severely limits the types of rhetorical
responses available to her. If she does speak, she may be belittled for simply
“complaining” or “whining.”
24
Women must recover a legitimate voice in the context of
birth, one that facilitates a range of experiences and interpretations. This study examines
cases where women have attempted to advocate for as much.
Thus far, I have described the state of childbirth in the United States, and have
hinted that the state of affairs women suffer has to do largely with rhetorical and social
efforts contributing to the entrenched professionalization of birth. This state of affairs
makes it incredibly difficult for women maintain control over where, and how, they will
give birth. Action, under the conditions of modern professionalism, is exceedingly

23
According to the U.S. Department of Health and Human Services, the rate of pregnancies resulting
in live birth has remained fairly constant, always falling between 73-75% since 1990. Stephanie J. Ventura,
Sally C. Curtin, Joyce C. Abrna, and Stanley K. Henshaw, “Estimated Pregnancy Rates and Rates of
Pregnancy Outcomes for the United States, 1990-2008,” National Vital Statistics Report 60, no. 7 (June 20,
2012); 18.
24
Charges of this sort will be addressed in Chapter Four of the present study.
11

difficult. And yet, action is vitally needed. If women are to enjoy a better birth
experience, one in which they are able to make choices and not lose pieces of their
humanity, we must continue to explore possibilities for agency and social change amidst
conditions of modernity and late modernity. Hannah Arendt’s astute analysis of “the rise
of the social” in modernity, and her theory of action, aptly named “natality,” provide an
unsurpassed framework for the study of agency – potential and realized – in historical
and contemporary contexts of birth. Women’s experience with pregnancy and birth
mirrors Arendt’s analysis of modernity and action in more than just metaphorical ways.
This project examines three case studies drawn from varying significant historical
moments of birth in the United States. It explores the ways in which political and
technological forces have constrained women’s agency in contexts of birth. It shows that,
despite massive constraints, women have been and are able to dissent from dominant
systems of birth. However, women’s advocacy in these contexts is not best viewed
through frameworks of mass resistance wherein individual sovereign subjects join
together to enact change and work for greater individual freedom of choice. Nor is their
advocacy best viewed through frameworks of postmodern reciprocity of power, wherein
highly fragmented individual subversive acts resist dynamic systems of control. Instead,
mothers’ advocacy and agency in contexts of birth can best be understood in Arendtian
terms, as beginnings forged through constraint and struggle.

Hannah Arendt, the Rise of the Social, and the Potential for Beginnings
Hannah Arendt’s germinal work The Human Condition meticulously analyzes
human potential in modernity. She begins in antiquity, laying out the contours of life in
12

the Greek city-state. Here, private and public spheres of life were sharply divided. She
holds that the private sphere corresponded to the household while the public sphere
corresponded to the political realm.
25
The private sphere was chiefly concerned with the
maintenance of life; all activities surrounding the biological rhythm of survival took place
herein. Hence, the private realm contained labor. For men, this labor involved the
provision of nourishment; for women, it involved giving birth.
26
Privileged men –
citizens – were able to liberate themselves from the bonds of this necessity and leave all
private labor in the hands of women and slaves. Within the household, freedom was not
possible; even the head of the household was burdened by the necessity of commanding
others.
27
Thus, only those privileged few who could transcend the necessities of the
private sphere were able to enjoy the freedom of the public.
The public was a space where free (male) citizens, freed from the burdens of
sheer survival, could appear together and engage in political activities. Indeed, to
overcome the physical necessities of life was the essential condition of freedom.
28
In
antiquity, the public realm was a space wherein one could achieve a kind of equality
through distinction. In contrast to modern notions of social justice through equality, to be
permitted to appear in public along with one’s peers was to belong to an exclusive group
of “equals.”
29
This was not a conformist sort of equality. On the contrary, Arendt
describes the public as being “permeated by a fiercely agonal spirit, where everybody had

25
Hannah Arendt, The Human Condition. (Philadelphia: University of Chicago Press, 1958), 28.
26
Ibid., 30.
27
Ibid., 32.
28
Ibid., 31.
29
Ibid., 41.
13

constantly to distinguish himself from all others, to show through unique deeds or
achievements that he was the best of all.”
30
Unique deeds and achievements were the
essence of action.
With the ascent of the modern age comes the rise of what Arendt calls “the
social” or mass society. No longer are private and public spheres separate; rather “the
dividing line” between them “is entirely blurred.”
31
Several characteristics or dynamics
mark the rise of the social. First, the public sphere begins to resemble the private sphere
writ large: “we see the body of peoples and political communities in the image of a
family whose everyday affairs have to be taken care of by a gigantic, nation-wide
administration of housekeeping.”
32
The structure of politics becomes akin to the structure
of family; furthermore, things like private property become matters of public concern.
Second, the advent of technological machinery facilitates substantial freedom
from the necessities of life. No longer are we intimately bound to the labor of producing
food, or the necessary pain of childbirth.
Third, and paradoxically, “the new social realm transformed all modern
communities into societies of laborers and jobholders; in other words, they became at
once centered around the one activity necessary to sustain life.”
33
Unlike the ancient
world, where distinction as a citizen was prized most highly, modern individuals are
consumed by jobs. The successful performance of a job occurs in something like the
public, but revolves entirely around making money for the private purpose of sustaining

30
Ibid.
31
Ibid., 28.
32
Ibid.
33
Ibid., 46.
14

life – or what we have come to understand as necessary for sustaining life, which is more
accurately described as “lifestyle.” To punctuate this vital point: to Arendt, the paradox
of the modern age is that humans are at once freed from the bonds of necessity and
singularly committed to its burdens. This perplexing dynamic persists in the realm of
birth as well; women are at once freed from the dangers of loss of life and exclusively
preoccupied with its maintenance.
Fourth, as life within the social becomes centered on the successful performance
of a job, all other concerns become relegated to the status of “hobby.” Arendt writes:
“The emancipation of labor has not resulted in an equality of this activity with the other
activities of the vita activa, but in its almost undisputed predominance. From the
standpoint of ‘making a living,’ every activity unconnected with labor becomes a
‘hobby.’”
34

Fifth, amidst imperative work and superfluous hobbies, humans become isolated
from one another: “men have become entirely private, that is, they have been deprived of
seeing and hearing others, of being seen and heard by them. They are imprisoned in the
subjectivity of their own singular experience, which does not cease to be singular if the
same experience is multiplied innumerable times.”
35

Sixth, and finally, the possibility for action becomes deeply troubled. Whereas the
public realm necessitated distinguished acts or “rare deeds” from individuals bent on high
political achievement of one sort or another, the social normalizes, regulates, and reduces

34
Ibid., 128.
35
Ibid., 58.
15

all potentiality to predictable behavior.
36
Arendt writes that the context of society
eliminates the possibility of action because it demands that individuals behave and follow
the rules. Following rules leads to normalization and a decreased ability to engage in
unpredictable or remarkable action.
37
Arendt emphasizes the gravity of this state of
affairs; she argues that a life without action ceases to be a life. Those who do not act are
“literally dead to the world”; they cease to be human because they no longer inhabit the
world together.
38

Arendt’s analysis of modernity, taken on its own, conveys a dire state of affairs.
Therefore, the main challenge in interpreting her work is to reconcile this gloomy picture
of human potential with her persistent emphasis on a sunny concept that emerges as her
most unique philosophical contribution: natality.
39
For as much as “the social” leads to
the conclusion that humans are doomed, natality insists upon humans’ continuous and
ceaseless potential.
Arendt holds that the two most basic human conditions are birth and death, or
natality and mortality.
40
These conditions motivate all human activity. However, in
opposition to those who emphasize the human preoccupation with mortality, Arendt
features what she considers to be the more useful category of natality. Of the distinction
between mortality and natality, Arendt writes, “The life span of man running toward
death would inevitably carry everything human to ruin and destruction if it were not for
the faculty of interrupting it and beginning something new, a faculty which is inherent in

36
Ibid., 42.
37
Ibid., 40.
38
Ibid., 176.

40
Ibid., 8.
16

action like an ever-present reminder that men, though they must die, are not born in order
to die but in order to begin.”
41
Patricia Bowen-Moore contends that Arendt’s emphasis on
natality offers a needed counterweight to a long philosophical tradition preoccupied with
mortality.
42
Margaret Canovan emphasizes that Arendt, above all, is a theorist of
beginnings.
43
To Arendt – and importantly for this study – all notions of beginning stem
from the beginning of birth.
Further, Arendt posits, human action requires a beginning: “action has the closest
connection with the human condition of natality; the new beginning inherent in birth can
make itself felt in the world only because the newcomer possesses the capacity of
beginning something anew, that is, of acting.”
44
Even though she maintains that action is
possible only in the public realm, wherein plural citizens may appear together and set
unique events into motion, Arendt’s terminology and metaphor connect her theory of
action to the biological and laborious facets of the vita activa. Indeed, action happens in
public, but without a vibrant sense of private labor action holds no meaning: “Necessity
and life are so intimately related and connected that life itself is threatened where
necessity is altogether eliminated. For the elimination of necessity, far from resulting
automatically in the establishment of freedom, only blurs the distinguishing line between
freedom and necessity.”
45
In other words, anyone who existed in a state of total freedom

41
Arendt, Human Condition, 246.
42
Patricia Bowen-Moore, Hannah Arendt’s Philosophy of Natality (London: Macmillan, 1989), 5.
43
Margaret Canovan, “Introduction,” In The Human Condition, vii-xx (Chicago: University of
Chicago Press): vii.
44
Arendt, Human Condition, 9.
45
Ibid., 71.
17

would recognize that “freedom” simply as a neutral state of being; to understand the
sensation and experience of freedom, one must also understand what it means not to be
free. Action is meaningful only when one also knows the struggles of labor. As Arendt
puts it, “the price for absolute freedom from necessity is, in a sense, life itself.”
46
Action
always must take place in connection with labor, the political in connection with the
biological. For Arendt, freedom is won as humans act to (never quite fully) free
themselves from the toil of necessity.
47
A life without action is dead to the world, but a
life without labor cannot even recognize action.
48

It is in the context of this necessary tension that beginnings become possible and
meaningful. Moreover, to begin, to act, and to be free are inextricable. First, Arendt
equates freedom with action: “Men are free—as distinguished from their possessing the
gift for freedom—as long as they act, neither before nor after; for to be free and to act are
the same.”
49
Then, she equates freedom with beginning: “Freedom as an inner capacity of
man is identical with the capacity to begin.”
50
She notes that, in both Greek and Latin,
two different words meant “to act.” One meant “to begin” or “to set in motion” while the
other meant “to achieve.” As time went on, she writes, the word which designated the
second part of action “became the accepted word for action in general.”
51
However, if

46
Ibid., 119-20.
47
Ibid., 121.
48
Ibid., 176.
49
Hannah Arendt, Between Past and Future: Eight Exercises in Political Thought (New York: Penguin
Books, 1977), 151.
50
Hannah Arendt, The Origins of Totalitarianism (New York: Houghton Mifflin Harcourt Publishing
Company, 1968), 473.
51
Arendt, Human Condition, 189.
18

action is designated only by the achievement of something, it is reduced to simply
finishing something that already has been set in motion: “action as such is entirely
eliminated and has become the mere ‘execution of orders.’”
52
Hence, the limits of
“choice” as we know them today; to Arendt, choosing between already-existing
alternatives constitutes neither action nor freedom. Instead, action and thereby freedom
are realized only in the beginning of something new—natality—the outcome of which is
unpredictable.
53
She concludes: “Beginning…is the supreme capacity of man; politically,
it is identical with man’s freedom.”
54

Several factors characterize natality. First, natality ruptures the predictable pattern
of time and events. It unleashes consequences not previously in motion. Second, natality
is both of the earth and not—it depends upon the capacity to start anew that is realized in
birth, and it takes shape in the realm of constructed political affairs: “Since we all come
into the world as newcomers and beginnings, we are able to start something new; without
the fact of birth we would not even know what novelty is, all ‘action’ would be either
mere behavior or preservation.”
55
Third, natality is meaningful because it constitutes a
“rare deed.” To Arendt, rare deeds illuminate time and imbue both life and history with
meaning; conversely, imposing generalized patterns upon the world “signifies nothing
less than the willful obliteration of [its] very subject matter.”
56
Fourth, natality is distinct

52
Ibid., 223.
53
Ibid., 220.
54
Arendt, Origins of Totalitarianism, 479.
55
Hannah Arendt, “On Violence.” Crises of the Republic (San Diego: Harcourt Brace & Company,
1972), 179.
56
Arendt, Human Condition, 42.
19

from “the modern yearning for novelty at any price.”
57
Oftentimes, according to Arendt,
natality actually springs from love of the world as it is and a desire to preserve some
aspect of it that is threatened.
58
Finally, natality happens among people, in public,
because action requires the presence of others.
59
Arendt explains: “Action, the only
activity that goes on directly between men without the intermediary of things or matter,
corresponds to the human condition of plurality, to the fact that men, not Man, live on the
earth and inherit the world.”
60
Moreover, this plurality, this difference, the fact that
“nobody is ever the same as anybody else who ever lived, lives, or will live,” drives our
need to act.
61
Action, therefore, is threatened when the ability of different people to
appear together in public is diminished.
Conditions of modern professionalism render women’s autonomy over birth
difficult to conceive; yet, as Arendt insists, the possibility of new beginnings persists.
This study examines the ways in which this tension between the social and natality plays
out in birth advocacy, both historical and contemporary. The following chapters explore
three significant moments in birth advocacy occurring over the past 120 years. These
moments were selected because they illustrate how women have striven to realize agency
in contexts of birth. Around the turn of the twentieth century, women used a professional
journal for midwives as a forum for contributing to technical and public discussion about
birth; in the latter part of the twentieth century, mothers reconstituted their control and

57
Hannah Arendt, On Revolution (New York: Penguin Books, 1977), 31.
58
Arendt, On Revolution, 31-32.
59
Arendt, Human Condition, 23.
60
Ibid., 7.
61
Ibid., 8.
20

biological mastery of birth through narratives of home birth; and, in the twenty-first
century, birthing women who experienced abuse at the hands of doctors claimed the
power to name and define their abuse in ways that defied the dominant paradigm of birth.
Before turning to the case studies, however, it is important to consider three
topics. First, I elaborate upon birth’s evolution across this time span, in order both to
contextualize the case studies in greater detail, and to highlight the process of
professionalization at which I have thus far only hinted. Next, I critically review prior
studies of birth and reproductive rights, in order to identify key themes and findings that
will inform analysis of the cases. Third, I provide theoretical grounding for the themes,
drawing upon scholars who will serve as conversants for Arendt as the cases proceed.

The History of Birth: A Rhetorical Movement
The evolution of birth in the United States resembles a rhetorical movement.
Karlyn Kohrs Campbell argued that rhetorical movements represent a unit of study
distinct from what other fields define as social movements. A rhetorical movement, she
claims, is defined by the style and substance of its rhetoric rather than by a historical time
frame, an identifiable group, or goal. Thus, a rhetorical movement might contain or
involve several social movements.
62
I begin with this idea to suggest that, despite shifting
goals, motivations, and contexts, threads of rhetorical continuity run through a long
history of birth-related advocacy. Moreover, looking at disparate examples of birth-
related advocacy drawn from differing historical moments highlights both contrasts and
continuities.

62
Karlyn Kohrs Campbell, “The Rhetoric of Women’s Liberation: An Oxymoron,” Quarterly Journal
of Speech 59, no. 1 (1973): 74-86.
21

Birth has been a significant element in the fight for reproductive justice for more
than a century. Across history, examples of activism demonstrate the political, social, and
personal significance of birth within larger themes of reproductive and social justice.
63

Major developments include the move from home to hospital, the rise of medical
intervention, the advent of “natural” birth, the hospital co-opting of natural birth, and the
maintenance of hospital control amidst discourses of “choice.”

From Home to Hospital and Midwife to Doctor
Prior to the nineteenth century, birth took place at home and, except in rare
circumstances, was attended only by other women. As a point of propriety, men had no
place in the birthing room. Cultural commitments to modesty and feminine delicacy,
along with jealous husbands who needed to remain in exclusive sexual possession of their
wives, reinforced this belief.
64
Women—understood to be the experts on birth—were
tasked with attending to all aspects of birth from start to finish. Those with the greatest
expertise were called “midwives” – a term derived from Old English and meaning “with
woman.”
Midwives typically honed their expertise through direct experience and the
teachings of their peers. A few references books did exist. Those with English origins

63
A concrete definition of social justice is difficult to pin down. Most commonly, this term is
associated with liberal notions of equality under the law. With regard to reproduction, this implies free
access to services, products, and procedures in such a way that any individual woman feels as though she
has been able to make her desired choice with regard to if, when, and how she will become pregnant and
give birth within the bounds of the law and without regard to any facet of her identity. However, when the
system itself constrains and disallows choice in ways that may be largely invisible, the concept of “justice”
needs to be rethought. Social justice, in this context, begins where institutional constraints on autonomy are
broken down and any lessened ability to exercise autonomy based upon one’s identity is made plain and
rectified. Injustice will persist, but steps in the direction of justice can be taken by relegating more power to
women.
64
Jane B. Donegan, Women & Men Midwives. (Westport: Greenwood Press, 1978), 113.
22

may have consulted a volume titled simply The Midwives Book, authored by a Mrs. Jane
Sharp who boasted more than thirty years of practical experience in the art of
midwifery.
65
The tome was organized into six books, each focusing on a different subject
of importance to the midwife. Topics included, “Anatomical Description of the Parts of
Men and Women,” “Signs of a Womans being with Child,” “the paines and difficulties of
Childbearing with their causes, signes and cures,” “how to order the Child when born,”
“How to order women in Childbirth, and of several diseases and cures for women in that
condition,” “Of Diseases incident to women after conception,” and “proper cures for all
diseases Incident to young Children.”
66
For its time, the volume provided a
comprehensive treatment of reproduction, pregnancy, birth, and post-natal care.
Women’s control over birth was threatened in the 1800s when employment of a
“male midwife” became the fashion for rich, urban, northern families.
67
Victorian notions
regarding gender roles contributed to this development. Richard Wertz and Dorothy
Wertz claim that female birth attendants became “unthinkable” because giving birth was
the “quintessential feminine act” while “attending birth was a fundamental expression of
the controlling and performing actions suitable only for men.”
68
At the same time, the
authors claim that a birthing woman’s femininity could be established if her pain in birth
were verified in front of a male audience.
69
Thus, developments and changes in gendered

65
Jane Sharp, The Midwives Book or The Whole Art of Midwifery Discovered (London: Simon Miller,
1671).
66
Ibid., 1.
67
Donegan, Women and Men Midwives, 120.
68
Richard W. Wertz, and Dorothy C. Wertz, Lying-In: A History of Childbirth in America, (New York:
The Free Press, 1977), 59.
69
Ibid., 65.
23

notions of the proper fulfillment of societal roles were important in shaping birth from the
very beginning.
Also, in the latter part of the nineteenth century, rapid advances in medical
science and technology provided hope that high maternal and fetal mortality rates could
be improved. The perception that birth was more like a disease than a normal event began
to grow at the same time that doctors began to replace midwives.
70

Still, until the end of the nineteenth century, most “normal” births were attended
by midwives, who enjoyed what William Ray Arney terms a “symbiotic relationship”
with doctors.
71
Other historians argue that an ill-defined medical profession, coupled with
a flood of new doctors graduating from largely unregulated medical schools, created a
situation in which doctors began to feel threatened by the presence of midwives, who
were “economically dangerous competitors.”
72
The field was becoming overly-crowded,
and midwives were the easiest targets for both blame and elimination.
73
But a physician
attendant was a privilege reserved for the rich: midwives continued to attend the births of
women who were immigrants, African-Americans, and living in poor and rural
communities.
74
The vast majority of births still took place at home, attended by a
midwife. Thus, midwives maintained a significant foothold in reproductive care in the
United States throughout the nineteenth century.

70
Judy Barrett Litoff, American Midwives: 1860 to the Present, (Westport: Greenwood Press, 1978):
21.
71
William Ray Arney, Power and the Profession of Obstetrics, (Chicago: University of Chicago Press,
1982), 6.
72
Wertz and Wertz, Lying-In, 55.
73
Litoff, American Midwives, 50, 137.
74
Wertz and Wertz, Lying-In, 47.
24

As medical science continued to advance around the turn of the century, however,
birth was treated increasingly as a pathology rather than a normal bodily function.
Accordingly, obstetricians increasingly became the dominant voice in birthing rooms.
75

At the same time, the effects of major societal changes, such as industrialization and
urbanization, which had begun to threaten traditional women’s social networks in the
nineteenth century were fully felt in the early part of the twentieth century, undermining
those communities of women that supported traditional modes of birthing.
76
In other
words, even if a woman wanted to give birth at home, attended by a midwife and a
community of other women, social isolation made this difficult.
At the same time, physicians wanted to cement their dominance and legitimacy in
the birthing room under the banner of the newly-burgeoning field of obstetric medicine.
In the first two decades of the twentieth century, they undertook an all-out attack on
midwives in the pages of their many professional journals.
77
Words were harsh and intent
was clear: fully to move birth out of the hands of female midwives and into the hands of
male physicians. According to Deborah Sullivan and Rose Weitz, the “marginal social
and economic status of most turn-of-the-century midwives and their clients” helped to

75
Arney, Power, 7.
76
Juduth Walzer Leavitt, Brought to Bed: Childbearing in America 1750-1950, (New York: Oxford
University Press, 1986), 176.
77
See, for example, Arthur Brewster Emmons and James Lincoln Huntington ,“A Review of the
Midwife Situation,” Boston Medical and Surgical Journal 164, no. 8 (1911): 251-262; J. Whitridge
Williams, “Medical Education and the Midwife Problem in the United States,” Journal of the American
Medical Association 58, no. 1 (1912): 1-7; Arthur Brewster Emmons and James Lincoln Huntington, “The
Midwife: Her Future in the United States,” The American Journal of Obstetrics and Diseases of Women
and Children 65, no. 3 (1912): 393-404; James Lincoln Huntington, “The Regulation of Midwifery,”
Boston Medical and Surgical Journal167, no. 3 (1912): 84-87; Charles Edward Ziegler ,“The Elimination
of the Midwife,” Journal of the American Medical Association 60, no. 1 (1913): 32-38; James Lincoln
Huntington, “The Pregnancy Clinic and the Midwife: A Comparison,” Boston Medical and Surgical
Journal 173, no. 21 (1915): 764-766; and Joseph B. DeLee, “Progress toward Ideal Obstetrics,” The
American Journal of Obstetrics and Diseases of Women and Children 73, no. 3 (1916): 385-399.
25

reinforce the physicians’ claims.
78
This is the context in which a professional journal of
midwifery, entitled The American Midwife—the subject of Chapter Two—arose.

Physician Intervention, “Natural” Birth, and Hospital Victory
A push to move birth from the home to the rapidly-expanding institutional scene
of the lying-in hospital followed on the heels of the physician campaign against
midwives. According to Judith Walzer Leavitt, physicians found the traditional home
birth fraught with problems. In the home, a doctor “could not make medical decisions
without the interference of the birthing woman, her friends, and her family.”
79
For
physicians, the way to achieve total control was to move birth into the hospital. The new
hospitals offered a safe and sterile environment away from the chaos of the home.
Moreover, many women desired the pain relief available in hospitals. Some became
advocates of “Twilight Sleep,” a combination of morphine and scopolamine that would
induce a catatonic state and remove all memory of pain. Leavitt writes that many leading
advocates for twilight sleep were active suffragists, who rooted their commitment to the
drug in their beliefs in women’s rights.
80
They believed that by choosing to go to sleep
they were controlling their own birth experiences.
81
Paradoxically, these women’s rights
advocates played a role in denying midwives’ professional autonomy.

78
Deborah A. Sullivan and Rose Weitz, Labor Pains: Modern Midwives and Homebirth, (New Haven:
Yale University Press, 1988), 11.
79
Leavitt, Brought to Bed, 138.
80
Ibid., 137.
81
Ibid.
26

In the 1920s and ‘30s, women gave birth in hospitals with increasing prevalence.
After 1910, the number of hospitals grew at a rapid rate.
82
Increased funding was
available thanks to the philanthropic activities of those with new oil and coal money, and
doctors began to extend their services to poor “charity” cases.
83
Doctors no longer wanted
the poor, African-Americans, or immigrants to seek the care of midwives; rather these
populations were more readily objectified as “cases” to be used as teaching material for
medical students.
84
In addition, immigration restrictions imposed in the 1920s, the
general decline of the birth rate, and new regulations of medical practice all helped push
midwives out of the birthing business.
85

Modern doctors thought that normal deliveries “were so rare as to be virtually
nonexistent.”
86
According to expert opinion, every birth varied from the ideal “norm”;
therefore, a series of “routine interventions” facilitated safer and better birthing.
87
Nearly
every woman giving birth during the 1920s and ‘30s was anesthetized, among other
interventions. Importantly, although women gave birth in hospitals with increasing
frequency, hospitals were no safer than the home. In this era, “it was more the image of
science’s potential, the lure of what science could offer, than any proven
accomplishments that attracted women to the hospital.”
88

82
Litoff, American Midwives, 141.
83
Barbara Ehrenreich and Deirdre English, Witches, Midwives and Nurses: A History of Women
Healers. 2nd ed. (New York: The Feminist Press, 2010), 81-82.
84
Ibid., 86.
85
Litoff, American Midwives, 141-42.
86
Wertz and Wertz, Lying-In, 141.
87
Ibid.
88
Leavitt, Brought to Bed, 174.
27

By 1940, 55.8 percent of births took place in hospitals, and by 1950 the number
had increased to 88 percent.
89
During this period some women began to feel disillusioned
with hospital birth and argued that it was inhumane.
90
Birthing in a hospital was likened
to an assembly line, with all individuality taken away.
91
Following the near-total takeover
of obstetrics, women were subjected to much poor treatment at the hands of those who
wielded the advanced technologies of birth. The realization that women were willing to
surrender all control and be completely “knocked out” during birth, so as to avoid all pain
led to more blatant abuses of power on the part of physicians. Women routinely were
separated from their partners, strapped to tables or otherwise restrained, drugged without
consent, penetrated and cut, separated from their babies for long periods of time, and not
allowed to breastfeed.
Not until the ‘40s and ‘50s did maternal mortality finally decrease significantly,
due in large part to antibiotics and transfusions.
92
However, as Gertrude Fraser
demonstrates, as care improved, African-American women often were left behind,
because poverty and lack of access to care contributed to poor maternal and infant
health.
93
Thus, this was an era of mixed progress. Certain individual women enjoyed

89
Neal Devitt, “The Transition from Home to Hospital Birth in the United States, 1930-1960.” Birth
and the Family Journal 4, no. 2 (1977): 47.
90
Charlotte G. Borst, Catching Babies: The Professionalization of Childbirth 1870-1920, (Cambridge:
Harvard University Press, 1995), 150.
91
Leavitt, Brought to Bed, 190.
92
Ibid., 194.
93
Gertrude Jacinta Fraser, African-American Midwifery in the South: Dialogues of Birth, Race, and
Memory, (Cambridge: Harvard University Press, 1998),128.
28

increased safety and better health, but these improvements were not equally enjoyed, and
many ended up feeling psychologically abused.
Some historians argue that the new promise of safety enabled women to recognize
that the routine procedures of hospital birth were harming them psychologically.
94
Some
also claim that the post-WWII return to ideal womanhood and mothering as a way of life
led women to want and expect more out of the experience that was supposed to be the
ultimate moment in their lives.
95
In any case, many women began to want something
more out of birth than a blank space in their memory and a baby in arms. A series of
articles detailing “horror stories” of birth published in the Ladies Home Journal is
credited with raising women’s consciousness and spurring a push for a more natural
birthing experience.
96

Popular culture responded to this desire for “something more” in diverse ways.
Some books touted “natural” birth as a more desirable means of parturition. Grantly
Dick-Read’s Childbirth Without Fear did so by “glorifying true womanhood.”
97

Childbirth was considered the height of women’s lifetime ambition; therefore, they
should experience the moment fully. Psychoanalytic literature suggested that “feeling”
the birth would help the mother bond with the child and also drew analogies between
birth and sex. The descending fetus was compared to the male penis, the “climax” of

94
Leavitt, Brought to Bed, 194-95; Wertz and Wertz, Lying-In, 167.
95
Wertz and Wertz, Lying-In, 182-83.
96
Sullivan and Weitz, Labor Pains, 24; Gladys Denny Shultz, “Journal Mothers Report on Cruelty in
Maternity Wards,” Ladies Home Journal (August 1958): 44-45, 152; Gladys Denny Schultz, “Journal
Mothers Testify to Cruelty in Maternity Wards,” Ladies Home Journal (December 1958): 58-59, 135, 137-
39.
97
Wertz and Wertz, Lying-In, 183-85.
29

crowning to orgasm, and the post-birth feelings of relief to post-sex euphoria.
98
Some
suggested that these sexual feelings were necessary to make the mother love her child.
99

So, while a range of reasons existed for crafting an alternative and “natural” childbirth
experience, none of them initially had to do with women’s rights. In 1959, the ideas of
French doctor Fernand Lamaze were introduced to America, with far-reaching
consequences.
100
The Lamaze method remains the most widely-known approach to
“natural” birth.
According to some historians, the spirit of social change that characterized the
1960s and ‘70s “led to the questioning and erosion of medical authority, and also led
many to want to pursue a more ‘natural’ path in life.”
101
The shattering of the “feminine
mystique” and the burgeoning Women’s Liberation Movement generated new reasons to
reject medicalized birth (although the motive of ideal womanhood by no means
disappeared). At the same time, the rate at which women gave birth in hospitals had
reached 96.6 percent by 1960, and 99 percent by 1970.
102
Unless a woman lived in a very
remote area, she most definitely was going to give birth in a hospital.
103
Despite growing
awareness of hospital indignities, and growing desire for a more natural birthing
experience, the hospital’s near-total containment of birth reached its peak, where it has

98
Wertz and Wertz, Lying-In, 189-90.
99
Ibid., 189.
100
Sullivan and Weitz, Labor Pains, 29.
101
Ibid., 36.
102
Devitt, “Transition from Home to Hospital,” 56; Marian MacDorman, “Statcast Number 18
Transcript,” NCHS Press Room, Centers for Disease Control and Prevention (March 3, 2010)
http://www.cdc.gov/nchs/pressroom/STATCASTS/statcast_18.htm.
103
Devitt, “Transition from Home to Hospital,” 56.
30

remained. As part of the effort to cement birth within the hospital, the medical profession
co-opted the language and practices of natural birth advocates, seeking to make hospital
confinement more palatable for those who wanted a better birth experience.
As the ideas of Lamaze and others spread during the 1970s, many doctors offered
a more “natural” childbirth experience for mothers. Typically, this included breath
control as a strategy for dealing with pain. These “natural” techniques notwithstanding,
doctors still utilized episiotomy, forceps, and even epidurals routinely.
104
In other words,
doctors entertained some natural methods, but only as a supplement to hospital
procedures that would “justify [their] professional presence and fees” and “keep birth
from being overly time-consuming.”
105
Barbara Katz Rothman notes that the earliest
classes offered by the American Society for Psychoprophylaxis in Obstetrics, or ASPO—
which was founded on the principles of the Lamaze method—routinely discouraged
women from questioning their doctors. In direct opposition to American Civil Liberties
Union guidelines regarding patient rights, the ASPO advised: “it is not for the parturient
to decide who should or should not examine her during labor” and, “if your doctor
himself suggests medication, you should accept it willingly—even if you don’t feel the
need for it—as he undoubtedly has very good reasons for his decision.”
106
Thus, the chief
organization ostensibly devoted to better birthing experiences encouraged women to
surrender control, inevitably, to doctors. Increased numbers of Certified Nurse Midwives
(CNM’s) in maternity wards offered some alternative to physician-attended birth.

104
Wertz and Wertz, Lying In, 195.
105
Ibid., 195.
106
Barbara Katz Rothman, In Labor: Women and Power in the Birthplace, (New York: W.W. Norton
and Company, 1982), 171, 175.
31

However, these were quite different than traditional midwives. All possessed a degree
(often a master’s) in nursing in addition to a midwife certificate, and were well-socialized
into hospital routines. Often, CNM’s simply reinforced doctors’ opinions.
While some “natural” methods became acceptable in hospital routines,
countercultural books by Ina May Gaskin and other natural birth activists provided an
alternative path. These books advocated return to a truly natural birth, fully understood as
a normal physiological process rather than a pathological sickness. Gaskin argued that
birthing at home, often with a lay midwife, was the only way to avoid the unnecessary
and undesirable procedures of the hospital, and was a healthier, happier alternative for
both mother and infant.
107
Although some women, at this time, chose to give birth at
home unassisted or with the help of a lay midwife,
108
the ideas of home birth advocates
like Gaskin remained on the fringe. Many women wanted more, and more natural,
options; however, eschewing the safety of the hospital seemed extreme. This is the
context in which narratives of home birth—the subject of Chapter Three—arose.

Natural Artifice and Choice
Although the 1960s had witness increased options for “natural” hospital births,
and decreased use of heavy narcotics for “twilight sleep,” physician continued to
intervene often in birth. In fact, while only 4 percent of births ended in Cesarean-section
in 1965, the number increased to 20 percent by 1985. Much “natural” birth in hospitals
was artifice. Hospitals offered many types of childbirth classes, teaching versions of

107
Ina May Gaskin, Spiritual Midwifery (Summertown: Book Publishing Company, 1975).
108
“Lay” midwives are now commonly referred to as direct-entry midwives, due to their “direct entry”
into the field of midwifery, rather than by way of nursing.
32

Lamaze and other approaches, which were modified so as not to interfere with hospital
routines. Instead of forums that encouraged women to learn and take an active role in
birth, these classes socialized women to “expect and accept hospital routines, including
fetal monitors, intravenous drips, labor augmentation, forceps, analgesics during early
labor, and anesthetics during delivery.”
109
These classes also prepared women mentally
for the possibility of a Cesarean section.
110

At the same time, the sensibilities of renewed Reagan-era neoliberalism rendered
childbirth a matter of individual consumer choice. Ultimately this led to some greater
satisfaction with the birthing experience among many individual women and families.
However, these changes “worked largely to ameliorate the system rather than to change it
radically.”
111
Women with information and money enjoyed greater control, but those with
neither remained subject to old-style mistreatment. And even those who could spend the
time and resources necessary to educate themselves and employ a midwife or other birth
advocate were not immune from indifferent, standardized clinical routines in hospitals.
During the 1990s, direct-entry midwives
112
who had been confined to the margins
of the birthing field worked toward legitimate legal status. Practicing outside the law in
many states, some saw a path to greater acceptance through government licensing. While
CNM’s practice legally at hospitals in all fifty states, the status of direct entry midwives

109
Sullivan and Weitz, Labor Pains, 39.
110
Ibid., 39.
111
Ibid., 45.
112
A direct-entry midwife is one who does not hold a nursing degree; hence, she “directly enters” the
field of midwifery.
33

is much less certain and to this day varies by state.
113
In some states direct-entry
midwives legally may attend “normal” births at home or at freestanding birth centers. In
others, however, they find themselves in legal limbo.
Changes in health care policy also undoubtedly will affect options available to
birthing women, but what this impact will be is as yet uncertain. As of January 2011,
under the Patient Protection and Affordable Care Act, Medicare reimburses 80 percent of
both doctor and CNM charges. Prior to the Affordable Care Act, CNM’s were
reimbursed only at 65 percent. This change may set a precedent for other insurance
providers.
114
Benefits to direct-entry midwives are much less certain; however, in states
where direct-entry midwives are licensed, many insurance providers offer at least some
level of reimbursement.
115
Although these developments facilitate more choice and better
birthing experiences for some, the benefits of midwife care remain largely inaccessible
for the uninsured, and the insured whose plans do not cover midwife services.
Furthermore, changes in health care policy do little—if anything— to challenge the
hegemony of standard procedures within hospital walls.
In the present moment, more choices than ever seem to be available to women
facing birth. Whether these alternatives are good choices is not clear. Women may have
some choice over the hospital environment. For examples, some hospitals offer “family-
centered” birthing rooms that are designed to feel “homey,” some women may have

113
“State by State Guide to Midwifery in the United States,” Citizens for Midwifery,
http://cfmidwifery.org/states/.
114
“Midwives and Medicare after Health Care Reform,” American College of Nurse-Midwives,
http://www.midwife.org/Midwives-and-Medicare-after-Health-Care-Reform.
115
“Which Insurance Companies Reimburse Direct-Entry Midwives?” Midwife Billing and Business,
http://www.midwifebilling.com/faq-items/which-insurance-companies-reimburse-direct-entry-midwives/.
34

water births, and some hospitals allow newborns to remain in the same room with the
parent(s) for extended periods of time.
116
Of course, hospital routine perseveres amidst
simulacra and minor adjustments. Birthing centers may be a better option for some, but
typically, they are affiliated with hospitals, and are not available in many locations. Home
birth is a viable option for some, but not all, women. The reality remains that the vast
majority of women give birth in traditional hospital settings attended by physicians. All
are subject to clinical standardization; some emerge feeling battered and abused. This is
the current context, in which claims of “birth rape”—the subject of Chapter Four—have
arisen.
This review has revealed a steady trajectory of professionalization. Some
scholars, e.g. Robert Hariman, treat this process at this time in history homogeneously,
and as undesirable.
117
But it may be more complicated than this. Professions are
historical, and rhetorical analysis is useful to see how they were constructed and to
recover alternative possibilities. Issues that develop in the formative moments of an
institution remain and resurface over time. This study calls attention to discursive
construction of the past in light of the present, particularly in the ongoing contention
between tradition and modernity in relation to natality.
Now that this broad historical picture of professionalized birth in the United
States is drawn, this project looks to other studies of birth to provide a synthesis of what
scholars have critically discerned previously. This review will be limited to critical and

116
See, for example, “Delivering in a Hospital,” What to Expect When You’re Expecting (blog).
http://www.whattoexpect.com/pregnancylabor-and-delivery/delivery-options/delivering-in-a-hospital.aspx
(accessed October 21, 2013).
117
Robert Hariman, “The Liberal Matrix: Pluralism and Professionalism in the American University,”
The Journal of Higher Education 62, no. 4 (1991): 451-66.
35

interpretive studies, which are relevant to the present study. Most existing research on
birth was undertaken from sociological and anthropological perspectives; these works are
examined first. Next, attention turns to the field of rhetoric, wherein prior works
centering on rhetoric of reproductive justice—including those focusing on abortion
rights, birth control rights, and birth rights—are overviewed. The focus within rhetoric
broadens for two reasons: first, very few studies of birth rhetoric exist; and second, it is
useful to demonstrate the analytical threads common across issues of reproductive justice.

Reproductive Freedom and Birth
Sociologist and birth scholar Barbara Katz Rothman emphatically states, “birth
matters.”
118
Indeed, women’s birth rights are an important issue of reproductive freedom.
While the issues at stake are different and sometimes perhaps even more complicated
than those at stake in struggles for abortion rights and birth control, all revolve around the
crucial question of whether women have control and decision making power over their
own bodies at a very basic level. Scant work exists on the subject of birth in the field of
rhetoric, but much has been done from historical (as has already been indicated), as well
as sociological and anthropological perspectives. In the following section I point out key
works from these disciplines to lay out the issues and arguments found to describe
women’s birth choices. Because the following studies rely mostly on interview and
ethnographic data, their foci and findings are somewhat different than the present project.
However, social scientists do provide key understandings of context by laying out a

118
Wendy Simonds, Barbara Katz Rothman, and Bari Meltzer Norman, Laboring On: Birth in
Transition in the United States (New York: Taylor and Francis Group, 2007): xvi.
36

terrain of controversy. Such studies also introduce several assumptions and themes that
underlie the present study.
To begin, critical and interpretive studies of birth emerging from the fields of
sociology and anthropology evince three major areas. First, they acknowledge and
interrogate the notion that birth is socially and culturally constructed; second, they
explore the meaning of “choice” within the socially constructed realm of birth; and third,
they comment on the relationships among gender, feminism and birth thereby noting
uneasy relationship and alliances. I briefly explore each of these areas as they play out in
the literature.

Sociological and Anthropological Perspectives
The Social Construction of Birth. First, every study, not surprisingly, emphasizes
the social construction of birth. Explicit and implicit acknowledgments that the medical
system of birth is not simply “objective” or value-free science permeate the works.
Overall, the progressive increase in medicalization of women’s lives has been a well-
established theme in studies of reproduction.
119
These works argue that childbirth has
become thoroughly treated as a disease because of careful construction via practices of
minutely managed and controlled procedure. Medicalization has been so complete, in
fact, that it has “eclips[ed] other perspectives” and other ways of dealing with human
problems like birth.
120
As scientific discoveries are made regarding what are pronounced

119
Marcia C. Inhorn, "Introduction: Defining Women's Health: A Dozen Messages from More Than
150 Ethnographies," In Reproductive Disruptions: Gender, Technology, and Biopolitics in the New
Millenium, edited by Marcia C. Inhorn, 1-34 (New York: Berghahn Books, 2007), 12.
120
Jacqueline S. Litt, Medicalized Motherhood: Perspectives from the Lives of African-American and
Jewish Women, ( New Brunswick: Rutgers University Press, 2000), 4.
37

to be “the ‘natural facts’ of the female body,” scholars continually rise to the task of
deconstructing the constructed-ness of these facts.
121
For example, Rothman examines the
ways in which the relationship between birthing woman and birth attendant is
constructed, and argues that such constructions are constituted in hospitals and stem from
the understanding that obstetrics is a surgical specialty. In surgery, doctors are trained to
treat all patients as simply a body, and to treat the body as a machine.
122
Within such an
ideology it is the job of the doctor to be like a mechanic who improves the performance
of the body-machine.
123

Medical anthropologist Robbie Davis-Floyd meticulously lays out the constructed
nature of hospital procedures in a book that analyzes the ritual aspects of every step of the
standard hospital birth.
124
She argues that routine obstetric procedure makes the
unpredictable predictable and reinforces the superiority of technology over nature.
125

Hospital routines, Davis-Floyd argues, are for the most part arbitrary and unnecessary,
constructed for purposes of hospital standardization, efficiency, and convenience. Infants’
heads are not uniform in circumference; yet, all women are instructed to start pushing
when they reach the arbitrary point of ten centimeters dilation whether they have the urge
or not.
126
Rather than evincing the triumphs of disinterested science, these standard

121
Margaret MacDonald, At Work in the Field of Birth: Midwifery Narratives of Nature, Tradition,
and Home, (Nashville: Vanderbilt University Press, 2007), 95.
122
Barbara Katz Rothman, In Labor: Women and Power in the Birthplace, (New York: W.W. Norton
and Company, 1982), 163-64.
123
Ibid., 181.
124
Robbie E. Davis-Floyd, Birth as an American Rite of Passage., (Berkeley: University of California
Press, 1992), 76-149.
125
Ibid., 2.
126
Ibid., 119.
38

hospital procedures work to reinforce specific cultural messages to women about their
place within the birth process and the ideals of American culture in general. Indeed, other
scholars of birth agree that mainstream obstetric medicine constructs a powerful cultural
model.
127

This “technocratic” model of birth tends to be placed, by advocates, in binary
opposition with “natural” birth.
128
This presents a troubling dichotomy, because women’s
bodies become determined either to be defective and dangerous by a medical
establishment that seeks to regulate and control them, or to be primitive, animalistic
creatures whose highest value is ability to reproduce. Therefore, some researchers
undertake the task of debunking claims of “natural” birth, and analyzing it as a social
construction alongside medicalized birth. Margaret MacDonald argues that, unlike other
social artifacts of analysis, nature in the realm of childbirth “has not been fully
problematized in scholarly analyses.”
129
Some critics are so eager to deconstruct
medicalized birth that they fail to recognize problems with the meaning of “natural” on
the other end of the spectrum.
Indeed, the meaning of “natural” birth is not now, nor has it ever been,
particularly clear. Caroline Bledsoe and Rachel Scherrer claim that cultural pressures to
have a “perfect birth” lead women to “fear actions by licensed practitioners that may
interrupt what they see as a natural reproductive event.”
130
They argue that “natural” is

127
Margaret MacDonald, At Work in the Field of Birth: Midwifery Narratives of Nature, Tradition,
and Home, (Nashville: Vanderbilt University Press, 2007), 169.
128
Davis-Floyd, Birth as Rite of Passage, 6.
129
MacDonald, The Field of Birth, 93.
130
Caroline H. Bledsoe and Rachel F. Scherrer, "The Dialectics of Disruption: Paradoxes of Nature
and Professionalism in Contemporary American Childbearing," In Reproductive Disruptions: Gender,
39

more closely connected with a woman’s ability to retain control than it is with nature.
131

Others show how “natural” birth is understood as a religious experience which
“confirme[s] for a woman her God-given role as a mother.”
132
Natural birth is also
connected with primitive animalism.
133
Scholars show that advocates employ essentialist
language when promoting natural birth, which reduces women to bare biological
function, then claims that to allow this biological function to happen is the highest
possible purpose. The ways in which birth is tied to nature have the potential to either
denigrate women or celebrate them for somewhat dubious reasons.
An intricate system of meaning is built up around natural birth, and this system is
not free from cultural or ideological systems of meaning and power. MacDonald insists
that we must “accept that all cultural systems—not just biomedicine—naturalize power in
the body in particular ways.”
134
Indeed, when natural birth advocates tout the practice as
being “the way birth was meant to be,” they reinforce the false notion that birth has the
potential to take place in a “prediscursive reality.”
135
Arney claims that the system of
natural childbirth “frees women from the brutality of old-time obstetrics, but it replaces
that brutality with a secure set of chains, in the fashioning of which women have

Technology, and Biopolitics in the New Millenium, edited by Marcia C. Inhorn, 47-78, (New York:
Berghahn Books, 2007), 49.
131
Ibid., 49.
132
Pamela E. Klassen, Blessed Events: Religion and Home Birth in America, (Princeton: Princeton
University Press, 2001), 28.
133
Ibid., 142.
134
MacDonald, The Field of Birth, 96.
135
Ibid., 96.
40

participated.”
136
Arney goes so far as to argue that natural childbirth is a more totalizing
system of control than hospital birth because it takes over women’s minds as well as their
bodies.
137

By acknowledging that natural birth is as much a construction as medical birth,
scholars tend to reject what many term to be a “false consciousness” view of birth.
MacDonald holds that ‘we must look beyond the impossible task of peeling away the
‘fictions’ of science and biomedicine as if to reveal the true female body and the natural
process of pregnancy and birth.”
138
Prior works thereby argue that social problems
relating to birth will not be solved simply by replacing one system with another.
However, it is important to remember that all socially constructed systems are not equal,
and the fact that all elements of a given form of birth are socially constructed does not
make them all harmful. For example, Marsden Wagner argues that dissociating birth from
sickness is a positive step,
139
while MacDonald demonstrates how some midwives work
to reconceive “natural” birth in ways that are positive for their clients.
140
The recognition
of constructed and ideological elements on both ends of the spectrum is an important step
in the pursuit of justice for birthing women, but it is only part of the total picture.
The Meaning of Choice. Literature on the subject of birth also places heavy
emphasis on the issue of choice and its meaning. For many, choice is situated within the

136
Arney, Power, 236.
137
Ibid., 236.
138
MacDonald, The Field of Birth, 96.
139
Marsden Wagner, Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women
and Children First (Berkeley: University of California Press, 2006).
140
MacDonald, The Field of Birth,
41

framework of American liberalism. Robin Gregg writes, “In the American political
culture, rights, freedom, and individual choice are inextricably linked: the right to
privacy, freedom of religion, freedom of expression, and other liberties guaranteed by
law all entail the freedom to make individual choice.”
141
It is hardly a surprise, then, that
mainstream feminist struggles for reproductive justice valorize the protection of “choice.”
Furthermore, reproductive choices are frequently framed as radically
individualized, wherein an individual woman solely determines her fate. Scholars
demonstrate that birth is no exception; Bledsoe and Scherrer claim that birth “is depicted
culturally as an individual achievement, one in which a woman should be in control of
her actions.”
142
However, the language of choice that signified a guarantee of equal rights
in the 60s and 70s has undergone a shift in meaning in more recent years. Sociologist
Christa Craven, in a study of contemporary midwifery in Virginia, argues that “claims to
‘the right to choose’… have now shifted toward a more singular focus on ‘consumer
rights’ under neoliberalism.”
143
Citizens, now constituted as consumer-citizens, are able
to wield the greatest power by exercising their pocketbooks. Thus, those with resources
are likely to have a birth experience that reasonably matches with their expectations.
However, those who do not have the ability to pay for access to greater choice in birthing
have such “choice” removed from their reach. Thus, scholars conclude that widespread
improvement in reproductive care for all women will not be achieved as long as access
remains connected in any degree to economic affluence. Pamela Klassen similarly notes

141
Robin Gregg, Pregnancy in a High-Tech Age: Paradoxes of Choice, (New York: New York
University Press, 1995), 9.
142
Bledsoe and Scherrer, Reproductive Disruptions, 68.
143
Christa Craven, Pushing for Midwives: Homebirth Mothers and the Reproductive Rights Movement,
(Philadelphia: Temple University Press, 2010), 115.
42

that birthing women “are able (or not) to enact [choice] based on a range of
interconnecting social contexts, like education, class, race and ethnicity.
144
Indeed, most
clients of direct-entry midwives are white and married.
145

Despite the lower frequency with which women of color receive midwife care and
give birth at home, Wagner indicates that an overhaul of the obstetric system with an
increased emphasis on midwife care is the path to equality in birth. He writes, “There are
precious few situations in life where the cheaper alternative is also the better
alternative—and maternity care is one.”
146
He bases this claim on the fact that, in actual
dollar amounts, the comparatively hands-off care offered by a midwife is far less
expensive than the mandatory tests and procedures that come standard with hospital birth.
However, Americans do not tend to pay for their healthcare directly, and until midwife
care is totally covered by all insurance providers, and covered uniformly across
geographic boundaries, it will not, in practice, always be the “cheaper alternative.”
Furthermore, because midwifery is often coopted by mainstream medicine, a future of
low-cost midwife care appears all the more uncertain.
Still, many scholars connect midwife care directly with “choice.” Bledsoe and
Scherrer claim, “the best way to ensure a natural birth is by giving birth at home with a
midwife in attendance. Next in order of preference is a free-standing birth center.”
147

MacDonald finds that “informed choice” is central to the philosophy and practice of the

144
Klassen, Blessed Events, 35.
145
Judith Pence Rooks, Midwifery and Childbirth in America, (Philadelphia: Temple University Press,
1997), 152.
146
Wagner, Born in the U.S.A., 242.
147
Bledsoe and Scherrer, Reproductive Disruptions, 56.
43

midwives she studied.
148
However, she finds that the focus on “choice” necessitates a
counterpart value of “trust.” Even in cases of home birth, where maximum autonomy for
the birthing woman is presumed, the woman must accept that a midwife will take steps to
save her life, without asking for consent, in dire circumstances.
149
Here, we see
acknowledgment of the limits of choice as a totally individual endeavor. In the real
world, choice is more often a collective project. Thus the importance of being in
community with those who can make the right kinds of choices together, which then
facilitate the felicitous playing out of events, cannot be overstated.
Feminism and Other Uneasy Relationships. Feminism is a final theme around
which many prior studies of birth converge. More specifically, studies acknowledge or
question the relationship between birth and feminism. Feminist critiques of the 1970s
played a major role in raising consciousness with regard to the oppression occurring
within the obstetric industry. Barbara Ehrenreich and Deidre English were among the
first to present the ways in which the patriarchal medical establishment was hurting
women. They argue that the medical establishment “is a fortress designed and erected to
exclude us.”
150
By denying the history of women healers and crafting the stereotype of
the expert male doctor, patriarchy leaves women out of their own care. Others, like
Adrienne Rich, continued the project of unmasking control of women’s bodies via the

148
MacDonald, The Field of Birth, 101.
149
Ibid., 104.
150
Ehrenreich and English, Witches, Midwives and Nurses,99-100.
44

patriarchal medical system and what she terms “alienated childbirth.”
151
Rich contents
that whether anesthetized or “natural,” childbirth is in the hands of men firmly.
152

Of course, different philosophies of feminism lead to varied views of birth. Much
of the difficulty that arises when attempting to connect feminism with birth stems from
the commitments of these differing philosophies. For example, the difference-oriented or
“gynocentric” approach synthesized by Iris Young places heavy emphasis on the
superiority of feminine traits and values; thus, the celebration of a natural birth is
considered feminist action.
153
Instead of trying to erase differences, this type of feminism
promotes the values of femininity over the “death, violence, competition, selfishness” of
masculine values.
154
However, in a culture that remains overwhelmingly patriarchal,
gynocentric feminists encounter a catch-22; a celebration of femininity may look like a
denigrating reduction of women to their biology.
Equally problematic are analyses based on the assumptions of what Young calls
“humanist” feminism, which is more widely known as liberal feminism. This more
“mainstream” feminist theory, which holds that women must be granted equality under
the law, has been critiqued for erasing all differences between the sexes. In a patriarchal
society, such a strategy does little to challenge the superiority of masculine values. It
instead demands that women live up to those values to attain “equality.” Women, in
effect, must become just like men in order to compete. Clearly this framework does not

151
Adrienne Rich, Of Woman Born: Motherhood as Experience and Institution, (New York: W.W.
Norton and Company, 1986), 167, 176.
152
Ibid., 159-175.
153
Iris M. Young, “Humanism, Gynocentrism, and Feminist Politics,” In Theorizing Feminisms edited
by Elizabeth Hackett and Sally Haslanger, 174-187, (London, Oxford University Press, 2006), 178-79.
154
Ibid., 178.
45

easily map onto calls for natural birth; yet it provides the underlying logic for much
advocacy for “choice.” If the language of the most widely-held feminist beliefs still
implies a need to overcome biology, birth is a very difficult topic with which to engage.
Access to both abortion and birth control is, in a sense, about a woman’s ability to assert
technological control over her body and transcend the limits its natural inconveniences;
birth is, in many ways, quite different. Hence, discourses of liberal choice begin to seem
somewhat out of place in childbirth activism.
That being said, some women do want to utilize technology to transcend the body
during birth as well; these viewpoints should not be discounted. Davis-Floyd notes some
dissonance between feminist critiques of birth and responses of interview subjects. She
did not observe women operating blindly under a “false-consciousness waiting for the
feminist conversion.”
155
Some women, well versed in the available alternatives, want to
utilize birth technology, and they are not necessarily doing so because they have
somehow been tricked. Faye Ginsburg and Rayna Rapp indicate that some women feel
that to control their birth means to request and accept intervention.
156
MacDonald notes
that some women feel empowered even after a Cesarean section.
157
Additionally, Klassen
points out that critiques of birth in North America tend to decry paternalistic practices of
intervention; however, in many developing countries women routinely die because they
do not have access to the same technologies.
158
Feelings of empowerment are not

155
Davis-Floyd, Birth as Rite of Passage, 5.
156
Faye D. Ginsburg and Rayna Rapp, “The Politics of Reproduction,” Annual Review of
Anthropology, 20 (1991), 322.
157
MacDonald, The Field of Birth, 99.
158
Klassen, Blessed Events, 35.
46

immune from social construction; sometimes empowerment is perceived when reality
matches up reasonably well with expectation.
159
I will not go so far as to say that
empowerment is totally relative. What is important to keep in mind is that the meaning
and usefulness of power shifts depending on context.
Generally power is understood to be an ability to exert influence, control, or
dominance over others or the environment. Empowerment happens when one is granted
this power. For most scholars of birth, the definition is somewhat narrower; power is
found in alliances among women. Craven asserts that even “uneasy alliances” “can be
fruitful.”
160
Wagner similarly notes that coalitions can be successful in advocating for
birth rights “because the issues in maternity care transcend the usual group
boundaries.”
161
Implicit in both these statements is the notion that birth is an area of
concern and action where people who are not typically bound by mutual identification
aspire to share common ideas and reciprocate interests. Women who seek reproductive
justice in the realm of birth, particularly those who locate this justice in natural modes of
birth, may identify as feminist or conservative, religious or non-religious, Democrat or
Republican, survivalist or new-age. Believers may not easily fit into one another’s
categories. Birth, an event that is intimately connected with new beginnings, might
constitute the perfect ground on which to forge or renew communities. Despite rhetorics
that would label birth as a solitary trial, justice considerations place greater emphasis on
the communal aspects that birth both relies upon and creates.

159
Leavitt, Brought to Bed, 194.
160
Craven, Pushing for Midwives, 145
161
Wagner, Born in the U.S.A., 233.
47

Reproductive Freedom in Rhetoric
Since concerns of those who fight for women’s autonomy with regard to issues
such as abortion and birth control tie into the realm of birth, the next section overviews
work undertaken in all these areas in the field of rhetoric. The purpose of this section is
not to provide a comprehensive review, but rather to offer a sample of work centering on
reproductive justice to demonstrate assumptions and findings on these issues. General
themes are posited which ground the present project.
Reproductive justice is a topic where issues of abortion and birth control are
brought up in addition to others regarding birth. These issues constitute another “uneasy
alliance.” Rhetorical studies of reproductive justice present the trajectories of influence
that knit such topics into public discussion and questions of influence. Mary Lay, for
example, points out how the privacy protections of Roe v. Wade gave midwives hope that
they might enjoy expanded freedom to practice; instead, she shows how Roe set a
precedent that would limit women’s choices with regard to birth attendant and setting.
162

When works from the field of rhetoric analyze abortion rights and birth control rights
advocacy in relation to artifacts surrounding birth, complex concerns become seen as
tied. Rhetoric adds to the historical, sociological, or anthropological approaches that
provide structural, causal, or ethnographic explanations.
Rhetorical scholarship on issues of reproductive justice does support sociological
and anthropological perspectives that emphasize social construction; however, it is the
task of rhetoricians to analyze the means of this social construction by scrutinizing the
discursive artifacts that advocate ongoing risks and contingencies in which a variety of

162
Mary M. Lay, “Midwifery on Trial: Balancing Privacy Rights and Health Concerns after Roe v.
Wade,” Quarterly Journal of Speech 89, no. 1 (2003): 73.
48

acceptable practices have been justified, others questioned, and overall boundaries drawn.
Celeste Condit accomplishes this in great detail for the abortion controversy, in two
studies tracing the development of arguments over the span of two and a half decades.
163

She evinces ways in which differing rhetorical strategies changed the shape of the
controversy over time. In a very general sense, the present study offers a similar analysis
for controversy over birth. More specifically, in addition to attending to the “how” and
“what” of social construction, rhetorical studies centering on issues of reproductive
justice coalesce around general questions of influence and practice. For example, studies
highlight ways in which women’s voices and their ability to craft their own meanings
have been hindered; the ways in which rhetorical divides and dichotomies are built and
broken, and how they might be both useful and troublesome; and the ways in which
nature manifests as an organizing principle within debates over reproductive justice.
Troubles with Voice. Rhetorical analysis reminds us that the issue of birth is rife
with contradictions. For example, in an analysis of the Supreme Court’s 1973 Roe v.
Wade decision, Katie Gibson finds that the decision so widely touted as a feminist
victory is not really “feminist” at all. Instead, the rhetoric of the decision undermines
female agency and denies women a voice in their own healthcare.
164
In another analysis
of rhetorical contradiction, C. Wesley Buerkle explores the difficulties Margaret Sanger
encountered in trying to craft an identity for women apart from motherhood. He finds that
a tension exists in Sanger’s rhetoric “between framing women’s use of birth control as

163
Celeste Michelle Condit, Decoding Abortion Rhetoric: Communicating Social Change, (Urbana:
University of Illinois Press, 1990); Celeste Condit Railsback, “The Contemporary American Abortion
Controversy: Stages in the Argument,” Quarterly Journal of Speech 70 (1984): 410-424.
164
Katie L. Gibson, “The Rhetoric of Roe v. Wade: When the (Male) Doctor Knows Best,” Southern
Communication Journal 73, no. 4 (2008): 322.
49

self-liberation and women’s use of birth control as a maternal obligation.”
165
Vanessa
Murphree and Karla Gower also undertake a study of Sanger, and demonstrate how she
shifted away from radical and feminist arguments in her work with the National
Committee on Federal Legislation for Birth Control. To gain governmental support for
the feminist goal of legal contraception, Sanger made conservative arguments.
166
In these
studies, the voice of women is compromised in the interest of legislative progress.
Kim Hensley Owens also emphasizes the issue of women’s voices, in a rhetorical
look at childbirth. She argues that the shift of birth to the hospital results in “birthing
women’s rhetorical disability,” and shows how women use birth plans to preempt this
disability.
167
Kimberly Kline looks at the media voice given to midwives by analyzing
depictions of midwife-attended births on television. She finds depictions “misrepresent
the ideology that is the basis of the midwifery model.”
168
Midwife-attended births are
shown to be chaotic, midwives are depicted as mean and controlling, and ultimately
medicine swoops in to save the day reinforcing the superiority of the hospital birth.
169
In
a subsequent study of the same three shows, Kline argues that humorous aspects of these
depictions remove the possibility for meaningful dialogue by making a joke out of

165
C. Wesley Buerkle, “From Women’s Liberation to Their Obligation: The Tensions Between
Sexuality and Maternity in Early Birth Control Rhetoric.” Women and Language 31, no. 1 (2008): 32.
166
Vanessa Murphree and Karla K. Gower, “Mission Accomplished: Margaret Sanger and The
National Committee on Federal Legislation for Birth Control, 1929-1937,” American Journalism 25, no. 2
(2008): 25.
167
Kim Hensley Owens, “Confronting Rhetorical Disability: A Critical Analysis of Women’s Birth
Plans,” Written Communication 26, no. 3 (2009): 248.
168
Kimberly N. Kline, “Midwife Attended Births in Prime-Time Television: Craziness, Controlling
Bitches, and Ultimate Capitulation,” Women and Language, 30, no. 1 (2007): 28.
169
Ibid., 22-26.
50

midwifery.
170
In another study, Jane Marcellus describes how women’s voices were
absent from public discussions about birth control in the early part of the twentieth
century; thus, many women got their information from misleading advertisements for
black market birth control.
171
Women were denied a voice but granted consumer status.
The potential for women to have a meaningful voice in the realm of personal and public
reproductive justice has been, and remains, dubious. Taken together, these works
demonstrate how women’s voices are hindered, misrepresented, mocked, and
commodified. Such troubles with voice stem, at least in part, from the sorts of absolute
categories and boundaries imposed upon women.
Boundaries and Divides. Rhetorically, issues surrounding birth limit women’s
voices where disputes are rendered extreme. Impermeable boundaries are asserted and
contested between sides imposing ideal standards as governing dicta. Several studies of
abortion rhetoric point toward such boundaries. In the first, Randall Lake observes the
polarization of opposing pro-choice and pro-life sides of the abortion debate, and pursues
an “explanation for the intractability of the issue.”
172
He argues that anti-abortion rhetoric
manifests a system of deontological ethics, which dictates a clear and definite line
between absolute right and wrong; any person deviating from absolute right must be in
the wrong.
173
Lake further explores the extremes of abortion rhetoric as he shifts attention
to the ascent-descent pattern of Burkean Order in deontological anti-abortion rhetoric. A

170
Kimberly N. Kline, “Poking Fun at Midwifery on Prime-Time Television: The Rhetorical
Implications of Burlesque Frames in Humorous Shows,” Women and Language 33, no. 1 (2010): 54.
171
Marcellus, “Black Market Birth Control,” 22.
172
Randall A. Lake, “The Metaethical Framework of Anti-Abortion Rhetoric,” Signs: Journal of
Women in Culture and Society 11, no. 3 (1986): 479.
173
Ibid., 482.
51

woman’s failure to uphold what is morally “right,” via the sin of lust, leads her to fall
from good to evil.
174
Absolute systems of ethics and order make the rules for behavior
definite and unbending.
The result of contestation between absolutes unsettles, but may also be
productive. Marsha Vanderford explores dichotomous boundaries from a somewhat
different angle, also related to abortion, as she unpacks the ways in which both pro-life
and pro-choice advocates employ vilification strategies in their rhetoric. These strategies
entrench alienation felt between sides and solidify commitment within sides.
175
In other
words, sustained polarization achieves specific goals, although it also forecloses options
and makes conversation across difference difficult. In a study of disagreement among
Catholics over the Church’s birth control stance, Edward Lamoureaux shows how the
Church dealt with disagreement by rhetorically silencing any opposition.
176
This strategy
foreclosed the potential for “healing dialogue” and created the danger that dissenting
members would total disengage.
177

The construction and maintenance of strict divisions may be useful or even
necessary for various parties to achieve strategic goals. Critically it may be useful to take
steps to reach out and transverse such divisions. These strategies of bridging divides,
crafting alliances, and cultivating collectivity sometimes overcome differences. For
example, Jennifer Bone demonstrates how Margaret Sanger moved across the boundary

174
Randall A. Lake, “Order and Disorder in Ant-Abortion Rhetoric: A Logological View,” Quarterly
Journal of Speech 70, no. 4 (1984): 435.
175
Vanderford, “Vilification,” 178.
176
Edward Lee Lamoureaux, “Silence and Discipline: Catholic Voices and Birth Control.” Journal of
Communication and Religion 20, no. 2 (1997): 67.
177
Ibid., 76.
52

between private and public spheres through rhetoric of personal experience.
178
Tasha
Dubriwny argues for a model of collective rhetoric, also. She shows how public
vocabularies are created through “the collective articulation of multiple, overlapping
individual experiences” through an analysis of a Redstockings’ abortion speak-out.
179

The importance of collective rhetoric and collective solutions is indicated by these works.
In a study of hearings on the legality of midwifery in Minnesota, Mary Lay, Billie
Wahlstrom and Carol Brown observe that members of the Minnesota Midwives’ Guild
were able to dialog with the state to establish a discourse of “common good.”
180
In doing
so, however, they effectively silenced and disempowered midwives not belonging to the
Guild.
181
Thus, these studies argue the productive possibilities of working across
difference, yet also demonstrate that the most disempowered may be left behind in
moments of supposed cooperation.
The Meaning and Use of Nature. Issues of women’s voice and boundaries find
their way ultimately to questions of nature. Edward Schiappa believes nature to be
constituted by rhetoric. He highlights the epistemic dimensions of the ways in which
questions regarding “what is a person?” and “what is a human life?” are argued in court

178
Jennifer Emerling Bone, “When Publics Collide: Margaret Sanger’s Argument for Birth Control
and the Rhetorical Breakdown of Barriers.” Women’s Studies in Communication 33 (2010): 16-18.
179
Tasha N. Dubriwny, “Consciousness-Raising as Collective Rhetoric: The Articulation of
Experience in the Redstockings’ Abortion Speak-Out of 1969.” Quarterly Journal of Speech 91, no. 4
(2005): 396.
180
Mary M. Lay, Billie J. Wahlstrom, and Carol Brown, “The Rhetoric of Midwifery: Conflicts and
Conversations in the Minnesota Home Birth Community in the 1990s,” Quarterly Journal of Speech 82
(1996): 397.
181
Ibid., 398.
53

decisions on abortion rights.
182
Lake’s essay on the ethics of anti-abortion rhetoric
touches on nature as well; he demonstrates the deontological need among anti-
abortionists to save humans from their nature. Within this ethical framework, human
“nature” comprises immoral and evil tendencies toward sin.
183
Amy Sarch also looks to
the darker side of nature. She argues that early advertisements for feminine hygiene and
birth control framed the natural body as dirty, grotesque, and impure.
184
These “dirty ads”
were “cleansed” when science and medicine took over the contraceptive market.
185
Karen
Foss takes up the question of nature in her discussion of the Catholic Church’s official
position on birth control. Appeals to natural law have been central to the Church’s long
history of belief that any method of birth control—other than the rhythm method— is a
violation of nature.
186
Mary Lay analyzes a freestanding birth center, and finds that the
physical surroundings of the place help clients to “re-materialize their bodies—extricate
those bodies from cultural constructions as they recall how they experienced identifiable
sensations.”
187
Assumptions about the body’s natural ability to cope with pain and the
sort of environment that is conducive to a natural birth become evident through the
analysis. Taken together, these studies demonstrate how appeals to “nature” work as a

182
Edward Schiappa, “Analyzing Argumentative Discourse from a Rhetorical Perspective: Defining
‘Person’ and ‘Human Life’ in Constitutional Disputes Over Abortion,” Argumentation 14 (2000): 315-332.
183
Lake, “Metaethical Framework,” 489.
184
Amy Sarch, “Those Dirty Ads! Birth Control Advertising in the 1920s and 1930s,” Critical Studies
in Mass Communication. 14 (1997): 35.
185
Ibid., 39.
186
Foss, “Singing the Rhythm Blues,” 34.
187
Lay Schuster, “A Different Place to Birth,” 31.
54

flexible constitutive grounding for argument. Nature may be defined as deficient and foul
or pure and sacred.
In sum, the topics of concern are well-established. This study strives for an
extended rhetorical examination of reproductive justice by bringing together concern for
voice and the ability to make meaning, problems of boundaries and divides, and the uses
of nature to focus on the topic of birth and social justice as it develops over time. These
themes are provided with theoretical grounding and employed as the frameworks in the
chapters that follow.
Although questions of boundary, nature, and voice run through controversy
centering on birth throughout modern history, each theme has particular use for a specific
moment in time and case study. In the early days of political controversy over birth,
wherein midwives were being rapidly pushed out of the field of birth, the ability (or lack
of ability) to cross discursive boundaries and advocate on their own behalf was critical.
After the triumph of professional medicine, when women had little chance of avoiding
routine interventions of technology, the need to draw upon the oppositional resources of
nature and the body become evident. In the present moment, some of the former
problems appear at least partially solved; for example, barriers to speech are broken down
by relatively equal access to forums for expression on the internet, and problems of
technological control over the body—though still widespread—have been somewhat
ameliorated by more diverse options for where and how birth may happen. However,
struggle persists with regard to how women may give voice and meaning to their
experiences. The following section will provide some theoretical grounding for these
problems, which are to be explored in the coming chapters.
55

Negotiating Agency Amidst Tensions of Boundary, Nature, and Meaning
The tensions explored in this project have been hinted at by prior literature, but
not been explored in the context of birth. Each tension is a constructive force, shaping the
ways in which women are able to claim and exercise agency. In the midst of social
controversy over birth, which is socially constructed, centered on “choice,” and
characterized by highly-stressed allegiances and divisions, it is prudent to direct attention
to the sorts of large rhetorical sociopolitical tensions that help shape the meaning of these
characteristics. Thus, the present study frames ideas relating to discursive boundaries, the
rhetorical constitution of nature, and questions of voice and meaning particular to
women. In each case study, women attempt to claim power and act to shape the meaning
of birth via differing means which are highly dependent on context. However, I
ultimately contend that it is through a common consideration of Hannah Arendt’s
natality, across all cases, that we see a special, generative, sort of agency emerge from
the actions of birth, broadly defined. In the following section, I provide theoretical
grounding for the themes framed herein. Only a brief overview will be offered here, as
each individual chapter contains additional treatment of relevant theory.

Discursive Boundaries: The Public and Private Sphere
Rhetoricians find it useful to unpack discursive boundaries through analyses of
spheres. Two major trajectories comprise this work. First, scholars theorize the public
sphere as a means to talk about deliberation and political participation. This expands into
discussions of publics and counterpublics. Second, feminist scholars use the spheres
56

framework to analyze women’s oppression. In both trajectories, agency depends on the
ability to speak in the public sphere and move freely between spheres.
The Public Sphere. In the ancient Greek polis, citizenship was tied to public
oratory. To be free was to appear in public and speak about pertinent topics; to be
virtuous was to do so with skill and ethics. Only land-owning men were granted this
privilege. The Greek notion that rhetoric occurred in public to craft a better life remains
central to the field. John Dewey and Jürgen Habermas provide foundations for
rhetoricians’ modern understanding of the public sphere. To Dewey, the public comes
together via the recognition of “lasting, extensive and serious consequences” which they
have interest in controlling.
188
According to Dewey, the modern public is decimated for
several reasons: first, the public does not perceive consequences; second, the public is too
large; third, the public’s great size means it has little to hold it together; and fourth,
because of the preceding reasons, the public cannot identity itself and thus cannot
exist.
189
Dewey blames public decimation on a lack of communication, debate, and
dissemination of information.
190

Habermas also finds discourse the basis of the public. He presents an ideal speech
situation wherein people meet and speak as equals and persuasion and judgment depend
on the force of the better argument. To Habermas, the public sphere comprises “private
people coming together as a public” who use reason to undercut rule directed down from

188
John Dewey, The Public and Its Problems (Athens: Swallow Books/ Ohio University Press, 1954),
67, 126.
189
Ibid., 131, 126, 137, 185.
190
Ibid., 208.
57

above.
191
In the public sphere, decisions of consequence are contested and reason is based
on quality argument rather than personal status.
192
In the ideal speech situation, each
person has equal chance to initiate communication and contribute ideas and feelings.
193

Moreover, the public sphere is not a static; it changes as contestations over discursive
practice play out.
194
The public sphere is organized by discourse, which then shapes the
world.
195
Thus, the public is composed of ordinary citizens, brought together by
recognition of common need and consequence, built upon and sustained by the
changeable grounds of discourse directed toward action, and constitutive of the world.
Critiques and Counterpublics. Modern public sphere theory sparks resistance
from scholars who argue that it erases difference. Nancy Fraser argues that the public
sphere’s claim of rationality and hierarchy suspension itself is a means of distinction.
196

Only those with privilege and social power may imagine a space free from difference and
hierarchy; not everyone can leave difference at the door. Thus, Fraser theorizes
counterpublic space where marginalized individuals come together, deliberate, and
organize to engage with the wider public. Counterpublics, she argues, contest the

191
Jurgen Habermas, The Structural Transformation of the Public Sphere (Cambridge: The MIT Press,
1989), 27.
192
G. Thomas Goodnight, “Public Discourse.” Critical Studies in Mass Communication 4, no. 4
(1987): 431; Craig Calhoun, "Introduction: Habermas and the Public Sphere," In Habermas and the Public
Sphere, edited by Craig Calhoun, 1-50 (Cambridge: The MIT Press, 1992): 2.
193
Seyla Benhabib, "Models of Public Space: Hannah Arendt, the Liberal Tradition, and Jurgen
Habermas," In Habermas and the Public Sphere, edited by Craig Calhoun, 73-98 (Cambridge: The MIT
Press, 1992): 89.
194
Goodnight, “Public Discourse,” 431.
195
Michael Warner, “Publics and Counterpublics,” Quarterly Journal of Speech 88, no. 4 (2002): 414,
422.
196
Nancy Fraser, "Rethinking the Public Sphere: A Contribution to the Critique of Actually Existing
Democracy," In Habermas and the Public Sphere, edited by Craig Calhoun, 109-42 (Cambridge: The MIT
Press, 1992): 115.
58

exclusionary nature of the public, and provide a space to practice the skills necessary to
engage with this public. A framework of competing counterpublics provides more room
for participation and parity than a single public.
197

Fraser’s critique precipitated a host of theory centering on the potentially
democratizing uses of counterpublics in relation to the public. Warner argues that
counterpublics occupy a subordinate place in society, yet they circulate discourse in
much the same way as the dominant public.
198
Ronald Greene observes that
counterpublics do not simply seek to persuade the dominant public of their positions;
rather, counterpublics challenge the norms of the dominant public.
199
Catherine Squires
draws distinctions among publics more finely, differentiating between enclave, counter,
and satellite publics.
200
Scholars examine counterpublics as wide-ranging as those made
up of environmentalists, World Trade Organization protestors, Arab-Americans, and the
queer community, to name just a few.
201
In sum, counterpublics are an alternative public
space positioned against the public sphere, composed of individuals on the outskirts of

197
Ibid., 122.
198
Warner, “Publics and Counterpublics,” 424.
199
Ronald Walter Greene, “Rhetorical Pedagogy as a Postal System: Circulating Subjects through
Michael Warner’s ‘Publics and Counterpublics,’” Quarterly Journal of Speech 88, no. 4 (2002): 439.
200
Catherine R. Squires, “Rethinking the Black Public Sphere: An Alternative Vocabulary for Multiple
Public Spheres,” Communication Theory12, no. 4 (2002): 448.
201
Phaedra C. Pezzullo, “Resisting ‘National Breast Cancer Awareness Month’: The Rhetoric of
Counterpublics and their Cultural Performances,” Quarterly Journal of Speech, 89, no. 4 (2003): 347; Mark
Porrovecchio, “Lost in the WTO Shuffle: Publics, Counterpublics, and the Individual,” Western Journal of
Communication 71, no. 3 (2007): 236; David Kaufer and Amal Mohammed Al-Malki, “The War on Terror
through Arab-American Eyes: The Arab-American Press as a Rhetorical Counterpublic,” Rhetoric
Review28, no. 1 (2009): 47; Thomas R. Dunn, “Remembering Matthew Shepard: Violence, Identity, and
Queer Counterpublic Memories,” Rhetoric & Public Affairs 13, no. 4 (2010): 612.
59

power who encounter barriers to participation in the public sphere, built and sustained by
discourse directed toward action, and constitutive of alternative worlds.
Crossing Boundaries and the Private Sphere. Feminist scholars in rhetoric
assume that the divide between public and private spheres was historically used as a
justification to oppress women.
202
Furthermore, material differences between the spheres
are central to gender role formation. Campbell’s breakthrough work on early female
rhetors emphasizes important differences in women’s speech that stem from occupying a
different sort of space. She draws connections between characteristic suffrage-era
women’s public speech and material conditions of their confinement to the private
sphere, and derives a theory of feminine style.
203
Some elements of the style are personal
tone, reliance on personal experience, inductive structure, and engagement and
identification with the audience as peers.
204
Campbell argues that this style developed
because women’s education was centered on learning “the crafts of housewifery and
motherhood.”
205
Women’s use of this style made their appearance at the podium less a
violation; they acted like women while engaged in men’s activity.
Since Campbell introduced this sphere-based theory of women’s discourse, other
scholars have elaborated the idea of feminine style and modes of discourse derived from
private life. For example, Lisa Gring-Pemble argues that correspondence was a private
forum through which women developed public consciousness; therefore personal letters

202
G. Thomas Goodnight, “The Personal, Technical, and Public Spheres of Argument: A Speculative
Inquiry into the Art of Public Deliberation,” Argumentation and Advocacy 18 (1982): 217.
203
Karlyn Kohrs Campbell, Man Cannot Speak for Her: A Critical Study of Early Feminist Rhetoric.
New York: Greenwood Press, 1989, 13.
204
Ibid., 13.
205
Ibid., 13.
60

were a “transitional space” through which women moved into the public sphere.
206

Martha Hagan contends that female antisuffragists faced a rhetorical dilemma; their need
to speak in public against women’s suffrage conflicted with their desire to uphold
traditional private roles. In other words, they had to speak in public to argue that women
should not be speaking in public.
207

Other scholars apply the feminine style to contemporary politics. Bonnie Dow and
Mari Boor Tonn argue that prominent woman rhetors use the feminine style to
“feminize” the public sphere, which empowers women in general.
208
Conversely, Shawn
Parry-Giles and Trevor Parry-Giles argue that men co-opt the feminine style to reinforce
patriarchy in the public sphere.
209
In sum, the constructs of public and private spheres
provide scholars with fruitful tools to explore the ways in which women’s discourse has
been both constrained and enabled throughout history.
Discerning a clear and definite boundary between public and private would be
neither possible nor useful in a contemporary context. Because of this, some advocate
discarding “crude” distinctions between public and private in favor of the notion of
“gendered space.”
210
However, I reject the notion that we must throw out the entire
framework in favor of a variation that ultimately attempts to get hold of the same sorts of

206
Lisa Gring-Pemble, “Writing Themselves into Consciousness: Creating a Rhetorical Bridge
Between the Public and Private Spheres,” Quarterly Journal of Speech 84 (1998): 42-43.
207
Martha Hagan, “The Antisuffragists’ Rhetorical Dilemma: Reconciling the Private and Public
Spheres,” Communication Reports 5, no. 2 (1992): 73.
208
Bonnie J. Dow and Mari Boor Tonn, “Feminine Style’ and Political Judgement in the Rhetoric of
Ann Richards,” Quarterly Journal of Speech 79 (1993): 287
209
Shawn J. Parry-Giles and Trevor Parry-Giles, “Gendered Politics and Presidential Image
Construction: A Reassessment of the ‘Feminine Style,’” Communication Monographs 63 (1996): 338.
210
Mac Donald, The Field of Birth, 140.
61

things, namely, the ways in which women and men are differently enabled to act in
different sorts of environments. Without claiming that a set of essential rules exist, or that
complications do not persist, or making sweeping generalizations, it remains useful to
consider the dynamics of public and private tensions and the sorts of discursive
boundaries they create, particularly in historical contexts. In nineteenth and early-
twentieth century artifacts, the spheres divide definitely has not lost its usefulness as an
analytical framework. Of course, we can add new ideas to the framework to present a
novel take on the gendered rhetorical dynamics of this era. Questions of rhetorical
barriers to speech, and the different ways marginalized groups attempt to break or
transcend these barriers are central to Chapter Two of this project. In the case to be
examined, a small group of late-nineteenth century midwives attempt to make their voice
heard in The American Midwife.

Natural Tensions: Technology and Biopower
Whether birth is a biological function or a pathological event by nature is a
fundamental and enduring disagreement. Histories of birth show that these disagreements
are rhetorically shaped over time. Rhetorical scholars, who analyze the pervasive
influence of science and technology in society, and particularly phenomena of
medicalization, tend to draw upon tools of discourse and biopower; Michel Foucault’s
theory of biopower heavily informs such works.
Discourse, Knowledge, and Power. Foucault’s emphasis on discourse makes him
popular among rhetoricians. Yet, his conception of circular power and the little room he
leaves for resistance troubles those concerned with agency in a more traditional rhetorical
62

sense. To Foucault, discourses are bodies of knowledge that shape the world. They are
communicated via speech, but also comprise normative ways of thinking or organizing
the world. Power operates through discourse and is like a web that exists everywhere;
rather than a means of top-down control, it is a productive force that captures and brings
individuals into its many structures. Power does not come from a central point; it moves
through relationships of inequality.
211
Foucault writes, “Power is everywhere; not
because it embraces everything, but because it comes from everywhere.”
212
Accordingly,
he directs attention and criticism to various forms of subjugated or everyday
knowledge.
213

Humans all exist within and participate in complicated and interconnected
systems of power relations. Hence, Foucault makes it difficult to imagine mass resistance
or movements. Instead, resistance in Foucault’s scheme looks a lot like highly
individualized forms of third-wave feminist activism—such as “building a feminist self-
identity”—described by Stacey Sowards and Valerie Renegar.
214

Biopower assumes “the body [is] an object and target of power.”
215
Foucault
theorizes “docile” bodies which are subjected, used, transformed, improved, explored,
broken down, and rearranged.
216
He describes the rise of biopower as “the emergence, in

211
Michel Foucault, The History of Sexuality: An Introduction (New York: Vintage Books, 1990), 93.
212
Ibid., 93.
213
Michel Foucault, “Two Lectures,” In Power/Knowledge: Selected Interviews and Other Writings
1972-1977 edited by Colin Gordon, 78-108 (New York: Pantheon, 1980): 82.
214
Stacey K. Sowards and Valerie R. Renegar, “Reconceptualizing Rhetorical Activism in
Contemporary Feminist Contexts,” The Howard Journal of Communication 17 (2006): 63-64.
215
Michel Foucault, Discipline and Punish: The Birth of the Prison (New York: Vintage Books, 1995):
136.
216
Ibid., 136-38.
63

the field of political practices and economic observation, of the problems of birthrate,
longevity, public health, housing, and migration.”
217
Furthermore, this emergence was
coupled with “an explosion of numerous and diverse techniques for achieving the
subjugation of bodies and the control of populations.”
218
Biopower makes all life part of
an explicit calculation.
219
Modern medicine, along with other institutions, utilizes and
maintains biopower.
220
Elements central to biopower include control of time, subjugation
of the mind, and management and transcendence of biological imperatives.
221
These
elements are explored in Chapter Three.
Biopower in Reproduction. The rise of professional medicine provides artifacts
for understanding the mechanisms of biopower. In Foucault’s analysis of the modern
medical facility he finds that “One began to conceive of a generalized presence of doctors
whose intersecting gazes form a network and exercise at every point in space, and at
every moment in time, a constant, mobile, differentiated supervision.
222
The power of the
clinic rests upon the inspecting gaze of expert doctors charged to observe the intricacies
of the body in detail. Clinical observances scientized and mathematized body processes.
At the same time, humans began to see themselves as objects of science and consider
their own existence part of the knowledge and discourse of medicine.
223

217
Foucault, History of Sexuality, 140.
218
Ibid.
219
Ibid., 143.
220
Ibid., 141.
221
Foucault, Discipline and Punish, 149-160; Michel Foucault, The Birth of the Clinic: An
Archaeology of Medical Perception (New York: Vintage Books): 197.
222
Foucault, Birth of the Clinic, 31.
223
Ibid., 197.
64

Other scholars examine specific manifestations of biopower in medicine and
reproduction. For example, Nathan Stormer argues that Foucauldian analysis illustrates
how reproduction is disaggregated from women’s bodies. Conversely, he contends that
textual analysis limits the analysis of “ever-expanding prenatal space.”
224
Kevin Kuswa,
Paul Achter and Elizabeth Lauzon argue that the ways in which legislators exert
biopower over pregnant women to limit access to abortion parallels ways in which
slaveholders exerted biopower over slaves.
225
Additionally, Catherine Waldby and
Melinda Cooper argue that in vitro fertilization is a form of reproductive biopolitical
rearticulation.
226
All find reproduction to be a biopolitical realm.
Foucault provides language which describes the contexts and events of modern
medicine in critically satisfying ways. However, unlike Stormer, I advocate for continued
attention to texts of birth in addition to more post-modern analyses. While attention to
texts may simplify the complexities of biopolitical control, this simplification has an
important purpose that must not be overlooked. For example, in natural birth narratives,
women encapsulate their experiences and cogently put them to work combatting
biopower. A more fragmented and individualized analysis, while certainly useful for
other reasons, would miss the impact of concerted group action. Thus, questions of how
science and technology rhetorically constitute the body, and the means by which it is
possible to resist this constitution, are central to Chapter Three of this project. Amidst the

224
Nathan Stormer, "Mediating Biopower and the Case of Prenatal Space," Critical Studies in Media
Communication 27, no. 1 (2010): 21.
225
Kevin Kuswa, Paul Achter and Elizabeth Lauzon, “The Slave, the Fetus, the Body: Articulating
Biopower and the Pregnant Woman,” Contemporary Argumentation and Debate 29 (2008): 173.
226
Catherine Waldby and Melinda Cooper. "The Biopolitics of Reproduction: Post-Fordist
Biotechnology and Women's Clinical Labour." Australian Feminist Studies 23, no. 55 (2011): 58.
65

total victory of hospital-centered birth, women claim agency as they craft an alternative
path through narratives.

Voice and Symbols: The Power to Make Meaning and Define
In contrast clinical exertion of power on the body, women assert agency by using
their own voices to make meaning. Battles between women and the professional medical
industry hinge on women’s ability to symbolically define and construct their own
experiences of birth. Strategies like appropriation, definition, association and dissociation
contribute to construction and contestation of meaning in these contexts.
Constructed and Contested Meaning. Helene Shugart writes that discursive
appropriation is “The claiming, by an individual or group, of another’s meanings, ideas,
or experiences to advance the individual or group’s belief’s ideas, or agenda.”
227
When
language is appropriated, original meanings are often deconstructed, distorted, or
destroyed.
228
Appropriation tends to involve redefinition of key terms to change meaning.
David Zarefsky points out that the way a thing is defined or named is an argument for
how the thing should be viewed.
229
Schiappa contends that definitions provide insight
into the ways social knowledge is rhetorically constituted. Furthermore, definitions are
“both the product of past persuasion and a resource for future persuasion.”
230
Thus, the

227
Helene Shugart, “Counterhegemonic Acts: Appropriation as a Feminist Rhetorical Strategy,”
Quarterly Journal of Speech 83 (1997): 211.
228
Ibid., 211.
229
David Zarefsky, “Strategic Maneuvering though Persuasive Definitions: Implications for Dialectic
and Rhetoric.” Argumentation 20, no. 3 (2008): 404.
230
Edward Schiappa, Defining Reality: Definitions and the Politics of Meaning (Carbondale: Southern
Illinois University Press, 2003), 167.
66

meaning of terms and ideas is actively and intentionally crafted by individuals and groups
and used for directed purposes.
Others frame contests over meaning in terms of association and dissociation.
Chaim Perelman and Lucie Olbrechts-Tyteca explain the usefulness of argumentative
association. They write that association is a “[scheme] which bring[s] separate elements
together and allow[s] us to establish a unity among them, which aims either at organizing
them or evaluating them, positively or negatively, by means of one another.
231

Conversely, dissociation is a “[technique] of separation which [has] the purpose of
dissociating, separating, disuniting elements which are regarded as forming a whole or at
least a unified group within some system of thoughts.”
232
Perelman elaborates on
dissociation, which he describes as “separating elements which language or a recognized
tradition have previously tied together.”
233
When people encounter incongruities between
meaning and reality, they resolve them by dissociating and reorganizing data.
234

Perelman argues:
When, faced with the incompatibilities that ordinary thought encounters, a person
does not limit himself to conjuring away the difficultly by pretending not to see it,
but instead tries to resolve it in a theoretically satisfying manner by reestablishing

231
Chaim Perelman and Lucie Olbrechts-Tyteca, The New Rhetoric: A Treatise on Argumentation
(Notre Dame, University of Notre Dame Press, 1969), 190.
232
Ibid., 190.
233
Chaim Perelman, The Realm of Rhetoric (Notre Dame: University of Notre Dame Press, 1982), 49.
234
Ibid., 52.
67

a coherent vision of reality, he will most often attain such a resolution by a
dissociation of the ideas accepted at the start.
235

People tend to dissociate when philosophical pairs cease to correlate: when appearance
does not match with reality, opinion does not match with truth, or name does not match
with thing named.
236
In sum, persuasive agency is found in the ability to symbolically put
together and take apart ideas and meanings in the interest of painting the world in a
particular way and convincing others see it as such.
Burkean Dramatism. Kenneth Burke is the most prolific scholar of this sort of
symbolic maneuvering. His theory of dramatism centers on the human capacity and
desire to act through symbolic processes of meaning-making. To Burke, humans operate
within large frameworks of symbols, through which events and acts come to hold
meaning. Frameworks are “terministic screens” that both direct attention and shape
observation.
237
These screens work to reflect, select, and deflect reality.
238
Frameworks
imply “pieties,” or a “sense of what properly goes with what.”
239
Furthermore, Burke
argues that frames amplify; every small element connects with the whole. Thus, he
writes, “the questioning of a little becomes amplified into the questioning of a lot, until a
slight deviation may look like the abandonment of all society.”
240
The familiarity of a

235
Ibid., 126.
236
Ibid., 134.
237
Kenneth Burke, Language as Symbolic Action (Berkeley: University of California Press, 1966), 50.
238
Ibid., 45; Kenneth Burke, A Grammar of Motives (Berkeley: University of California Press, 1969),
59.
239
Kenneth Burke, Permanence and Change (Berkeley: University of California Press, 1984), 74.
240
Kenneth Burke, Attitudes Toward History (Berkeley: University of California Press, 1984), 103
68

symbolic frame and the suasion of piety limit the meanings humans are able to make and
comprehend.
Encounters with experiences or phenomena unexplainable in the existing frame
prompts new forms of sense-making. Burke argues that an old frame may be made to
accommodate new meanings via “casuistic stretching.”
241
A. Cheree Carlson argues that
female leaders in the moral reform movement casuistically stretched the frame of the
feminine ideal, and engaged in traditionally masculine activities to achieve a conservative
goal.
242
Rhetors may combine the new with the old to stretch the bounds of accepted
conduct.
Burke highlights “the stealing back and forth of symbols” as another strategy for
reshaping meaning.
243
During this practice, a Burkean version of appropriation, new
symbols are brought in and redefined to reinforce a threatened frame. For example, when
women became disillusioned with hospital birth, hospitals began offering courses in
natural birth which socialized women to the routines of the hospital. Hospitals used the
name “natural” strategically, to frame the courses in a particular way, and the frame of
medical birth endured. The frame was stretched to accommodate new meanings, and
symbols were stolen and redefined, offering new names for old practices along with a
reinforced frame. These practices are part of Burke’s larger theory of human symbol use.
Much of what Burke has to offer in terms of agency relates to the counterpart
notions of identification and division. In one sense, identification is necessary for humans

241
Ibid., 23.
242
A. Cheree Carlson, “Creative Casuistry and Feminist Consciousness: The Rhetoric of Moral
Reform,” Quarterly Journal of Speech 78 (1992): 17.
243
Burke, Attitudes, 103.
69

to express the fundamentally human drive to act together.
244
In another sense, if an
individual is too closely identified with a particular frame or another person, their ability
to act is inhibited and action becomes motion. At the same time, total division makes
action impossible, because a person divided from all others lacks the ability to begin
communicating or acting. Thus, Burke says, “put identification and division ambiguously
together, so that you cannot know for certain just where one ends and the other begins,
and you have the characteristic invitation to rhetoric” and action.
245
Struggles over
meaning constrain and enable identification and action, and are central to Chapter Four of
this project. In this case, some women redefine their birth experiences as “birth rape”
while others vehemently resist this definition. Here, women’s attempts to claim agency
center on the ability to frame and describe their experiences in the ways they see fit.

Arendtian Benefits and Limitations
Ultimately, I contend that tensions over rhetorical boundary, appeals to nature,
and contested meaning—which have long preoccupied rhetorical scholars—are central to
unpacking agency in the realm of birth. However, I also contend that it is necessary to
take a small step beyond what others have done and incorporate a theory of action that is
particularly suited to contexts of birth. Thus, I posit Arendtian natality as a productive
way to converse with, complicate, and contend the notions surveyed here. Critiques of the
public sphere, biopower, and dramatistic strategies are useful, but limited; natality
connects the full range of topics discussed by critics and advocates who unite questions

244
Kenneth Burke, A Rhetoric of Motives (Berkeley: University of California Press, 1969), 21.
245
Burke, Rhetoric, 25.
70

of social justice with discourses of birth. Hence, the remainder of this project puts natality
in conversation with these other theoretical trajectories. Natality finds significance as a
perspective that explains how bodies and words are born and reflexively interpreted and
understood.
One limitation of Arendt, particularly in the context of this study, is her near-total
blindness to gender. Given her focus on natality, this absence is striking. In a sense, it is
disheartening to read Arendt’s work and note that she locates action in the moment when
someone is born, not when someone births. Indeed, in Arendt’s writing, the pre-social
polis where agents are born to one another as they appear in public and speak and act is
made possible because of “women and slaves” who labored in private to make and keep
the home.
246
Thus, while I argue that a more-than-metaphorical connection between birth
and action exists in terms of the cases to be analyzed, in Arendt’s writing the connection
seems sadly just a metaphor, and an ironic one at that. Men are born as actors only
because women keep the birthing at home. This gender-related puzzlement in Arendt, I
contend, provides a dynamic tension from which to launch the remainder of the study.
Hence, in addition to using Arendt as a supplement to other theory and a connecting
thread between cases of birth advocacy, I will use the cases of birth advocacy to begin a
feminist revisioning of Arendt. I will strive to push natality beyond its status as a
metaphor, to explore the agency that actually happens through women’s bodies without
reducing women to their bodies. Arendt’s theory provides for a vision of agency that is at
once political and biological, even if she did not fully articulate as much. The selected

246
Arendt, Human Condition, 72.
71

case studies provide ample opportunity to comment on both the benefits and limitations
of an Arendtian approach to action.

Preview of Chapters to Come
In the following pages, I will analyze what I have determined to be three critical
moments within the long-spanning rhetorical movement and controversy centering on
birth. These case studies are drawn from different historical periods, and represent
turning points in the timeline of birth advocacy. At the same time, and more importantly,
these case studies are chosen because of the specific sorts of rhetorical phenomena they
illustrate. Each case study gives expression to a different theoretical trajectory in
conversation with natality, and thus each provides a different view into how the
beginnings of birth can provide the necessary rhetorical tools for the beginnings of action.
In Chapter Two, I examine the late nineteenth-century publication The American
Midwife. This short-lived journal, published in 1895-96, immediately preceded the
ramping-up of the campaign against midwives in the medical journals of the time. The
American Midwife is the only known professional midwife journal of its era; thus, its
significance as a yet-unstudied rhetorical artifact should not be understated. To this point,
only a few short paragraphs of commentary have been devoted to this immensely
interesting piece of the history of birth in this country.
247
In this chapter, I demonstrate
how the issue and problem of women speaking in public might be understood within a
framework of natality. I argue that a dialogue between physicians and midwives offered
the beginning of a rhetorical path forward that circumvented a restrictive discursive and

247
Litoff, American Midwives, 39-41.
72

practical dichotomy that was being established by leading obstetricians and which left no
place for midwife practice.
In Chapter Three, I analyze natural birth stories drawn from two anthologies of
narratives: Janet Schwegel’s Adventures in Natural Childbirth: Tales from Women on the
Joys, Fears, Pleasures, and Pains of Giving Birth Naturally, and Ina May Gaskin’s Ina
May’s Guide to Childbirth. The narratives span from the early 1970s through the early
2000s. Schwegel’s book contains a collection of around 40 narratives from individual
women who have given birth naturally with either a midwife, a doula, a physician, or
alone; and Gaskin’s book contains numerous narratives from women who gave birth to
their babies either at home or on a commune called The Farm, located in rural Tennessee.
In this chapter, I outline the ways in which natality provides theoretical dimensions
through which to understand resistance to the biopower of mainstream medicine. I argue
that the narratives begin to enact a posture of political natality, through expressions of
time, subjectivity, and biology, which subverts biopolitical control.
In Chapter Four, I explore the ways in which birth advocacy takes shape in the
present by looking to online debates surrounding women’s bad birth experiences.
Specifically, I focus on controversy centering on the particularly agitative phrase, “birth
rape.” The debate over this term provides a window into how the meaning of birth is
contested on the internet, and demonstrates the shape of online birth activism to come. In
this chapter, I show points of agreement between the ideas of Kenneth Burke and
Arendtian natality, and integrate natality into an analysis of contested meaning.
Specifically, I argue that by naming their experiences “birth rape,” women claim the
agency to understand the events of their birth in new and potentially liberating ways.
73

In Chapter Five, I seek to elaborate on the significance of these case studies by
drawing implications from their comparison. By looking to the ways in which birth
activism has developed over the course of the past hundred years, we can draw
conclusions relating to both the efficacy of activism and to the potential for cultivating
agency within the contexts of birth as homo natal. Furthermore, I discuss directions for
continued and future research in the general area of birth, as the present study
unfortunately yet necessarily neglects many important dimensions of the controversy.

74

Chapter Two
Resisting the Dual Standard: The Medical Public and the Potential for Natality in
The American Midwife

The late nineteenth and early twentieth centuries were marked by intense debates
over healthcare that corresponded with dramatic changes in practice. Developments in
understandings of disease and its spread, and in novel surgical procedures, rapidly were
changing the face of medicine in the United States. Along with these developments came
major changes in the practice of childbirth and the growing field of obstetric medicine. At
the time, most births took place in the home, and most were attended by a midwife.
248

However, as medicine became increasingly professionalized, the midwife gradually was
replaced by the obstetrician, and births moved from the home into the hospital. Several
thorough histories of these shifts exist; however, scholars disagree about the nature of and
reasons for the changes. Some argue that an overt and sexist takeover by male doctors led
to the midwife’s demise.
249
Others, however, diffuse blame. Judith Walzer Leavitt
explains that expectant mothers chose to invite male doctors into their birthing rooms
because they perceived them to be more knowledgeable and able to make both mother

248
See, for example, Charlotte G Borst. Catching Babies: The Professionalization of Childbirth 1870-
1920. (Cambridge: Harvard University Press, 1995); Neal Devitt, “The Transition from Home to Hospital
Birth in the United States, 1930-1960.” Birth and the Family Journal 4, no. 2 (1977); Francis E. Kobrin,
“The American Midwife Controversy: A Crisis of Professionalization,” Bulletin of the History of Medicine
40, no. 4 (1966); Richard W. Wertz and Dorothy C. Wertz, Lying-In: A History of Childbirth in America
(New York: The Free Press, 1977).
249
Barbara Ehrenrich and Diedre English. Witches, Midwives and Nurses: A History of Women
Healers. 2nd ed. (New York: The Feminist Press, 2010), 28; G. J. Barker-Benfield, The Horrors of the
Half-Known Life: Male Attitudes toward Women and Sexuality in Nineteenth-Century America (New
York: Harper and Row, 1976), 61.
75

and baby safer.
250
Richard Wertz and Dorothy Wertz agree, stating that women simply
stopped choosing midwives as caregivers.
251
Deborah Sullivan and Rose Weitz indicate
that a burgeoning faith in science in the late 1800s contributed to this rejection of
midwives.
252
Charlotte Borst attributes the shift to the lack of a professionalization
strategy among midwives.
253
Of course these reasons are not mutually exclusive. A
variety of social, political, economic and cultural factors converged, around the turn of
the century, to encourage hospital births and nearly eliminate midwifery.
Still, many scholars seem to agree that, in the midst of changing social and
cultural conditions, midwives did not simply fail to professionalize; but never really
tried.
254
One turn-of-the-century journal, however, provides evidence to the contrary.
Hence, one purpose of this chapter is to counter claims that midwifery nearly
disappeared, replaced almost completely by physician-attended hospital birth, due to
apathy. To do so, this chapter will examine the unique and important professionalizing
efforts of The American Midwife.
It is important to note that professional physicians and other expert voices at the
turn of the twentieth century heatedly debated over how best to improve a perceived low
standard of midwife care. This was in spite of the fact that, by today’s standards, birth
outcomes were universally and equally bad among both midwives and doctors, with

250
Judith Walzer Leavitt, Brought to Bed: Childbearing in America 1750-1950 (New York: Oxford
University Press, 1986): 39.
251
Wertz and Wertz, Lying-In, 48.
252
Deborah A. Sullivan and Rose Weitz. Labor Pains: Modern Midwives and Homebirth. (New
Haven: Yale University Press, 1988), 9.
253
Borst. Catching Babies, 5.
254
Ibid., 4-5; Wertz and Wertz, Lying-In, 47; Kobrin, “The American Midwife Controversy,” 362-63.
76

some research suggesting that midwives produced better outcomes.
255
This debate played
out largely in major medical journals. Physician arguments can be grouped into two
primary camps. On one side of the debate were those who thought midwives wholly
unnecessary, and who wanted to dispense with them immediately.
256
On the other were
those who thought midwives a necessary, but temporary, evil, and who wanted to train
and license them.
257
Many variations upon these basic positions exist, but the central
dispute was whether educating and licensing midwives would improve the situation, by
allowing for monitoring and control, or make it worse by legitimizing their status,
thereby entrenching a “dual standard” of obstetric care. Doctors vehemently opposed this
alleged dual standard by showcasing the latest in scientific medical advancements and
casting midwives as ignorant, unclean relics. There was no pro-midwife side of this
debate, as both sides ultimately wanted midwives gone; they simply disagreed over when
and how to best accomplish this. Some favored legislation and legal action.
258
Others

255
J. Whitridge Williams, “Medical Education and the Midwife Problem in the United States,” Journal
of the American Medical Association 58, no. 1 (1912): 7.
256
Ibid.
257
See, for example, C. S. Bacon, “Failures of Midwives in Asepsis,” Journal of the American
Medical Association 28, no. 6 (1897): 247-249; C. S. Bacon, “The Midwife Question in America,” Journal
of the American Medical Association 28, no. 6 (1897): 1089-1093; James A. Egan, “The Midwives of
Chicago,” Journal of the American Medical Association 50, no. 20 (1908): 1622; Josephine S. Baker,
“Schools for Midwives,” The American Journal of Obstetrics and Diseases of Women and Children 65, no.
2 (1912): 256-270; Clara D. Noyes, “The Training of Midwives in Relation to the Prevention of Infant
Mortality,” The American Journal of Obstetrics and Diseases of Women and Children 66, no. 6 (1912):
1051-1059; Ira S. Wile, “Immigration and the Problem of the Midwife,” Boston Medical and Surgical
Journal 167, no. 4 (1912): 113-115; Edmond F. Cody, “The Registered Midwife: A Necessity,” Boston
Medical and Surgical Journal 168, no. 12 (1913): 416-418; A. K. Paine “The Obstetrical Problem of the
Poor,” Boston Medical and Surgical Journal 169, no. 4 (1913): 121-123; A. K. Paine “The Midwife
Problem,” Boston Medical and Surgical Journal 173, no. 21 (1915): 759-764; J. Clifton Edgar, “The
Education, Licensing, and Supervision of the Midwife,” The American Journal of Obstetrics and Diseases
of Women and Children 73, no. 3 (1916): 385-399; J. M. Baldy, “Is the Midwife a Necessity?” The
American Journal of Obstetrics and Diseases of Women and Children 73, no. 3 (1916): 399-407.
258
See, for example, “The Midwife,” Journal of the American Medical Association 50, no. 17 (1908):
1354; Egan, “Midwives of Chicago,” 1622.
77

thought that only a public relations campaign to educate people about the science of
proper obstetric care would be effective.
259

These spirited debates carried heavy weight; these men had the power to affect
legislation and policies of developing medical boards, thereby shaping the whole future
of medicine in the United States. Around the turn of the century, professional medicine
was organizing rapidly and laying out national standards for licensing and care. Major
organizations, such as the National Confederation of State Medical Examining Licensing
Boards, established in 1891, and the American Confederation of Reciprocating
Examining and Licensing Boards, established in 1902, were crafting policy and deciding
who could practice, and how. In 1912, these two organizations combined to form the
Federation of State Medical Boards (FSMB), which is still in charge of all medical
licensing in the United States today.
260
At precisely the same time, knowledge from an
extensive study known as the “Flexner report” was spreading across the nation,
profoundly impacting the nature of medical education. Funded by the Carnegie
Foundation, schoolmaster and educational theorist Abraham Flexner visited all 155
medical schools in the United States, and reported on the quality of each.
261
The report
criticized many schools as low-quality “diploma mills,” and advocated that medical
education be standardized. Following this report, many schools merged or closed their

259
See, for example, Emmons and Huntington, “A Review,” 260-61; Williams, “Medical Education,”
6; Moran, “The Endowment,” 126.
260
“FSMB History,” Federation of State Medical Boards http://www.fsmb.org/centennial/history.html.
261
Andrew H. Beck, “The Flexner Report and the Standardization of American Medical Education,”
Journal of the American Medical Association 291, no. 17 (2004): 2139.
78

doors altogether. Within twenty-five years, the number of medical schools in the United
States had been reduced by more than half.
262

In the midst of this increasing organization and scrutiny, medicine also was
becoming increasingly specialized. Among the developing specialties, obstetricians had a
particularly difficult time establishing their legitimacy. Many bemoaned this state of
affairs in the medical journals, and blamed it on midwives.
263
Because midwives were
attending a majority of births in the United States, and because birth still was regarded
largely as a naturally-occurring physiological event, male physicians whose expertise
centered in this field often were considered to be a lesser class of doctor; they even were
disparaged as “male midwives.”
264
In this light, it is not difficult to understand doctors’
desire to pathologize birth and find reasons for medical intervention. Obstetricians had to
prove their legitimacy to their peers, which apparently was difficult so long as midwives
were around. If physicians could get rid of midwives, they would have a clear and
necessary place in the medical community.
Running counter to this tidal wave of overt attempts to discredit and dispense with
midwives, one publication made a serious attempt to provide both a space for midwives
to enter into medical dialogue with doctors and a means of improving upon midwife

262
Mark D. Hiatt and Christopher G. Stockton, “The Impact of the Flexner Report on the Fate of
Medical Schools in North America After 1909,” Journal of American Physicians and Surgeons 8, no. 2
(2003): 37-40; numerous sources cite the impact of the Flexner report, both short- and long-term. The study
cited here seeks to quantify the effects of the report to determine whether school closings were directly
caused by Flexner. The authors indicate that “Between 7 and 22 percent of schools may have closed or
merged because of what Flexner wrote” (39). Despite the uncertainty regarding direct causality, the lasting
professional and cultural impact of Flexner, as part of a broader context of changes in the medical field, is
undeniable. It is important to note, also, that the report disproportionately hurt women and African-
Americans, as the closing of schools and decreased applicant pool led to a nearly all-out banning of these
populations, who previously had been enjoying increased access to education.
263
DeLee, “Progress,” 410; Moran, “The Endowment,” 125-26.
264
Ibid., 126.
79

education. This chapter will detail the rhetoric of a professional journal that was a
singular voice of advocacy in opposition to the campaign against midwives. The
American Midwife was no utopian, midwife-created, -written, and -published space for
discourse. In reality, the journal was created, edited, and written in large part by male
doctors. Significantly, however, the journal provided a forum for midwives to enter into
intelligent dialogue and discussion with physicians on relatively equal terms. I argue that
this conversation showed the potential to resist the dominant narrative, developing among
physicians, of a “dual standard” of care, a narrative that excluded midwives from the
medical community. However, this conversation was short-lived; over the course of the
journal’s brief twelve-issue lifespan, we see a transformation of content and purpose that
is indicative of the contextual constraints of the time. In what follows, I briefly detail
obstetrician arguments, drawn directly from late-nineteenth and early-twentieth century
medical journals regarding the dual standard, and discuss the connection between these
arguments and prior analyses centering on gender and spheres of discourse. To get a
well-rounded picture of the debate, I reviewed all articles on the subject of midwives
from three major medical journals: The American Journal of Obstetrics and Diseases of
Women and Children, the Journal of the American Medical Association, and the Boston
Medical and Surgical Journal (which later became the New England Journal of
Medicine.) Then, I discuss theory centering on the public sphere, putting Hannah
Arendt’s theories of natality and the public sphere into conversation with other notions of
publics. Next, I analyze The American Midwife to demonstrate how the publication
illustrates both the potential and limitations of this theory. It is my contention that public
sphere theory provides the tools needed to speculate why The American Midwife failed to
80

create a solid foundation for midwife advocacy, and to imagine ways in which it might
have better served the interests of midwives. Finally, I provide some concluding thoughts
about the efficacy of the journal.

The Medical Public and the Dual Standard of Care
At this historical point in the overall timeline of birth advocacy, issues and
tensions regarding public and private spheres are brought to the forefront. Engaging in
lively debate through writings in scholarly journals and medical magazines, professional
physicians held a monopoly on scientific knowledge. Doctors lauded medical advances
and reported the latest scientific discoveries and procedures, while simultaneously
dismissing midwives as suitable only in cases of natural labor.
265
Physicians hailed
progress in aseptic
266
practices and derided midwives as being unclean.
267
They spread
knowledge of the latest in surgical intervention, including the Caesarian section,
symphyseotomy,
268
craniotomy,
269
and embryotomy,
270
while emphatically arguing that
no midwife ever could be qualified to perform even the simplest of medical

265
“A Much Needed Reform Begun,” Journal of the American Medical Association 26, no. 18 (1896):
884.
266
Disinfecting to standards of surgical sterility.
267
C. S. Bacon, “Failures of Midwives in Asepsis,” Journal of the American Medical Association 28,
no. 6 (1897): 248.
268
Dislocating the pubic bones to widen the pelvis, to create more room for the baby to emerge.
269
Crushing of the fetal skull to aid in extraction of a dead fetus.
270
Dismembering a fetus to aid in extraction.
81

procedures.
271
Even the most commonly-wielded obstetric instrument, the forceps, was
off-limits to the midwife.
272
As scientific advancements burgeoned and physicians
increasingly managed births, doctors argued that birth was pathological rather than
natural. They surmised that normal physiological parturition was the exception rather
than the rule.
273
One physician justified this view by explaining that, while poverty and
vice stunt the poor, luxury enfeebles the rich, which makes both classes pathological
specimens incapable of anything but pathological labor.
274
If birth was pathological, it
made sense to transition care from midwife to doctor, and home to hospital; pathology
necessitates medical attention. Physicians advocated educating the public to the
superiority of hospital birth,
275
called for more hospitals to be built,
276
and suggested
replacing midwife and home care with physician care at state-sponsored maternity
hospitals.
277

In stark contrast to the modern physician practicing science in a state-of-the-art
hospital, the midwife practiced homeopathic superstition in an unclean, unsafe home.
This ideological dichotomy is the foundation upon which physicians built their “dual

271
Z. Lincoln Whitmire, “Infant Mortality During Labor and its Prevention,” Journal of the American
Medical Association 28, no. 7 (1897): 293; Arthur Brewster Emmons and James Lincoln Huntington, “A
Review of the Midwife Situation,” Boston Medical and Surgical Journal164, no 8 (1911): 258.
272
John F. Moran, “The Endowment of Motherhood,” Journal of the American Medical Association
64, no. 2 (1915): 123.
273
Ibid., 126.
274
Edward P. Davis, “Modern Obstetrics, with Relation to the General Practitioner, the Student, the
Midwife, and the Specialist,” Journal of the American Medical Association 59, no. 1 (1912): 24.
275
J. Whitridge Williams, “Medical Education and the Midwife Problem in the United States,” Journal
of the American Medical Association 58, no. 1 (1912): 6.
276
Davis, “Modern Obstetrics,” 21.
277
Charles Edward Ziegler, “The Elimination of the Midwife,” Journal of the American Medical
Association 60, no. 1 (1913): 36.
82

standard” argument. Once the dual standard was established as an argumentative
construct, physicians made moral claims to demonstrate the necessity of its practical
dissolution. One argues that achieving true equality among individuals in the United
States will not be possible with two classes of medical care.
278
The editors of the Boston
Medical and Surgical Journal state that legitimating a dual standard would be wrong.
279

Others argue that the medical community does not have the moral right to offer two
standards of care.
280
The notion that a dual standard was unfair and antithetical to the
spirit of equality necessary in a democratic society was an oft-repeated refrain. Moreover,
an entrenched and enduring dual standard, some argued, was inevitable, were midwives
allowed to continue practicing. Arguments grounded in the dual standard were designed
to erect a boundary between midwives and obstetric practice, much the same way that
arguments grounded in the divide between the public and private spheres were designed
to erect a boundary between women and political participation.
Midwives’ exclusion from professional medicine is just one example of a larger
phenomenon that has received considerable scholarly attention: the differences between
the public and private spheres, and the historical exclusion of women from the former
and confinement to the latter. The public sphere is the place where deliberation happens,
policy is debated, and decisions are made by a variety of political and social actors on
community and societal levels.
281
Scholars of gender have noted that, historically, men

278
Ibid., 33.
279
“The Case of the Midwife,” Boston Medical and Surgical Journal 168, no. 12 (1913): 436.
280
Emmons and Huntington, “A Review,” 251.
281
See, for example, G. Thomas Goodnight, “The Personal, Technical, and Public Spheres of
Argument: A Speculative Inquiry into the Art of Public Deliberation,” Argumentation and Advocacy 18
83

had access to the public sphere, while women were limited to the private sphere of the
home. In the private sphere, the duties of housekeeping and motherhood were primary,
and women learned crafts and skills that enabled them to be effective in their duties as
caregivers. Karlyn Kohrs Campbell has demonstrated how, when the first women
attempted to move into the public sphere and speak before audiences of both men and
women, they applied the knowledge of the private sphere. Thus, women’s rhetoric
demonstrated characteristics learned via a life in private, including a personal tone and
reliance on personal experience as evidence.
282
Other scholars have demonstrated how
the separation of the public and private sphere has been justified in legal decisions
affecting women’s rights,
283
how private activities, such as letter-writing, helped women
find their voice and bridge the gap between the private and public spheres,
284
and how
notable contemporary women might go about challenging the spheres dichotomy.
285
The
literature demonstrates the firmly and ideologically entrenched nature of the spheres, and
the difficulties faced by women attempting to move between the two.
In the medical journals, the midwife’s home-based sphere of practice is
completely debased, and her activities therein allegedly justify her exclusion from those

(1982): 214-227; and G. Thomas Goodnight, “Public Discourse” Critical Studies in Media Communication
4, no. 4 (1987): 428-431.
282
Karlyn Kohrs Campbell, Man Cannot Speak for Her: A Critical Study of Early Feminist Rhetoric
(New York: Greenwood Press, 1989): 13.
283
Katie L. Gibson, “Judicial Rhetoric and Women’s ‘Place’: The United States Supreme Court’s
Darwinian Defense of Separate Spheres,” Western Journal of Communication 71, no. 2 (2007): 163.
284
Lisa M. Gring-Premble, “Writing Themselves into Consciousness: Creating a Rhetorical Bridge
Between the Public and Private Spheres,” Quarterly Journal of Speech 84, no 1 (1998): 42-43.
285
Barbara Pickering, “The Hillary Factor: A First Lady Challenges the Distinction between Public
and Private Spheres.” Proceedings of the National Communication Association/American Forensic
Association Alta Conference on Argumentation (1993): 355.
84

privileges afforded to those in the professional medical public, such as education and a
voice. Immediately prior to this resolute shoring-up of the separate spheres, The
American Midwife appeared to facilitate dialogue between midwives and doctors. The
following section provides a framework for analyzing how this happened, by
synthesizing theory centering on the creation and function of discourses within and
among publics.

Perspectives on the Public and the Social
In light of the arguments that were being made against midwives and the function
that The American Midwife apparently was trying to serve, along with the larger context
of women’s status in society at the time and their inability to participate in professional
and political matters, it makes sense to highlight theoretical features of spheres when
analyzing the journal. Examination of the texts indicates that three large ideas which have
been prevalent in public sphere theory hold relevance for The American Midwife. First,
midwife-physician dialogues point to the feasibility of Habermasian interpretations of the
public sphere. Second, attempts at midwife organization indicate the potential for
development of counterpublic sensibilities. Finally, the incorporation and erasure of
midwives’ voices points to the power the Arendtian conception of “the social” has to
overtake deliberation.

The Public Sphere and Critiques
Many rhetoricians regard Jürgen Habermas as a foundational thinker and theorist
of the public sphere. According to Habermasian thought, the public is where “freedom
85

was to be found.”
286
Habermas’s bourgeois public sphere consisted of “private people
com[ing] together as a public” to debate matters of common concern.
287
This sphere of
private individuals debating in public seized a degree of control away from traditional
ruling powers. Ideally, individuals from a range of backgrounds and social classes would
come together to debate on equal grounds, relying on rational-critical discourse and
rendering judgment based upon “the force of the better argument.”
288
Calhoun points out
that this idea of the public is predicated on the notion that there exists a general interest
basic enough that discourse “need not be distorted by particular interests” and could
approach an objective truth.
289
According to Habermas, this ideal vision of a public
sphere is in steady decline, as public debate is replaced by mass media and mass
consumption. Interestingly, Mary Ryan notes, “Starting at approximately the same time
and place where Habermas commences his story of the eviscerating of the public
sphere… feminist historians plot out the ascension of women into politics.”
290

Since the translation of Habermas’s The Structural Transformation of the Public
Sphere in 1989, many have critiqued and elaborated his notion of the public sphere. Some
critiques allege that rational-critical debate fails to take differences in identity and power

286
Craig Calhoun, "Introduction: Habermas and the Public Sphere," in Habermas and the Public
Sphere, edited by Craig Calhoun (Cambridge: The MIT Press, 1992), 6.
287
Jurgen Habermas, The Structural Transformation of the Public Sphere: An Inquiry into a Category
of Bourgeois Society (Cambridge: The MIT Press, 1989), 27.
288
G. Thomas Goodnight, “A Translation of Habermas on the Public Sphere,” Argumentation and
Advocacy 28, no. 3 (1992): 145-147.
289
Craig Calhoun, "Introduction: Habermas and the Public Sphere," in Habermas and the Public
Sphere, edited by Craig Calhoun (Cambridge: The MIT Press, 1992), 9.
290
Mary P. Ryan, "Gender and Public Access: Women's Politics in Nineteenth-Century America," in
Habermas and the Public Sphere, edited by Craig Calhoun (Cambridge: The MIT Press, 1992), 262.
86

into account.
291
G. Thomas Goodnight points out that the term “sphere” is problematic
due to its historical use in arguments used to keep women from speaking. The notion of
spheres as static realms of life grounded discriminatory arguments “on the basis that God
had suited women to rule the home and men the professions.”
292
Later, Nancy Fraser calls
into question “the assumption that it is possible for interlocutors in a public sphere to
bracket status differentials and to deliberate as if they were social equals.”
293
Arguments
by Fraser and others point out ways in which the liberal notion that anyone, no matter
their identity, can somehow leave their differences at the door and participate in rational
argument is not only counter to reality, but also harmful to those who most desperately
need to have their voices heard. Formulations of this sort overlook cultural and structural
barriers that some face when approaching the public, and entrench a privileged system of
debate as the norm while keeping anyone who differs securely in the margins. Fraser
argues: “A discourse of publicity touting accessibility, rationality, and the suspension of
status hierarchies is itself deployed as a strategy of distinction.”
294
Rather than provide a
space where everyone can participate, the rational public sphere maintains a system of
vastly inequitable privilege and silence.

291
Craig Calhoun, "Introduction: Habermas and the Public Sphere," in Habermas and the Public
Sphere, edited by Craig Calhoun (Cambridge: The MIT Press, 1992), 3.
292
G. Thomas Goodnight, “The Personal, Technical, and Public Spheres of Argument: A Speculative
Inquiry into the Art of Public Deliberation,” Argumentation and Advocacy 18 (1982): 217.
293
Nancy Fraser, "Rethinking the Public Sphere: A Contribution to the Critique of Actually Existing
Democracy," in Habermas and the Public Sphere, edited by Craig Calhoun (Cambridge: The MIT Press,
1992), 117.
294
Ibid., 115.
87

Furthermore, Fraser contends, there has never been a singular public sphere;
rather, “there were competing publics from the start.”
295
Counterpublics formed by
subaltern groups, in opposition to discourses of domination, have “contested the
exclusionary norms of the bourgeois public.”
296
She goes on to argue that societies which
“accommodate contestation among a plurality of competing publics better promote the
ideal of participatory parity than does a single, comprehensive, overarching public.”
297

Within subaltern counterpublics, subordinated groups are able to generate their own
discourses, specific to their own needs, which reflect their own experiences.
298
In so
doing, members are able to simultaneously commiserate with equals and cultivate skills
of speech and action that can be directed toward social change on a larger scale.
299

Fraser’s analysis has inspired an abundance of scholarship regarding counterpublics.
300

Hannah Arendt on Spheres and the Social
Hannah Arendt’s theory of natality offers a complementary framework for
understanding public and private spheres. To Arendt, a necessary condition of acting, i.e.,
beginning something new, was appearing in public;, someone who did not appear in
public could not act and thereby was not fully human.
301
Arendt writes: “The distinction

295
Ibid., 116.
296
Ibid.
297
Ibid., 122.
298
Ibid., 123.
299
Ibid., 124.
300
For several additional examples, see Robert Asen and Dan Brouwer (eds.). Counterpublics and the
State (New York: State University of New York Press, 2001).
301
Arendt, Human Condition, 50.
88

between a private and a public sphere of life corresponds to the household and the
political realm, which have existed as distinct, separate entities at least since the rise of
the ancient city-state”
302
Arendt laments the collapse of both public and private spheres in
the modern world. She argues that both public and private have been eclipsed by the rise
of “the social realm.”
303
The prior dividing line between public and private, she argues,
has become completely blurred as matters of formerly private concern have become open
to public scrutiny and concern: “In the modern world, the two realms indeed flow into
each other like waves in a never-resting stream of the life process.”
304
When “the
activities connected with sheer survival are permitted to appear in public” the public and
private spheres may no longer be regarded as separate and distinct.
305

Whereas many scholars have looked to the blending of spheres as a positive
development for those who previously would not have been allowed to move in the
public sphere, Arendt regards the blending of spheres as unequivocally negative. To
Arendt, the private sphere was the place that housed all labor devoted to sustaining and
preserving life, including reproduction. With the “necessities” of life contained in private,
humans were free to act in the public sphere.
Furthermore, its survival requires that the public be a space of both equality and
distinction, where unique individuals are permitted to interact on equal terms. The public
must remain a space composed of infinite difference and diversity. Regrettably, she
argues: “Since the rise of society, since the admission of household and housekeeping

302
Ibid., 28.
303
Ibid.
304
Ibid., 33.
305
Ibid., 46.
89

activities to the public realm, an irresistible tendency to grow, to devour the older realms
of the political and private… has been one of the outstanding characteristics of the new
realm.”
306
To Arendt, the rise of the social realm has eclipsed public diversity ; and its
major consequence is the foreclosure of action. Whereas the public provides a space of
distinctiveness and uniqueness, the social makes everything the same: “society expects
from each of its members a certain kind of behavior, imposing innumerable and various
rules, all of which tend to ‘normalize’ its members, to make them behave, to exclude
spontaneous or outstanding achievement.”
307

Interpretations of Arendt
Leading Arendt scholar Margaret Canovan, along with others, has noted the
influence Arendt had on the work of Habermas. She reports that Habermas himself
“acknowledged a profound intellectual debt to Hannah Arendt” in a 1980 lecture.
308

Canovan argues that Habermas, being inspired by Arendt, proceeded to read his own
original ideas back into her work, and as a result, “what he learned from Arendt was not
quite what she would have liked to teach him.”
309
Canovan writes that Habermas’s ideas
distort Arendt’s views “because they substitute talking for acting, consensus for
disagreement, and unity for plurality in politics.”
310
She claims that Arendt would have

306
Ibid., 45.
307
Ibid., 40.
308
Margaret Canovan, “A Case of Distorted Communication: A Note on Habermas and Arendt,”
Political Theory 11, no. 1 (1983): 106.
309
Ibid., 107.
310
Ibid., 108; I choose to bracket Canovan’s talking-acting distinction. This can of worms is beyond
the scope of this project.
90

disagreed that disputes can be settled purely rationally, and “that the whole notion of
getting individuals to act as one was a dangerous illusion.”
311
Arendt’s ever-present and
persistent focus on pluralism indicates that her ideas of action diverged from Habermas’s.
I would also add to Canovan’s critique the observation that Arendt’s emphasis on
natality, and the necessarily contingent consequences of acting via the creation of
something new, requires discourse that goes beyond the boundaries of the established
rationality of a given context.
Arendt’s focus on pluralism has been likened to notions of agonistic democracy.
Ginna Husting, for example, draws connections between Arendt’s theory of the public
sphere and scholars who point to the harms that come along with the “construction of a
homogenous, harmonious nation.”
312
For Robert Ivie, a vibrant public requires “rowdy
rhetorical deliberation” that can highlight and bridge existing differences rather than
ignore them.
313
From this perspective, an absence of difference and dissent is a sign of
“weakness and vulnerability,” rather than being indicative of the presence of
rationality.
314
According to Ivie, “…rhetorical advocacy turns dark and cynical only
when competing perspectives and interests are ignored or suppressed rather than engaged
and bridged sufficiently to muddle through the moment.”
315
From this perspective, public

311
Ibid., 110.
312
Ginna Husting, “Neutralizing Protest: The Construction of War, Chaos, and National Identity
through US Television News on Abortion-Related Protest, 1991,” Communication and Critical/Cultural
Studies 3, no. 2 (2006): 164.
313
Robert L, Ivie, “Rhetorical Deliberation and Democratic Politics in the Here and Now,” Rhetoric &
Public Affairs 5, no. 2 (2002): 279; Robert L. Ivie, “Evil Enemy Versus Agonistic Other: Rhetorical
Constructions of Terrorism,” The Review of Education, Pedagogy, and Cultural Studies 25 (2003): 192.
314
Ivie, “Rhetorical Deliberation ,” 281.
315
Ibid., 278.
91

discourse should engage and possibly even highlight difference. When difference is
absent, Arendt would tell us, the social has taken over and action, natality, and freedom
become impossible.
The split between rationally informed and personally performed contexts of
communication pose distinguishing, dialectically opposed spaces between
conceptualizations of private and public life. The discourses surrounding topics of birth
move back and forth between these categories. Thus, disagreements surrounding the
characteristics and function of discourse in the public sphere are important to keep in
mind when considering The American Midwife journal. Articles gesture both toward the
liberating aspects of a formerly silenced group breaking into the public sphere as well as
represent the troubling aspects of the bracketing of difference and the collapse of both
public and private into social. Natality produces a topical dynamic in discourses
concerning child birth. These dynamics are all present within the pages of The American
Midwife. It is important to examine what role these discursive dynamics played in both
the constitution and demise of the journal and the unrealized dream of professional
midwifery at the turn of the twentieth century. By setting Arendt’s ideas of public natality
and the social into contrast with other works the significance of The American Midwife
within the overall picture of advocacy and activism centering on birth can be appreciated.

The American Midwife and Women’s Voices
Examination of the The American Midwife journal reveals that it furnished a
novel space wherein the midwife could “appear” in public.
316
At the time of the journal’s

316
Arendt, Human Condition, 179.
92

publication, an active public existed among doctors who were already finding expression
in the medical journals, at conventions, and within professional associations. Rapid
advances were taking place in the areas of asepsis, pharmaceuticals, and surgical
procedures. Doctors vigorously debated the merits of these advances across platforms.
Within the next two years, obstetricians within this community would burst forth in the
pages of the most respected academic journals with a barrage of vehement opinions about
midwives.
Historians have portrayed the physician takeover of obstetrics as an inevitable
result of scientific advancement, yet the publication betrays a discourse gestured toward
other options. Before physicians began in earnest to set up an impermeable dichotomy
through the medical journals, disparaging the low standard of care offered by midwives
and hailing the high standard offered by physicians, a group of doctors and midwifes
attempted to craft a different path for childbirth care. The American Midwife provided
midwives with a forum to define and establish a standard of care on their own terms.
Furthermore, the journal indicates both the potential for physician-midwife dialogue as an
alternative to physician debate and for female action, realized through natality, within the
arena of childbirth practices and care.
317
In opposition to a dichotomy which created a
choice between two bad alternatives, the potential existed for the creation of something
entirely new.
The dialogue between physicians and midwives evinced in The American Midwife
circumvents the dual standard dichotomy established in the medical journals, and
represents what was perhaps a singular opportunity for midwives to stake a claim within

317
Arendt, Human Condition, 247.
93

the professional medical public. Although publication of the journal was short lived and
has been nearly lost to history, this circumvention demonstrates the latent possibility of
developing a hybridized form of birth-attending, incorporating standards of both safety
and care. However, as the following sections will show, this possibility was quickly
squelched even within the pages of The American Midwife. While early issues
demonstrate the basis for a groundbreaking dialogue between midwives and doctors,
wherein individuals of unequal social rank could engage in debate on relatively equal
grounds, later issues evince the reassertion of total physician control and the silencing of
midwives. Subsequent sections will detail these developments in the journal.
The American Midwife was written and published in the context of nineteenth-
century female voices. It is difficult to reflect upon nineteenth century discourses with
twenty-first century eyes. In doing so it is important to emphasize that midwife-attended
home birth cannot be treated as enactment of progressive choice in the same way that it is
conventionalized today.
318
At the same time, it would be both reductive and disingenuous
to treat midwifery as a backward and oppressive institution like some of the more
privileged progressive voices of the era would have done. Indeed, among many
progressive, urban, middle- and upper- class white women, (who were the same class of
women leading the charge for suffrage and other rights,) a midwife-attended and un-
medicated birth would have represented a traditional form of women’s oppression. I
could assume this stance as well – other authors certainly have
319
– however, doing so
would perpetuate a privileged and primarily white positionality that remains hidden if not

318
See Chapters Three and Four, this volume.
319
Wertz and Wertz, Lying-In, 48.
94

intentionally made apparent. Instead, consider these artifacts as part of a more complex
set of exigencies. For example, while late-nineteenth century white, economically
privileged, urban women may have felt that medicated, doctor-attended birth would
constitute a step toward liberation, women residing in rural areas, poor women, and
women of color would not have had access to the same quality of services. Some women
preferred to be attended by other women for reasons of modesty, female camaraderie and
solidarity. Moreover, the care afforded to a poor rural woman in the 1890s by an
experienced midwife was very likely to be of better quality than that provided by
whatever general physician would have been available to her, if any.
320
Put another way,
it is apparent that the loudest and most powerful voice proclaiming the path to liberation,
in any era, is often not representative of the needs of subaltern groups. This highly
troubling phenomenon has been repeated over and over again in feminist activism and
elsewhere. The voices of midwives are not to be understood necessarily as “liberating
and progressive” in the same way that present-day advocates for natural birth advocate
the practice. Yet, the emancipatory potential in the voices of midwives should be
remembered. From a rhetorical perspective, then, inquiry into discourses promising
“liberation” require reading in context with regard to what practices are counted as
constraining and enabling, oppressive or emancipatory. Thus, while I am ever-mindful of
the concurrent women’s rights movement, and wish to consider its impact (or lack
thereof) on efforts toward unity among midwives, the study resists treating certain forms
of childbirth as the standard by which all other forms of women’s activism are judged.

320
Abraham Flexner, “Medical Education in the United States and Canada,” A Report to the Carnegie
Foundation for the Advancement of Teaching (1910): ie., x, 10, 16-17.
95

The pages of The American Midwife, in both its triumphs and failures invite us to
appreciate a much more complicated story.

History and Description
The American Midwife appears to have been the only professional journal for
midwives of its time. Because of this, one purpose of this chapter is simply to highlight
the remarkable nature of this publication, which has been almost entirely lost to history.
Judy Barrett Litoff briefly attests to the uniqueness and significance of the journal in her
history of the midwife debate; to my knowledge, this is the only existing scholarly
mention of the journal.
321
The inaugural issue of The American Midwife was published in
November of 1895 in St. Louis, MO. The editors were male physicians A. A. Henske,
Henry H. Summa, and O. E. Treutler all professors at the St. Louis College of Midwifery.
Joining them on the Board of Trustees and Faculty of the College were two midwives,
Mrs. Katharina Zrotz and Mrs. Annie J. Byrns. Byrns, in particular, was a regular
contributor to the journal in its early issues. Affiliation with both the college and the
physicians likely provided the journal with the credibility it needed to be published in its
day. The monthly journal contained articles detailing such topics as the proper use of
particular medications and instruments, diagnosis of pregnancy, and health hazards to the
mother and newborn. In addition, the journal printed submitted stories from midwives’
practices as well as letters of support, and reprinted articles from other medical
magazines. Each issue of the journal was printed in both English and German, and a

321
Judy Barrett Litoff, American Midwives: 1860 to the Present (Westport: Greenwood Press, 1978):
41.
96

yearly subscription could be obtained for the price of one dollar. Only three known
copies of the journal have survived.
322

In the remainder of this section, I explore how the journal’s stated purpose invited
a range of reactions, and then analyze those reactions guided by theories of the public
sphere. Portions of the journal evince dynamics of both a public and an insulated
counterpublic, before both are eclipsed by homogenization that embodies the Arendtian
rise of the social. The purpose of illuminating elements of The American Midwife that
function in these various ways is not to simply categorize the text; rather, juxtaposing the
journal with contested notions of the public will demonstrate the complexity and
multiplicity of spheres of discourse in moments of social change. Moreover, analysis
reveals that features in the early issues of the journal pave the way for midwife silencing.
Rather than highlighting the unique perspective and expertise that midwives bring to
childbirth, they attempted to conform to medical standards and implicitly conceded to a
pathologized birth, thereby colluding with doctors to affect their own demise. This will
be explained in more detail in the coming pages.

Purpose and Reactions
The lead article of the inaugural issue is an editorial detailing the purpose and
mission of the journal. The editors state:

322
The materials used for analysis in this chapter were obtained from the Bernard Becker Medical
Library at the Washington University School of Medicine in St. Louis. Other copies of the journal are
housed at the Francis A. Countway Library of Medicine at Harvard Medical School, and the Historical
Medical Library at The College of Physicians of Philadelphia. Additionally, the National Institute of
Health’s U.S. National Library of Medicine has a copy of the journal on microfilm.
97

Midwives in America have so far been neglected by the publishers of medical
literature. Practicing midwifery exclusively, they have neither the time nor
training to read medical journals which cover more or less all branches of
medicine. The journals of obstetrics and gynecology, so far published are
intended for physicians only, and cannot be utelized (sic) by our midwives.
To fill this want, “The American Midwife” will treat exclusively of
midwifery, diseases of infants, infant feeding and nursing, in its editorials, essays
and correspondence.
323

The editors of the journal indicate their feeling that midwives do not willfully ignore
research relevant to their field of practice; but rather, do not have access to it for lack of
time or literacy. This journal, then, would be tailor-made for midwives, with short
articles written in simple language relative to the scholarly medical journals, and printed
in two languages. The editors go on to say that “modern midwifery” progresses
scientifically alongside medicine; thus, midwives must keep abreast of developments by
attending to the literature. The American Midwife purports to pass along “all the latest
advances in her science” as well as “all important discoveries in the different branches of
obstetrics” and the “latest methods of procuring antisepsis.”
324
In this way, The American
Midwife’s goal was to provide the midwife a means of furthering her education, keeping
up with new science, and providing care up to the standard of the time. It is the opinion of
the editors that the midwife must stay up to date with advances in the field of obstetrics,
and yet, she has thus far been unable to do so. Far from being a superfluous publication

323
“Editorial,” The American Midwife 1, no. 1 (1895): 1.
324
Ibid.
98

within a community of women not wanting to learn or professionalize, then, the journal
instead purports to fill a major void in the canon of medical literature.
This notion is supported by letters printed in the first two issues from both doctors
and midwives. Dr. T. L. Papin, a professor at the Missouri Medical College, writes:
In a long time, I have not learned of a purpose so worthy and calculated to do so
much good, as the object of your teachings and of your proposed journal. First: a
thorough scientific teaching of the principles and practice of midwifery will
elevate the standard and usefulness of our midwives; and, secondly: their
knowledge and its application in practice will become a source of safety and
preservation of life to many who employ them.
325

Even though he is a supporter of the journal, Papin qualifies his praise by stating the
seemingly universally-held sentiment among physicians at the time that the majority of
midwives are ignorant and oftentimes heartless as well. He also encourages the editors to
use the journal as a forum to “knock at the doors of legislature” to ask for laws to protect
mothers - whom he refers to as “our wives” – against these “so called” midwives. In spite
of the tendency of the medical journals to paint all midwives with one broad brush,
Papin’s comments are indicative of a willingness to differentiate between midwives, and
grant legitimacy to those whom were willing and able to attain a certain level of
knowledge. Dr. Louis Bauer implicitly acknowledges this differentiation a bit more
charitably in the second issue, and says, “Many… have had no opportunity of perfecting

325
T. L. Papin, letter to the editors, The American Midwife 1, no. 1 (1895): 4.
99

themselves by knowledge and practical instruction… such a journal constitutes a great
benefit in furnishing their wants and advancing their skill.”
326

The editor of the Medical Mirror magazine sends more whole-hearted praise in
issue two, saying, “I can conceive of no field that has been so thoroughly neglected as
that of the midwife… I trust and believe that you will have the co-operation of the world
of midwives and the medical profession in it’s entirely in your work, which is certainly
deserving.”
327
The Medical Review magazine communicates a similar sentiment, saying,
“There being, to our knowledge, no similar publication in this country, and it being,
moreover, our experience that some midwives are sadly lacking in the information which
they should possess, the new St. Louis acquisition will have a very useful and
commendable mission to perform.”
328
This passage, and those before it, reveals how the
scientific and professional progress of medicine created a “lack” amongst midwives, as
compared to the standards set by physicians. Obstetricians repeatedly railed against
midwives in the medical journals for creating the dual standard in obstetrics, when it was
obviously the professionally-driven obstetrician who had built the dual standard on top of
the midwife’s long-existing practice.
While the letters from physicians reveal a tentative and paternalistic support for
the journal, insofar as it can elevate the midwife to the scientific standard of care set by
obstetricians, letters from midwives reveal an alternate sentiment. Yet, at the same time,

326
Louis Bauer, letter to the editors, The American Midwife 1, no. 2 (1895): 4.
327
I. N. Love, letter to the editors, The American Midwife 1, no. 2 (1895): 3.
328
“The American Midwife,” The American Midwife 1, no. 2 (1895): 3.
100

they indicate recognition of the role they have been placed in by physicians. In the second
issue of the journal, a letter from Mrs. Emma E. Peters states:
…I must confess that I am highly pleased to receive so valuable a paper in the
interest of womankind. I must congratulate the enterprising men who are the
instigators of so useful a journal… and I hope that the thinking midwives will do
all in their power to aid them in so noble a work.
I will say this to my sisters who follow the obstetrical profession, that they
should not think for one moment that they are through learning; that day will
never come… Sister midwives, do not hesitate to subscribe for so worthy a paper.
Be true to yourselves and reap all the knowledge in your branch possible, and
then you will be true to all suffering women, and you will know the dangers to
which they are exposed.
329

This passage demonstrates a markedly different stance than those from the doctors.
Although Peters acknowledges that the journal is made possible by men, the remainder of
the letter is a tentative call to empowerment. To Peters, learning is a means of self-
improvement and greater success in the autonomous practice of midwifery. Her call to
her “sisters” indicates a desire to form a community of like-minded and enlightened
women, able to participate in scholarly conversations along with doctors and provide
quality care to other women. While the doctors’ submissions reveal a desire to bring the
poorly-trained midwife up to the minimum standard, this letter advances a vision of
limitless potential for continuous learning.

329
Emma E. Peters, letter to the editors, The American Midwife 1, no. 2 (1895): 6.
101

These divergent sentiments perhaps foreshadow things to come in the journal.
While the purpose was a worthy one, and the response enthusiastic from midwives and at
least some doctors, the at-odds nature of this enthusiasm sets the tone for the remainder
of the journal. In the following sections, the constrained ways in which midwives were
able to participate in both public and counterpublic discourses in the journal are
examined

The Possibility of Public Natality
Toward the Public: Physician-Midwife Interaction
Discourse between physicians and midwives in The American Midwife begins on
a decidedly hostile note. In the first issue, a scathing article titled simply “Midwives” is
reprinted from The Medical Progress magazine. This article mirrors the opinions of the
harshest critics from the scholarly medical journals. The unnamed author(s) state(s) that
the midwife would best be entirely done away with, and that she is not necessary. The
author charges midwives with stealing business from doctors and monopolizing the
practice of obstetrics in some communities. Furthermore, the author states that “…as a
rule, they are illiterate and belong to the lower stations, as regards not only education and
intelligence, but are also, as a rule, very low in the social scale.”
330
For this writer, the
midwife’s “low” social status is connected to her inability to maintain an aseptic state of
surgical sterility. The author refers to the midwife’s lack of cleanliness multiple times,
stating at one point, “…engaged as she is in the household duties of one of her station,
and how improbable it is that even with the care the learned and capable obstetrician

330
“Midwives,” The American Midwife 1, no. 1 (1895): 3.
102

takes she could render herself clean.”
331
Even though the writer argues that the midwife
could never achieve cleanliness even if she knew the proper procedures of washing, he
still, for some reason, appears to advocate for educating midwives, and calls for thorough
training and examination overseen by the government. Although, any applicant, in the
author’s view, must hold good standing in her community, be of good moral character,
and be able to resist the temptation toward crime for profit.
332
For an example, the author
exhorts readers to look to the appearance of the trained nurse, as she has the education
and ostensibly also the habits and etiquette to which the midwife should aspire.
Beginning a Dialogue. It is initially puzzling why an article of this nature would
appear in a journal, the stated goal of which is to provide information for midwives to
improve their knowledge and practice as well as a space to share their own knowledge
and stories. Writings of this sort would seem to either anger or discourage midwives, and
would do nothing to serve the goals of the journal. Perhaps the editors, in keeping with
their promise to “bring all the news concerning the profession”
333
felt it was their duty to
inform midwives of the current medical sentiment toward them. However, the article
becomes the beginning of a conversation when midwife Annie J. Byrns crafts a response
in the second issue. Her writing reveals that, whether intended or not, one function of the
initial article was to begin a physician-midwife dialogue, something entirely new on the
public and professional level.

331
“Midwives,” The American Midwife 1, no. 1 (1895): 4.
332
Ibid., “Crime for profit” here refers to abortion.
333
“Editorial,” The American Midwife 1, no. 1 (1895): 1.
103

Byrns response to the unnamed authors of the previous indictment includes
counterarguments which both defend midwives and accuse physicians. Because this piece
marks a significant rhetorical statement for a midwife of her time, I will recount Byrns’
essay in some detail here. First, she states that the previous article “…dealt quite severely
with midwives and classed them all alike, leaving no space open for anyone, no matter
how good they might be.”
334
Byrns rightly perceives that, although the prior indictment
ultimately called for the education of midwives, the harsh denouncements of the majority
of its text left no room for this as an actuality. If the class from which she is drawn makes
a midwife always-already doomed to be unclean, there can likely be no hope for
betterment. Instead, Byrns says that within the anonymous author’s view, midwives are
“…ranked as virulent bacteria who had come to stay, and should be exterminated.”
335

Byrns characterizes the assumed doctor’s true motive as a desire to end the practice of
midwives entirely, shrouded in a thinly veiled request that they be educated in a society
that by and large offered weak if any provision and support for such education.
Byrns goes on to blame doctors for the prevalence of uneducated midwives. She
concedes that some midwives are “not up to the times,” and yet in spite of their lack of
education they continue to practice due to the inability of many families to afford the
high fees charged by doctors.
336
Even those who can afford to pay for a doctor receive
substandard service according to the midwife standard of care as conceived of by Byrns,
in that the doctor is simply called in, attends the birth, collects his fee, and promptly

334
Annie J. Byrns, “Midwives,” The American Midwife 1, no. 2 (1895): 4.
335
Ibid., 4.
336
Ibid.
104

leaves. Thereby, he facilitates an efficient birth but leaves all the “care” to the midwife
who may assist him, or to other family members or neighbors. In this way, Byrns
challenges the doctor-defined notion of the “dual standard” by recuperating the
importance of the midwife standards. Byrns further articulates how the midwife can also
mimic the physician standard, with her frank description of hygienic procedures. She
states:
I will kindly inform the doctor that the United States can boast of midwives who
not only wash their hands with soap, but scrub them to their elbows, clean their
finger nails, and then use their antiseptic solution. They also know, never to lay
hands on a woman, until they have washed and disinfected the external sexual
organs of the woman, and in every case of labor are able by external examination
to diagnose the exact position and presentation of the child.
337

This statement both refutes the claims of the anonymous doctor, but also sternly informs
all potentially errant midwives of the standard of cleanliness expected by those at the top
of the field.
Byrns then informs the doctor of the midwife’s burgeoning professional status.
She reports that St. Louis is home to two groups organized and incorporated under the
heading “Scientific Association of Midwives.”
338
These societies have semi-monthly
meetings, hear lectures from distinguished physicians, hold debates between midwives
over specific cases, all for the purpose of keeping midwives “abreast with the times” with

337
Ibid.
338
Ibid.
105

regard to the practice of birthing.
339
At the same moment the midwives are organizing to
improve their care, Byrns illustrates the infrequently cited but historically factual problem
of physicians who do not uphold their own standards. She tells of a case where a doctor
arrived at a home at the last minute, and, being concerned that the already-present and
already-sterilized midwife would usurp his fee, quickly dipped his fingers into the sterile
solution and proceeded with the delivery. Another example chides a physician for
wrongly and dangerously interfering with a normal and healthy delivery.
340
Byrns boldly
points the finger of accusation back at physicians for not only failing to uphold the
midwife standard of care, but for failing to uphold their own as well. This is a particularly
important move by Byrns, as she both makes a mockery of the physician standard of care
and advocates for an alternative, midwife-defined standard of care. This is perhaps the
best moment in the whole journal, which unfortunately will not be repeated with regard
to style of subject matter. While midwives perhaps should have continued to focus on
scolding doctors who wrongly intervened where it was not necessary, they instead spent
far more time demonstrating that they could conform to the medical standards for dealing
with pathologized birth.
In the closing section of her piece, the author shifts the focus of blame from
doctors onto the government. She wonders how anyone can expect the typical midwife to
be an expert in her craft while schools and State Boards of Health continue to churn out
incompetent graduates. She scolds those whom are simply concerned with whether a

339
Ibid.
340
Ibid.
106

woman can pay and whether her character is moral.
341
Here Byrns counters the claim,
made by the anonymous doctor, that midwives emerging from the lower societal class are
automatically deficient. Rather, she implicitly argues that the ability to pay high fees for
school and the assumed moral worthiness that goes along with such an ability trivialize
actual talent for midwifery and encourage many who would not have otherwise had such
an inclination into the field. Along with the doctor, she argues that education is a
necessity for midwives, and that the standards of such an education need to be examined
and reformed; yet, she does so in a way that seems to open the door for a more
democratic participation rather than restrict access. Her final statement continues along a
similar thematic vein, saying, “… I hope the midwives will make themselves heard
though [the journal’s] columns so that the doctor will in the future think more kindly of
those whom he has not had the pleasure of meeting.”
342
Byrns issues an invitation and a
challenge to midwives, to contribute their knowledge for the education of their
colleagues, the understanding of their adversaries, and thereby the betterment of both.
This extended example illustrates the way in which Byrns, along with other
midwives, is essentially caught between two worlds. She wants to advocate for a midwife
standard of care, and yet feels compelled to perform her ability to conform to the doctors’
standard. What midwives of this time likely did not realize was that by acquiescing to
standards that were becoming increasingly regulated by doctors, and which were to an
ever-greater extent organized around the assumption that birth is pathological rather than

341
Ibid.
342
Ibid., 6.
107

physiological, they were helping to move birth outside the bounds of their own expertise
and ability to practice.
A second example of the way dialogue functioned in the journal was initiated by
Byrns in the first issue. In an article titled “From My Practice,” the author describes a
difficult case of post-partum hemorrhage which she was able to cure by injecting multiple
quarts of water and a pint of vinegar into the patient’s vagina, along with orally
administering doses of both Ergot
343
and brandy. One purpose of the article is to advocate
for the use of a particular type of syringe. A secondary purpose is discovered as Byrns
carefully describes her procedures in the delivery room. Having arrived to find the baby
already born, Byrns recounts:
I looked to see if there was any hemorrhage, placed my hand on the abdomen to
see if the womb was contracting – it was. The placenta had as yet not loosened
itself, there was no hemorrhage so I washed and disinfected my hands, tied the
cord, and wrapped up the baby. I again placed my hands on the abdomen, when a
pain set in I performed the Crede operation
344
but, as the patient was a very stout
person, and had very fleshy abdominal walls, I did not succeed with the same. As
there was no cause for alarm I then washed the baby. Then I washed my hands
again took hold of the cord and the placenta came away without a particle of
trouble. After examining it I thoroughly washed the external parts and made my
patient comfortable…
345

343
A medication derived from a fungus found on rye, used to stop hemorrhage.
344
According to The John Hopkins Manual of Gynecology and Obstetrics, “The Crede maneuver
(application of deep suprapubic pressure designed to decrease the risk of uterine eversion) may be
performed as the placenta is being delivered” (85).
345
Annie J. Byrns, “From My Practice,” The American Midwife 1, no. 1 (1895): 5.
108

Byres then left the home, thinking everything normal, only to be called back an hour and
a half later by the frantic husband:
I had no time to think, but to work as quick as possible. I found the womb largely
distended and an enormous amount of blood had flowed into the bed. I
immediately called for hot water, which they luckily had and a syringe – a bulb
syringe was given me and I ordered the husband to get a four quart fountain
syringe. While they were getting the water I took the pillows from under her head,
washed and disinfected my hands.
346

Byrns then manually removes a large blood clot from the woman’s cervix and
successfully proceeds with the remainder of her treatment. The fact that she explicitly
recounts each time she washes her hands indicates the perceived rarity of this act among
at least a portion of her audience. With this article, Byrns simultaneously recounts a
complicated yet successful labor, advocates for the use of an instrument she has found to
be superior in practice, and rhetorically performs her clinical expertise.
The response to this article, ostensibly written by one of the journal’s editors,
recuperates the expertise of the physician by detailing the pitfalls of syringe use by
midwives. The article advises, “The midwife should never carry a syringe with a view of
using the same indiscriminately on her patients, on account of the danger of carrying
infection from one to the other.”
347
The article goes on to detail the meaning of and
procedures involved in surgical cleanliness, and the differences between this standard and

346
Ibid.
347
“Syringes,” The American Midwife 1, no. 2 (1895): 2.
109

“housewifely” cleanliness.
348
The author then goes into greater specifics about the
reasons for avoiding the sharing of syringes, focusing on the presence of germs:
If these germs are of a pathogenic (disease-producing) character we speak of the
article as being surgically unclean, or septic, or infecting.
Syringe points are frequently surgically unclean and have been known to
transfer diseases such as child-bed fever, erysifelas, gonorrhea, syphilis,
chancroids, diphtheria, etc., not only from family to family, but also from one
member of a family to another. For this reason the midwife should not use her
own syringe on her patients.
349

The author offers one caveat: if the family is too poor to purchase their own brand-new
syringe, the midwife should use her own only after it has been thoroughly sterilized.
350

Overall, this article avoids the typical physician perspective which would assume the
midwife incompetent to safely utilize any instrument, and instead takes the opportunity to
plainly teach about proper procedures and offer advice. This exchange thereby raises an
issue and then expounds upon it in a dialectical fashion, where both parties are able to
contribute their own knowledge – experiential from the midwife and medical from the
physician – and provide a synthesis of perspectives.
Evident from these two extended examples of dialogue between physician and
midwife is the potential for synthesis of the so-called dual standard. On the part of the
contributing physicians, writings demonstrate some effort to include the midwife within

348
Ibid., 3.
349
Ibid.
350
Ibid.
110

the medical standard of care. At the same time, the contributions of midwives indicate an
attempt to redefine the dual standard, and elevate the importance of the midwife standard
of providing more complete care for both mother and child. There clearly exists a desire,
on the part of the midwife, to both maintain her own standard of care while incorporating
the best practices of the medical profession. However, the actions of doctors both within
and beyond the pages of the journal were creating a bind for midwives. Within the
journal, they were advocating for and attempting to facilitate medical education for
midwives; yet at the same time, both within and outside the journal, they were telling
midwives that they must not practice medicine. Midwives, in their collaboration with
doctors, walked right into this trap.
This situation illustrates the difficulty found when individuals attempt to
“bracket” difference in the interest of maintaining dialogue, because in situations of
unequal power and influence some parties have a clear and overwhelming advantage over
others. As many scholars have noted, the notion of an ideal public wherein difference is
bracketed often amounts to an erasure of difference that benefits those in a position of
power. In this instance, as midwives work to incorporate language advocating their
standard of care while performing their cleanliness and medical knowledge for the benefit
of physicians, the physicians make no such accommodations to “equal” midwives while
putting forth their views. They assume a tone ranging from vaguely patronizing to
downright berating. Indeed, the physicians offer no concession, assume no risk, and
ultimately give no real indication that they truly want to exchange ideas. Even those who
look favorably upon midwives – the editors of The American Midwife, for instance – do
not grant the midwives any measure of expertise or indicate that she has any knowledge
111

to bring to the table. Although these doctors are polite, they construct the midwife as
having a lack which can be filled by the knowledge of better-educated and morally
superior doctors.
Continuing Midwife Attempts. The only instances of doctors engaging in even the
semblance of dialogue with midwives cease after the first two issues of the Journal.
Midwife voices maintain the attempt a bit longer; examples from issues four and five
indicate a desire on their part to continue discussion. An article titled “My First Case” by
Lillian V. Young appeared in issue four, wherein the author describes the first delivery
she attended as a midwife. She describes the circumstances of the normal and relatively
uneventful birth, making sure to emphasize to her readers that she was both clean and
knowledgeable. She writes:
I made an external examination but could ascertain but little by it, owing to the
thickness of the abdominal walls, however, I found the pelvis to be somewhat
contracted; I then made an internal examination (after taking the necessary anti-
septic precaution with both myself and the patient,) and found a vertex
presentation, second position.
…the amniotic sac ruptured at 7 P.M., I feared a laceration of the
perineum during the second stage, but fortunately none occurred and I delivered
her of a male child at 10:30 P.M., forty minutes afterward, I expressed the
placenta by the Crede method, then remained with the patient for a while in order
to see that the uterus contracted well and that there was no hemorrhage.
351

351
Lillian V. Young, “My First Case,” The American Midwife 2, no. 4 (1896): 15.
112

The author’s overall point, in the end, is to advocate for additional clinical training at
schools of midwifery; for even though the birth was normal, her “feelings during the
ordeal” were indicative of her lack of practical experience.
352
She finds the “scarcity of
clinical material” to be a problem and hopes that schools will endeavor to approach the
standard of “the European Colleges.”
353
While many doctors discuss and lament a similar
problem at medical schools in the pages of their own medical journals, no similar
discussion ensues in the pages of The American Midwife.
In a final example, midwife Carrie E. Leiberg of Idaho writes, in issue five, on the
subject of “Hypertrophy of the Vaginal Wall.” She begins by quoting an article, written
by a Dr. J. W. Lockhart, from another publication called The Medical World. Lockhart
claims that a previous article demonstrated a misdiagnosis by both a midwife and a Dr.
Taylor, as the condition described was a “mechanical impossibility.”
354
Midwife Leiberg
proceeds to refute Lockhart’s claim of impossibility by detailing a case of her own
wherein a similar condition was observed. She observed the condition, “immensely
hypertrophied” vaginal tissue projecting “six and a half inches beyond the vulva” in a 35
year-old woman with eight children and a ninth on the way.
355
Here, a midwife
demonstrates her ability to intelligently debate with a physician, providing empirical
evidence from her own experience to support her argument. Again, however, the
“dialogue” is advanced by the midwife alone; there are no response articles or notes from

352
Ibid.
353
Ibid.
354
Carrie E. Lieberg, “Uterine Procidentia and Protruding Hypertrophy of the Vaginal Wall,” The
American Midwife 2, no. 5 (1896): 23.
355
Ibid.
113

anyone taking up a position or advancing the conversation in any way. There are,
however, dialogues which take place over the remaining issues that involve only doctors,
wherein more than one physician will comment on a procedure, position for labor, or
drug. Instead of continuing to include midwives, however, the physicians commence
talking amongst themselves.
It is evident that the only instances wherein any doctor converses on any subject
with a midwife in this way involve the doctor “educating” the midwife about something
she has done wrong. It is important to remember, at this point, that while doctors made
every claim to superior knowledge and practice regarding birth, their statistics were no
better (and at times worse) than midwives.
356
The prior section has indicated the
difficulties faced by midwives who attempted to enter into public dialogue with doctors
as equals. Not only were they treated as subordinates, but the tone, style, and subject
matter they were compelled to assume ultimately would have aided in their own demise.
The following section will examine a somewhat different form of discourse manifest in
the pages of The American Midwife, and consider the potential for midwives establish
their own community rather than attempting to gain acceptance to the medical public.

Counterpublic Midwife Consciousness
In later issues of The American Midwife, the journal undergoes subtle changes.
First, the midwife-physician dialogue that commenced in the first few issues ceases; thus,
the foundation that was laid for a dialectic that could have worked toward mediating the
bifurcated “dual standard” of care is unfortunately abandoned. In the language of public

356
Williams, “Medical Education,” 7.
114

sphere theory, we might understand this as a failure to incorporate divergent others into
one sphere of equals, and evidence of the difficulty of bracketing difference for the sake
of rational argument.
Even though physician-midwife dialogue in the journal was short-lived, other
features emerge in later issues which indicate the raising of midwife consciousness and
the beginnings of a midwife counterpublic. First, there is evidence in the pages of the
third issue, published in January, 1896, that midwives were responding positively to the
journal and eager for more; a spark had been lit among midwives. In the opening article,
the editors write:
‘The American Midwife’ in entering its second [calendar] year has reason to
congratulate itself for its unexpected success. The midwives of America have
received us kindly and extended the hand of welcome to us. From every city of
the United States and Canada we have received letters of encouragement.
357

They continue:
Our list of subscribers increases daily; in fact, far beyond our expectations. There
is no city in this country which has not added a number of names to it.
[…]
We shall shun neither labor not expense. ‘The American Midwife’ shall be
the journal that will furnish the midwife with well written articles, treating on
different subjects of her science, and will keep her well advised of all the latest
advances and of all important discoveries in the different branches of obstetrics.
358

357
“The American Midwife,” The American Midwife 1, no. 3 (1896): 1.
358
Ibid.
115

Here, the editors indicate the presence of a growing community of midwives forming
around the journal. Letters printed in later issues support the presence of this community
to a degree, as they come from midwives in Wisconsin, Iowa, Illinois, Minnesota,
Kansas, Missouri, and Washington. The journal was apparently building a robust base of
support across the Midwestern states and beyond.
359

Establishing a Society. Further and stronger evidence of a burgeoning
counterpublic and collective consciousness among midwives is found in the fifth issue of
the journal. Here, a “Constitution of the St. Louis Society of Midwives” is printed in full.
It is unclear whether this is a new organization, distinct from the St. Louis Scientific
Association of Midwives No.’s 1 and 2 referenced by Annie Byrns’s article in No. 2 of
the Journal, or perhaps a new organization combining the two. Either way, the language
of the Constitution is telling. It states that the Society “shall confine its operations to the
advancement of the Midwives and its collateral science in general, and to the
improvements of the profession.”
360
Furthermore, “all members shall have equal
privileges in the discussion of scientific questions” and “any member may volunteer to
read a communication or to lecture at the succeeding meeting.”
361
To apply for
membership, a midwife needed to present either a diploma or proof of ability, and her

359
Hausine Klemm, letter to the editors, The American Midwife 2, no. 5 (1896): 26; Mrs. Boberg, letter
to the editors, The American Midwife 2, no. 5 (1896): 26; Olga Moberg, letter to the editors, The American
Midwife 2, no. 5 (1896): 26; Cora M. Harris, letter to the editors, The American Midwife 2, no. 6 (1896):
37; A. E. Abler, letter to the editors, The American Midwife 2, no. 6 (1896): 37; C. Walkenwitz, letter to the
editors, The American Midwife 2, no. 6 (1896): 37; J. Waltham, letter to the editors, The American Midwife
2, no. 6 (1896): 37; C. M. H. Wright, letter to the editors, The American Midwife 2, no. 6 (1896): 37; U.
Cole, letter to the editors, The American Midwife 2, no. 6 (1896): 37; P. Beisswingert, letter to the editors,
The American Midwife 2, no. 6 (1896): 37; Martha Every, letter to the editors, The American Midwife 2, no.
6 (1896): 37; M. A. Dubnall, letter to the editors, The American Midwife 2, no. 6 (1896): 37.
360
“Constitution of the St. Louis Society of Midwives,” The American Midwife 2, no. 5 (1896): 24.
361
Ibid., 25.
116

membership had to be approved by a vote of three-fourths of active members. The
Constitution states that meetings will be held twice a month, and lays out rules and
procedures for the election of officers and the business of meetings. The society would
provide regular opportunity for midwives to gather and commiserate, discuss their
experiences, and share knowledge, which would ostensibly cultivate the strength-in-
numbers that could aid them in defending against attacks from physicians.
The Constitution also states that “No member shall be eligible to retain
membership in this society who shall by publication in newspapers, and advertisements
announce her superior qualification in medicine or secret remedies or diseases, or who
shall commit an abortion.”
362
The organization sets a standard for behavior and practice,
offering increased legitimacy to those willing to conform. Anyone seeking their own
personal gain above that of the collective would not be tolerated and anyone engaging in
activities that would have invited legal investigation or contributed to moral abatement
among midwives was to be expelled. The Constitution closes with a “fee bill,” which
states:
The standing fee should be ten dollars;
363
when a midwife is called to an urgent
case because the family attendant is not at hand, she should resign the case on her
return receiving a compensation for whatever service she has rendered, if delivery
is accomplished she shall be entitled to one-half. That we lend each other a

362
Ibid., 24.
363
$10 in 1896 is said to be equivalent to $277.78 in 2013, according to the inflation calculator at:
http://www.davemanuel.com/inflation-calculator.php.
117

helping hand and be ever courteous to one another, and be governed by
professional rules, etiquette and visit each other in case of sickness or death.
364

Thus, in addition to providing basic rules for conduct, the society seeks to regulate the
fees collected by midwives and set guidelines for their fair division. Interestingly, this
passage also indicates a desired personal code of behavior and institutionalized
camaraderie.
It can be speculated that this organization would have aided midwives in
numerous ways. First, meetings would have provided a forum for discussion, sharing of
knowledge, and potentially consciousness-raising. Second, the group of women officially
established by an organization such as this would have increased the strength of
midwives, as a collective. The group may have been able to wield considerable power in
both a professional and political sense. Of course, the reach of this power would have
been small compared to similar organizations of male physicians at the time, who were
already well-positioned to impact government decision-making and legislation; however,
the influence and strength of the collective would have far exceeded that of any
individual midwife of the day.
However, it would be a mistake to be too optimistic about the potential for this
society to cultivate a viable collective consciousness among midwives. Indeed, the
exclusions featured in the constitution would have prohibited many from participating.
Instead of extending welcome to midwives with less education and then working with
them for mutual betterment, the midwives of the society decided to cut them loose. It is
made plain that this organization was more concerned with maintaining what little

364
Ibid., 25.
118

credibility they had with doctors than uniting all midwives. Thus, although the collective
strength of the organization could potentially have been mobilized to defend against
attacks from physicians, there is not much evidence to suggest that this would be a
function of the organization. Instead, this organization seems more geared toward
impressing physicians and dissociating with the lower class of midwives.
Extending Influence. Also in the fifth issue is an article titled “What Should Be
Done in Chicago?” In this piece, the author calls attention to the need for a society of
midwives in Chicago, similar to that in St. Louis, saying it is necessary for midwives “for
the purpose of protecting themselves against all forms of quackery in th[is]
profession.”
365
Justification for such a society is found in protection from “quackery”
rather than protection from physicians or others who would seek to drive the midwife out
of business. While in hindsight it is clear that they were trying to protect themselves from
the wrong enemy, this orientation proved to be a repeating theme. Organization and
education were consistently framed as means of personal betterment, and the enemy was
designated as unscrupulous midwives rather than physicians. This might be attributed to
the fact that the journal was published by men, and that the prevailing gender and cultural
logic of the time would have constituted midwives to understand themselves to be
inferior to the intelligent, educated, upper-class male physicians. Although it is certainly
not the fault of midwives that they were not looking to doctors as the source of their
oppression at this point, it is clear how this could have significantly curtailed the group’s
power to effect change. By attempting to set themselves apart by scapegoating the

365
J. A. “What Should be Done in Chicago,” The American Midwife 2, no. 5 (1896): 26. Crumbling
pages make bits of this article impossible to read; thus, bracketed portions of text are my best guesses.
119

“quackery” of their less educated counterparts, professional midwives sold out their
sisters for a chance to win the approval of physicians.
The author writes:
Above all an organization is necessary, a society or union o[f] midwives should
be called into existence to represent the interests and wellfare (sic) of their
professio[n.] With great satisfaction we must acknowledge that a g[reat] many
midwives favor this proposition.
In the last few weeks of our sojourn in Chic[ago, en]couraged by the better
class of midwives, we attemp[ted to] bring into existence such an organization;
but the time left to us was too short to accomplish our project. But d[ur]ing the
coming Summer proper representatives from St. L[ouis] will visit Chicago to
attend meetings for that purpose.
Unity among the regular and graduated midwives is above all required. Is
the organization once established, [a] society of midwives created, then it will
soon attract [the] attention of all interested ladies and of the boards of [health.]
Such a society will be the best instrument to p[rotect] midwives and elevate the
profession.
We have had the pleasure to become acquaint[ted with] many, not only
competent but also highly intelligent ladies who possess all the qualities to take a
leading part in the undertaking. If all competent midwives join, setting aside all
selfish private interests, success will not fail; and the profession as well as the
public will soon derive the benefit of it.
366

366
Ibid., 26.
120

These words are notable for several reasons. First, they cast serious doubt upon those
who have claimed that midwives did not attempt to organize and professionalize in the
midst of the physician takeover of obstetrics. Not only did midwives organize a
professional society alongside a school of professional midwifery in St. Louis, but this
organization swiftly realized its worth and worked to support the creation of similar
groups elsewhere. At the same time, however, the statement further solidifies the notion
that a clear divide was being purposefully created between two different classes of
midwives, by both midwives and doctors. One comprised a group of educated, intelligent,
competent, responsible ladies, while the other was implied to comprise uneducated,
ignorant, careless, unscrupulous trollops. The better class could move forward if they
agreed to conform to standards set by doctors and leave behind other midwives.
Additionally, the notion that individual gain is “selfish” and must be set aside for the
betterment of the collective is carried over from the Constitution; “unity” is the foremost
concern – but only unity for some, not for all.
Although the rhetoric within these counterpublic-like discourses held promise,
midwives never realized or articulated the purposive harm being done to them by doctors.
There are, however, some indications of the sort of consciousness being developed
among women’s rights organizing of the time, where women were being called to come
together and work toward their mutual betterment and liberty. There is a surfacing
realization that unity wields power, change, and progress. However, much like the
contemporary movements for women’s rights of the time, liberty was only an option for a
select group.

121

The Social: Midwife Erasure
In the wake of cautiously promising discourses of unification and solidarity in
issue five, the emancipatory potential of the journal quickly dissipates. In fact, issues six
through eleven contain not a single midwife-written article, nor do they contain any
updates on the activities of the Society. Issue six is the last that contains a midwife voice
in any tangible way; eight letters from midwives are published, only one of which goes
much beyond a brief “I am pleased with your journal and would like a subscription” type
message. Cora A. Harris from Eagle Bend, Minnesota writes in praise of Annie Byrns’
prior article in defense of midwives and relays a story of a difficult birth from her own
practice. After issue six, only two very brief letters are published in the entirety of the
remaining six issues: the first appears in issue eight and requests a remedy for
“impoverished blood,”
367
and the second appears in issue eleven and asks for an
explanation for lumps found under the arms of a patient.
368
Aside from these two very
short notes, issues seven through eleven consist entirely of articles written by male
doctors. Editor A.A. Henske writes one article per issues, while the bulk of the remaining
space is filled with articles reprinted from other medical publications.
Content and Tone. The range of topics covered in later issues is wide and varied;
but perhaps the most notable characteristic is a shift in tone. At this point, a decreased
portion of the articles seem to be geared toward an audience of midwives. The articles are
oftentimes complex, technical, and pertaining to procedures and surgeries that would
have been outside the scope of midwife practice, and all were written by male doctors.

367
Anna P., letter to the editors, The American Midwife 2, no. 8 (1896): 68.
368
P. Aitkin, letter to the editors, The American Midwife 2, no. 11 (1896): 97.
122

For example, articles detail cases of Cesarean section,
369
bladder disorders among
pregnant women,
370
treatment for ruptured uterus,
371
treatment for inverted uterus,
372
the
use of forceps,
373
cancers of the uterus and cervix,
374
how to deal with a lacerated
cervix,
375
and curettage of the uterus.
376
In some cases, more than one doctor would write
on a common topic, turning the journal into a forum for dialogue and debate among
doctors to the exclusion of the midwife. It seems odd that a journal with the stated
purpose of “treat[ing] exclusively of midwifery, diseases of infants, infant feeding and
nursing,” would exclude midwives’ voices from its pages, and publish articles detailing
invasive procedures and surgeries that midwives were being actively discouraged and
prohibited from performing.
377
And of course, these procedures were often unnecessary,

369
A. A. Henske, “A Case of Caesarean Section,” The American Midwife 2, no. 8 (1896): 67.
370
A. A. Henske, “Affections of the Bladder in Puerperal Women,” The American Midwife 2, no. 6
(1896): 33-35.
371
“Rupture of the Uterus. Recovery,” The American Midwife 2, no. 7 (1896): 55; Sherwood-Dunn,
“Rupture of the Uterus – An Unusual Case,” The American Midwife 2, no. 10 (1896): 84-85.
372
A. A. Henske, “Inversion of the Uterus,” The American Midwife 2, no. 7 (1896): 55; Walter
Lindsey, “A Case of Acute Uterine Inversion,” The American Midwife 2, no. 9 (1896): 73-74.
373
“Forceps,” The American Midwife 2, no. 9 (1896): 77.
374
“Early Recognition of Uterine Cancer,” The American Midwife 2, no. 9 (1896): 77; “Pregnancy and
Labor Complicated by Cancer of the Cervix.” The American Midwife 2, no. 11 (1896): 97.
375
“Lacerated Cervix,” The American Midwife 2, no. 9 (1896): 78.
376
“Indications for Curettement of the Uterus and Method of Procedure,” The American Midwife 2, no.
8 (1896): 66-67; “Rational Treatment of Abortion,” The American Midwife 2, no. 10 (1896): 86; “Curettage
after Labor,” The American Midwife 2, no. 10 (1896): 87.
377
“Editorial,” 1.
123

as medical journals would later begin to admit that intervention-prone doctors often
caused problems in birth that would not have otherwise arisen.
378

At the same time, the remaining articles with subject matter which would have
been relevant to midwives seem quite elementary. Many appear to be authored by doctors
who, at the time, would have been looked upon as second-class by those on the cutting
edge of research and practice. Or, alternatively, it is possible that these doctors may have
“known better” but were purposefully condescending to an audience of perceived lower
intelligence. For example, the author of an article in issue eight titled, “Some Hints in the
Line of Practical Obstetrics” states that he would like to offer “A few practical points on
obstetrics given as a talk to beginners in the practice of the ‘divine art.’”
379
He advises
being “clean in person, even to the finger nails,” while midwife-authored contributions to
earlier issues spoke of asepsis in more technical terms than these. The author suggests
that a midwife should not interfere with “Dame Nature” when possible, apply “the golden
rule” to patient care, and make sure to act “from right and pure motives;” furthermore, he
opines that “A sunshiny doctor carries his remedy in his personality.”
380
In a sense, this is
not bad advice; a positive attitude and a commitment to intervening only when necessary
would likely not have done any harm. However, statements such as these are written as if
they were addressed to children as opposed to professional birth attendants. Since much
of the language in the article does not measure up to the professional and scientific
knowledge being demonstrated by the voices of midwives, it does not seem that an article

378
Joseph B. DeLee, “Meddlesome Midwifery in Renaissance,” Journal of the American Medical
Association 67, no. 16 (1916): 1127-28.
379
William Shaw Stewart, “Some Hints in the Line of Practical Obstetrics,” The American Midwife 2,
no.8 (1896): 65.
380
Ibid.
124

such as this would have been particularly useful to those midwives interested in
improving their education and practical skills. Perhaps the most astonishing illustration of
this comes when the doctor recommends putting down layers of newspaper underneath
the birthing woman as a sterile bed covering
381
– a practice which would not have won
the approval of the medical experts of the time.
The journal’s diminishing quality over time provides indications of a phenomenon
that could be likened to Arendt’s rise of the social. On the one hand, an influx of articles
of a highly technical nature dealing with procedures that were not typically practiced by
midwives (ie., cesarean, symphysiotomy and other surgical procedures) indicate a lack of
engagement with The American Midwife’s stated primary audience and represent a
turning away from those who were supposed to benefit from its publication. These
articles reinforce the “deviance” of the midwife and highlight her inadequacy. They
indicate a social “standard” to which the midwife cannot rise, thereby seriously curtailing
her potential for action. On the other hand, articles that contain out-of-date information or
talk down to midwives similarly position the community of midwives outside of the
agreed upon boundaries of the social standard. They articles do not make serious efforts
to dialogue with midwives as equals, nor do they offer much (if any) useful information
or hold any educatory potential. In fact, many articles in the later issues have no
relevance to midwifery whatsoever, and deal with topics such as facial hygiene,
382

381
Ibid., 65.
382
“The Hygiene of the Face,” The American Midwife 2, no. 9 (1896): 75.
125

bicycle safety,
383
restoring hair to its natural color,
384
the meaning of love,
385
and how
colds are caught.
386

The later issues of the journal function as an eraser of the midwife as a legitimate
practitioner in the field of childbirth, and of the potential for midwives to contribute to a
public dialogue regarding obstetric practices, in dual ways. Depending on the type of
article, the midwife is either ignored or belittled. Neither option makes an attempt to
engage with midwives as equals or seriously include them in discussion or development
of the field, and neither represents an earnest attempt to further midwife education.
Understood within the context of the rest of the journal, it is clear how the ways in which
both midwife-physician dialogue and midwife organizing developed paved the way for
this to happen.
The Last Female Voice. To conclude this section, it is interesting to note the one
significant female voice that appears in the later issues of the journal. A substantial article
titled “Anesthetics in Labor,” a reprint from another medical periodical, appears in issue
number twelve of the Journal and is said to be authored by “A Doctor’s Wife.” This
article represents a major departure from any other woman’s voice in the journal. Her
article represents the complete adoption of the medical standard of care, and the total
abandonment of an oppositional female voice. She strongly advocates for the use of
anesthetics, specifically Chloroform, to ease the pain of birth. The author begins:

383
“Woman and the Bicycle,” The American Midwife 2, no. 9 (1896): 74.
384
“Hair Restorative,” The American Midwife 2, no. 9 (1896): 77.
385
“Love,” The American Midwife 2, no. 10 (1896): 85.
386
“How Colds Are Taken,” The American Midwife 2, no. 11 (1896): 97.
126

I hope the medical fraternity will pardon me for again intruding myself upon these
columns, but as this is a subject in which I am so deeply interested I hope you will
accept this as sufficient apology. The doctor who answered my query sent in some
time ago said that one reason why anesthetics were not used oftener in obstetric
practice was that it required some skill to use them. I believe that is so, but I also
believe that no physician has the right to attend a case of this kind, and expect to
receive pay for it, unless he is competent and willing to afford her all the relief
which the light of the latter part of the nineteenth century affords.
387

After apologizing for using her voice in public, in a manner typical of female rhetors of
the day, she goes on to berate doctors for not using chloroform more frequently. She cites
information from another medical journal attesting to the “perfectly safe” nature of
chloroform, and that “no well-authenticated case of death from the use of chloroform in
labor has occurred when administered in the hands of a properly qualified medical
man.”
388
Of course, this is completely wrong; many otherwise healthy people died from
chloroform use, but its danger had not been realized by the medical community at the
time.
This author, unaware of the danger of her proposition, clearly feels that she is
advocating for progressive change for women. She writes:
Medical men, awake and relieve us to the extent that you can before we demand it
of you, for that time is coming, you may rest assured […] Women are fast shaking
off the shackles that have bound them for ages past, and they will yet demand the

387
“Anesthetics in Labor,” The American Midwife 2, no. 12 (1896): 105.
388
Ibid., 106.
127

relief which anesthetics can afford them […] The old-fashioned doctor who sits
around… and only goes once in a while to examine his patient and tells her she is
getting along nicely and exhorts her to be patient when she knows she can’t be,
will be replaced by the active, wide-awake, progressive doctor of to-day, who
having found a measure of relief, hastens gladly to use it for the benefit of his
patient.
389

This article provides further indication of the difficulties that midwives faced at the turn
of the century. First, they were being attacked and discounted by male doctors who would
soon ramp up an outright campaign to dispatch with them. Second, even the “better” class
of midwives attempting to professionalize were being ignored by upper-class women
who, with a growing voice and consciousness, were demanding to be afforded the latest
and greatest in medical care; intervention was fast becoming a symbol of progress and
freedom. Demonstrating a logic that predicts what we now call “post-feminism” by one
hundred years, this woman acknowledges (whether consciously or not) her ability to
move forward by aligning herself with the stance of the powerful men of the time.
390
Of
course, this was exactly what educated midwives had been attempting to do in earlier
issues of the journal; unfortunately, aligning themselves with doctors ultimately cost
them their entire profession. While doctor-prescribed up-and-coming methods of pain
management undoubtedly eased the suffering of some, this ease was part of a growing

389
Ibid., 106.
390
This phenomenon has been documented in, for example, Ariel Levy, Female Chauvinist Pigs:
Women and the Rise of Raunch Culture (New York: Free Press, 2005); and Angela McRobbie, The
Aftermath of Feminism: Gender, Culture and Social Change (Los Angeles: Sage, 2009).
128

tide that ended in the near-erasure of one of the only female-dominated professions and
means of monetary empowerment of the time.

The End of The American Midwife
A few other features of the Journal’s final issue are worth briefly noting. The
most striking element of the issue, upon first glance, is that its front-page lead article is
printed in German. In every other issue, the journal is printed in full in both English and
German – the English version appear first, followed by the complete issue in German.
However, in this issue, the lead article of the English version is printed in German with
no English translation offered. Translated and paraphrased, the article states that this will
be the last issue of the first annual volume of the journal. The authors thank the readers
and say that there is no American city in which the journal cannot be found. Furthermore,
they say, there is no other journal like this. According to the article, the success of The
American Midwife was achieved because of the goodwill of readers and heavy monetary
sacrifices on the part of the editors. The authors admit that not everything went perfectly
during the first volume, but promise that the next volume will be even better. They say
that producing the Journal was difficult and time-consuming work, but every beginning is
difficult. They ask readers to please not complain if everything was not as they wished –
the journal will improve each year. They remind readers that many prominent men in the
field have given their support to the journal. The article concludes by asking that
subscribers who wish to receive the second annual volume please send a postcard
informing the publisher.
391
No explanation is offered for why this article was printed only

391
“Aufruf!” The American Midwife 2, no. 12 (1896): 103; translation by Martin Hilbert.
129

in German. One could speculate that this may have influenced the number of subscriber
postcards received.
An insufficient number of interested returning subscribers may have been an
influencing factor in the journal’s demise, but a few other clues indicate that the journal
may have faced other challenges. Midway through the volume, the journal publicly
parted ways with business manager J. Attenberger. No explanation is given; a notice is
simply published in the advertisement section stating that “Mr. J. Attenberger… is no
longer connected in any capacity whatever with ‘The American Midwife.’”
392

Additionally, in the twelfth issue, O.E. Treutler is no longer listed as an editor, and A.A.
Henske’s byline indicates that he has moved to another university; therefore,
administrative instability may have been an issue. Or perhaps the editors, sensing the
coming changes in obstetrics, saw no point in continuing. Whatever the reason for its
ending, the demise of The American Midwife marked the end of the only attempt at a
midwife-centered professional publication of its era. Within thirty years, the midwife was
completely erased from the obstetrical landscape of the United States.
The American Midwife was a publication facing significant constraints, which in
some way or another clearly became overwhelming after a year. Being the only journal of
its kind, it had no model to work from other than medical journals and magazines aimed
at physicians. Affiliated, as it was, with the St. Louis College of Midwifery, the journal
could have been an important piece of a continuing effort to both educate and organize
midwives in the Midwestern states and beyond. However, in order for a publication like
this to have a meaningful impact on the course of the profession it would have had to do a

392
“Publisher’s Notice,” The American Midwife 2, no. 7 (1896): n.p.
130

better job printing content relevant to midwives, facilitated significantly more midwife
participation in the writing and publishing of the journal, and possibly even worked
harder to encourage the organizing of midwife societies across the country. Considering
physicians’ outright slander campaign, which would reach the height of its fervor a few
years after The American Midwife’s end, a publication such as this would have been like
a tiny pebble in the midst of a raging river. So, the journal’s primary significance is not
found in any actual impact it had on the fate of the profession of midwifery at the turn of
the century.
The journal is significant, however, because of what we can learn from its pages
about the voices of midwives of that era. At the time of the journal’s publication, it had
been almost 50 years since the Seneca Falls Convention and the publication of Elizabeth
Cady Stanton’s Declaration of Sentiments. While certain groups of women across the
country were speaking out and taking action in favor of suffrage, property rights,
reproductive rights, marriage reform, and equal pay, almost no written accounts of
midwife advocacy exist and there has been virtually no study of midwives’ professional
or political activities outside the birthing room. The voices of early midwives deserve
attention, and their efforts to professionalize and defend themselves against threats to
their livelihood are fascinating.
In some ways, the advocacy of midwives, in its infancy, mirrors that which was
occurring simultaneously in the movement for women’s suffrage. They were “using the
master’s tools,” attempting to speak in a male-dominated forum and make their voices
sound like those of the men, in both style and content. This, I conclude, was their chief
downfall. The ways in which both public and counterpublic discourse took shape paved
131

the way for the rise of the social – a system of obstetrics in which all cases were treated
pathologically and all births were closely regulated and managed by physicians in a
uniform way characteristic of the turn of the century scientific zeitgeist. For a moment,
expressions of natality were seen, as one midwife highlighted her difference by
advocating for an alternative midwife standard of care. However, other voices, instead of
picking up on this thread and working to elaborate upon it and expand its influence,
acquiesced to the language of medicine. In speaking the language of the medical public,
midwives were implicitly assenting to the thesis that birth is pathological. Being
pathological, it requires attention from someone with a medical education. In the coming
years, the Flexner report and other changes in the profession would push women from the
margins to the external. Vying with doctors for position to treat a universally-defined
pathological birth, midwives would lose every time. Their predicament may be described
as follows: in their efforts to participate in the medical public, they adopted that public’s
beliefs, thereby contributing to their own extinction.
Perhaps another strategy would have worked better for midwives. It may have
been more effective to cultivate an oppositional position regarding the classification of
birth. If a growing chorus of voices could have persuasively argued that most births were
not pathological, doctors may have wanted to avoid association with these cases for fear
of diminishing their status and credibility as medical practitioners and surgeons. At the
time of the journal, there was much evidence and precedent to support physiological
birth, and there was significant public support for this position as well. Although this
public support was soon to be chipped away by the persistent efforts of doctors
132

advocating pathology, midwives might have been able to capitalize on it while it existed
and to preserve a space for their practice outside of the medical public.
Here, Arendt’s ideas about the public’s function are instructive. In order for
citizens to take action, the public had to be a space of pluralism, of individuals coming
together across difference. Only in spaces allowing difference was it truly possible to
create something new. The natality of practices and policies depended upon an ability to
start anew and apart from what had come before. The American Midwife abandoned its
natality by upholding the hierarchy of the medical profession and becoming a space of
conformity. By the end, The American Midwife was more of a second-rate medical
magazine than a professional journal for midwives. Attempts among midwives to bracket
differences and participate in dialogue with doctors were short lived and unsuccessful.
Organizations that could have constituted a midwife counterpublic were built upon
exclusion and the desire to be accepted by the establishment. However, ever-increasing
structural barriers made midwife acceptance within the medical establishment a virtual
impossibility at the time. It seems as though a better option may have been for midwives
to argue against the pathologizing of birth rather than attempting to fit into this new
paradigm. Had educated midwives joined with other midwives to emphasize their
difference from doctors in both practice and expertise, and to establish their domain in
the realm of physiological birth, they may have had more success in maintaining their
profession. Of course, there is no way to know for sure what might have happened, and
the rapid scientific growth may have overwhelmed even the strongest arguments for
midwife-attended birth. So while it may not have been successful, at least this alternative
path would have avoided denigrating the roots of their own profession and scapegoating
133

their sister midwives. Opportunities to include non-German immigrant and African-
American midwives in discussions of how best to establish a well-defined space for, and
defend, midwifery may have provided grounds for cross-cultural coalition that had been
for the most part abandoned by women’s rights advocates of the era.
Despite the failures of The American Midwife, it is an important historical
document through which to consider features and developments of public discourse at the
turn of the century. As is evidenced by the journal, there would have been immense
pressure and incentive for those women invited to participate to conform to the standards
being set by male doctors. Within the text, however, there are glimmers of possibility, as
Annie Byrns defends herself and her profession from the attacks of a physician, and
midwives make plans to travel across the country to help organize professional societies.
These instances of natality, though tragically brief, indicate that the rise of a homogenous
obstetric “social” was not an inevitability.
The following chapter will examine advocacy for natural birth beginning in the
1970s. Whereas in this chapter, the central relevant tension centers around “the public,”
and who might participate and how; the next chapter demonstrates how the problems of
technological intervention and control become the chief concern in later advocacy, as
advocates evince resistance to what had by then become the well-established pathology
of birth.

134

Chapter Three
Natural Birth Narratives and Natality: Considering Time, Subjectivity, and Biology

The contemporary context of normative hospitalized physician-attended birth is
the product of at least a century’s worth of effort on the part of obstetricians and others.
In the wake of the early-twentieth century scholarly debate centering on the status of the
midwife, the number of midwife-attended births taking place in the home dropped
dramatically and rapidly. Fervent publishing on the issue reached it crest between 1910
and 1918 and had quieted significantly by the mid-1920s. In January of 1925, a New
York Department of Health Bulletin, reprinted in The Boston Medical and Surgical
Journal, stated that during the prior year only 27,466 babies – 21.3 percent of the total
births – had been delivered by midwives. This was down from 40.35 percent of births in
1909, the year when the city began undertaking efforts to regulate the midwife.
393
By the
latter part of 1928, the journal had changed its name to The New England Journal of
Medicine, and the number of midwife-attended births had dropped to 20,959.
394
A doctor
writing to the Journal of the American Medical Association in 1925 cites his state board
of health and reports that, in the state of Minnesota, only six percent of births were
attended by midwives.
395
By the 1935, the number of midwife-attended births had
dropped to 10.7% overall and the number of hospital births had increased to 36.9%. By
1950, the number of hospital births had increased to 88% of total births, and by 1960 the

393
“Midwives in New York City,” Boston Medical and Surgical Journal 192, no. 4 (1925): 190.
394
“Midwives in New York City,” New England Journal of Medicine 199, no. 10 (1928): 488.
395
A. J. Chesley, “Births Attended by Midwives in Minnesota,” Journal of the American Medical
Association 85, no. 8 (1925): 630.
135

number had increased to 96.6%. The virtually total domination of physician-attended
hospital births would remain unchanged as decades passed, exceeding 99% by 1975.
396

The home birth movement has been recently enjoying increased attention in
mainstream media. For example, Ricki Lake’s two-part documentary series The Business
of Being Born has brought popular attention to the issue, while mainstream press articles
document what seems to be a growing tide of women publicly opting out of hospital
birth. An article in The Guardian recently claimed to investigate the mothers “starting to
fight back” against medical intervention in childbirth,
397
while The New York Times
reports that the employment of a midwife is becoming something of a status symbol
among “trendy” mothers.
398

Although mainstream popular culture has developed something of a fascination
with home birth in the last five years, in reality, women began mobilizing in the 1960s
and 70s to both practice “natural” birth and to publicly advocate for the return of birth to
the home. The movement was spurred on by hospital horror stories and a desire to
rediscover the natural experience of childbirth, as well as the perceived injustices acted
upon the few remaining midwives. During this period, the practice of home birth was
alive and well in small enclave communities; however, participating in home birth was

396
Neal Devitt, “The Transition from Home to Hospital Birth in the United States, 1930-1960.” Birth
and the Family Journal 4, no. 2 (1977): 47-48, 56.
397
Louise Carpenter, “The Mothers Fighting Back against Birth Intervention,” The Guardian
(December 15, 2012) http://www.guardian.co.uk/lifeandstyle/2012/dec/16/mothers-fighting-against-birth-
intervention.
398
Danielle Pergament, “The Midwife as Status Symbol,” The New York Times (June 15, 2012)
http://www.nytimes.com/2012/06/17/fashion/the-midwife-becomes-a-status-symbol-for-the-hip.html?_r=0.

136

dangerous. Midwives were regularly arrested for practicing medicine without a license
and even for murder in rare cases of maternal or infant death.
399

Occurring in the wake of the protests of the 1960s and concurrently with the
Women’s Liberation Movement, the home birth movement was in many ways unlike
other social movements of its era. There was very little protesting and marching, and in
many ways the desire to give birth naturally seemed at odds with the logic of liberalism
which undergirded other progressive movements of the era. This chapter endeavors to
document the significance of the home birth movement, and the strategies deployed
advocates who attempted to legitimize a practice placed so swiftly and firmly outside the
mainstream that many to this day view it as insane.
400

Although the constructed nature of “natural” has been documented by scholars,
401

to those in the movement, natural birth may be defined as the act of parturition without
the aid or intervention of any drug, medical device or procedure. Interventions to be
avoided include use of several different types of pain medication including epidurals,
sedatives, analgesics, and narcotics;
402
the induction of labor via oxytocin;
403
use of

399
Mary M. Lay, “Midwifery on Trial: Balancing Privacy Rights and Health Concerns after Roe v.
Wade,” Quarterly Journal of Speech 89, no. 1 (2003): 60.
400
See, for example, Alissa Warren, “Why Home Birth is Crazy and Why a Hospital is the Only Place
to Have a Baby,” The Telegraph (April 22, 2012) http://www.dailytelegraph.com.au/news/opinion/why-
home-birth-is-crazy-and-why-a-hospital-is-the-only-place-to-have-a-baby/story-e6frezz0-1226335144670;
Amelia Hill, “Home Birth: ‘What the Hell Was I Thinking?’” The Guardian (April 15, 2011)
http://www.guardian.co.uk/lifeandstyle/2011/apr/16/home-birth-trial-or-rewarding.; Michelle Goldberg,
“Home Birth: Increasingly Popular, But Dangerous,” The Daily Beast (June 25, 2012)
http://www.thedailybeast.com/articles/2012/06/25/home-birth-increasingly-popular-but-dangerous.html.
401
Margaret MacDonald, At Work in the Field of Birth: Midwifery Narratives of Nature, Tradition,
and Home, (Nashville: Vanderbilt University Press, 2007), 93.
402
“Giving Birth: Pain Medicine,” Allina Health, http://www.allinahealth.org/ac/pregcc.nsf/page/bpm
(accessed February 26, 2013).
137

external or internal fetal monitoring devices;
404
administering of intravenous fluids;
episiotomy;
405
use of forceps
406
or vacuum extractor;
407
and Cesarean section.
408
Those
who advocate for natural birth hold that these interventions are unnecessary and often
pose more risk to both the mother and the baby than would a natural birth.
The desire to give birth naturally and at home might be understood as a reaction
to what John Marks has called “biopolitical anxiety.”
409
This anxiety, he states, leads to a
desire to preserve and defend human integrity and dignity in the face of increasing
technological advance and intervention into all areas of life. With this in mind, I argue
that narratives for home birth make a case for resisting the biopolitics of birth by enacting
a posture of natality. As a rhetorical strategy, natality features particular expressions of
time, subjectivity, and biology. Why is natality resistant to biopower? How does natality
offer subversive constructions of time, subjectivity, and biology? These answers to these
questions, I believe, in a collection of natural birth narratives that elucidate a politics of
natality. These natality infused narratives yield a link between agency and natural birth.

403
“Labor Induction,” Mayo Clinic, http://www.mayoclinic.com/health/labor-induction/MY00642
(accessed February 26, 2013).
404
“Fetal Monitoring,” Children’s Hospital of Wisconsin,
http://www.chw.org/display/PPF/DocID/23192/router.asp (accessed February 26, 2013).
405
“Episiotomy: When It’s Needed, When It’s Not,” Mayo Clinic,
http://www.mayoclinic.com/health/episiotomy/HO00064 (accessed February 26, 2013).
406
“Forceps Delivery,” Mayo Clinic, http://www.mayoclinic.com/health/forceps-delivery/MY02085
(accessed February 26, 2013).
407
“Vacuum Extraction,” Mayo Clinic, http://www.mayoclinic.com/health/vacuum-
extraction/MY02084 (accessed February 26, 2013).
408
“C-Section,” Mayo Clinic, http://www.mayoclinic.com/health/c-section/MY00214 (accessed
February 26, 2013).
409
John Marks. “Biopolitics.” Theory, Culture & Society 23, no. 2-3 (2006): 334.
138

Biopolitics and Natality
In recent years, a large body of literature has emerged centering on power and
biopolitics. This may be due, at least in part, to the release of three of Michel Foucault’s
previously-unpublished lectures on the subject.
410
At the same time, in a more general
sense, and in a context of ever-advancing technologies of surveillance, communication,
war, genetics, and medicine (to name just a few areas of concern) it is not at all surprising
that scholars are preoccupied by the modes and means of power being brought to bear on
the lives of individuals and communities. Biopolitics is a term closely related to
Foucault’s biopower, and has been put forward by scholars interested in understanding
the ways in which political structures and powers “manag[e] the life of the
population.”
411
The genealogy of biopolitical power traces its development to a
significant shift in the understanding of biological life, from something that was neutral
and unchanging to something that could be shaped and controlled. In the midst of this
shift, all aspects of biological life are “drawn into the domain of power and
knowledge.”
412
Many have theorized the relationship between biopolitical order and
liberalism, arguing that while biopolitics seeks to “preserve humanity as a species,” it
also strives to impose societal regulation to “reinforce and maintain contemporary
western liberal-capitalism.”
413
Indeed, the preservation of life and the health and progress
of a population are wrapped up with liberalism; as Milbank has noted, “liberalism

410
Rob Cover, "Biopolitics and the Baby Bonus: Australia's National Identity, Fertility, and Global
Overpopulation." Continuum: Journal of Media & Cultural Studies 25, no. 3 (2012): 440.
411
Kathrin Braun, "Biopolitics and Temporality in Arendt and Foucault." Time & Society 16, no. 5
(2007): 10.
412
John Marks, “Biopolitics.” Theory, Culture & Society 23, no. 2-3 (2006): 333.
413
Cover, "Biopolitics," 443.
139

promotes an imagined self-governing of life through a certain capture and disciplining of
natural forces.”
414
Of course, locating a unified source of biopolitical control in a liberal
society is impossible; as Nathan Stormer and others have observed that this power is
channeled through and across “institutions, discourses, and practices that are not
coordinated by any single intelligence.”
415
Biopolitical control is not enacted in a top-
down fashion; in a sense, it is all around us and comes from myriad sources. As Foucault
has argued, the structure of power “makes it possible to use its mechanisms as a grid of
intelligibility” which “must not be sought in the primary existence of a central point.”
416

Power is “omnipresent” because it is continually produced everywhere and in relation to
all things. Foucault writes that “Power is everywhere…because it comes from
everywhere.”
417

Manifestations of this power and control have been readily observed in the realm
of medicine, and in reproduction and reproductive discourses more specifically. As
Foucault and subsequent others observed, biopower is intensified in and through medical
advancement and the health care and hospital system.
418
As David Macey observed, “In
modern hospitals, life and death are not decided by sovereign powers, but by advances in
medical terminology.”
419
Procedures like in vitro fertilization, pre-natal genetic

414
John Milbank. "Paul against Biopolitics." Theory, Culture & Society 25, no. 7-8 (2008): 126.
415
Nathan Stormer. "Mediating Biopower and the Case of Prenatal Space." Critical Studies in Media
Communication 27, no. 1 (2010): 9.
416
Michel Foucault, The History of Sexuality: An Introduction (New York: Vintage Books, 1990), 93.
417
Foucault, History of Sexuality, 93.
418
David Macey. "Rethinking Biopolitics, Race and Power in the Wake of Foucault." Theory, Culture
& Society 26, no. 6 (2009): 202.
419
Ibid., 202.
140

screening, and other new reproductive technologies throw into high relief the power that
may be wielded over the creation of life itself.
420
Others have demonstrated how
biopolitical interest in women’s reproductive biology continues to intensify, as research
in stem cell technology advances and the literal trading of tissues places women across
the globe into a complex biomedical market.
421

As much as biopower is evident in modern healthcare contexts, using a
framework of biopolitical control to understand the myriad discourses and experiences
that comprise the world of reproduction and, in this instance, birth specifically, can be
frustrating for those interested in understanding the potential for agency and alternatives
to the neoliberal system of medical economies of progress. Any sort of mass resistance is
difficult to conceive of within a framework of biopolitical control. The situation invites
critical riposte by taking into account the discourse of others who pose natality as an
alternative to biopolitics. Hannah Arendt held that natality is the human capacity to begin
something completely new; in other words, it is the capacity to act. This capacity is
inherent to being born; every new human born disrupts the former order of things and
changes the world.
422
Humans are imbued with the potential to do something new by the
very event of their birth; natality, then, can be “the miracle that saves the world.”
423

Because it presumes that every human holds the potential for unique and world-changing
action, natality provides a theoretical “way out” of the pervasive system of ever-present

420
Marks, “Biopolitics.” 333; Macey. "Rethinking Biopolitics,” 202.
421
Catherine Waldby and Melinda Cooper, "The Biopolitics of Reproduction: Post-Fordist
Biotechnology and Women's Clinical Labour," Australian Feminist Studies 23, no. 55 (2011): 57-73.
422
Arendt, Human Condition, 9.
423
Ibid., 247.
141

biopolitical control. To put it differently, Arendt’s conception of natality might “take us
beyond the spell of biopolitics.”
424
As opposed to being acted upon by an invisible power,
the freedom that comes along with the exercise of the human capacity to begin anew is,
in Kathrin Braun’s view, synonymous with individual power.
425
To Braun, the most
liberty any person can hope for within a Foucauldian framework is a self-centered
attitudinal liberty, or a liberty of thought.
426
Natality, on the other hand, overcomes
biopolitical power. Braun states, “While the Foucauldian concept of power in a
specifically crypto-normative way denotes a ubiquitous, pervasive, and somewhat dark
and troubling force, power in Arendt emanates from concerted political action.”
427

Whereas biopolitics seeks to normalize, regulate, and categorize (as in, fit-unfit, healthy-
unhealthy, regular-irregular), natality’s project is one of highlighting uniqueness and
capitalizing on difference.
428
Joan Faber McAlister argues that natality “provides an
account of political life that avoids the twin traps of nihilism and fatalism.”
429
Natality,
when viewed in contrast to other analytical models, is decidedly optimistic.
Time. The contrast between natality and biopolitics can be seen across three
primary analytical dimensions: time, subjectivity, and biology. Of course, each dimension

424
Kathrin Braun.,"Biopolitics and Temporality in Arendt and Foucault," Time & Society 16, no. 5
(2007): 7.
425
Ibid., 20.
426
Ibid.
427
Ibid., 6.
428
Ronald C. Arnett "Biopolitics: An Arendtian Communication Ethic in the Public Domain."
Communication and Critical/Cultural Studies 9, no. 2 (2012): 229.
429
Joan Faber McAlister. "Natality Vs. Mortality: Gender and Embodiment in Hannah Arendt's
Political Philosophy." Conference Proceedings -- National Communication Association/American Forensic
Association Alta Conference on Argumentation (2010): 301.
142

is not mutually exclusive, but for purposes of clarity I will treat them as discrete for the
moment. Biopolitical time can be understood as linear, progressive, and “processual.”
430

Biopolitics, concerning itself with questions such as birth rate or overall number of
“normal” pregnancies, focuses on collective phenomena which “pass through” and
subsume an individual’s life. The unique experience of an individual life is replaced by
biological processes; in the context of biopolitical time, “individual life is just a transitory
moment.”
431

In contrast to this, natality opens up an alternative understanding of time which
Kathrin Braun terms “the temporality of the interval.”
432
In fact, Braun goes so far as to
say that “to focus on natality would…mean putting an end to processual temporality and
replacing it with the time of the interval.”
433
Biopolitics is concerned with regulating,
controlling, and generalizing for large populations over long periods of time, while
natality disrupts this process with the beginning of a new interval. Natality “disrupt[s]
determined existence” and begins anew.
434
In the unending span of biopolitical time, the
life of the individual becomes just a “transitory moment,” where “human activities are
qualified and treated as mere means to feed an automatic, relentlessly proceeding
paramount process” and every possible human action becomes nothing more than a

430
Braun, "Biopolitics and Temporality," 11.
431
Ibid.
432
Ibid., 16.
433
Ibid., 19.
434
Rosalyn Diprose. "Women's Bodies between National Hospitality and Domestic Biopolitics."
Paragraph 32, no. 1 (2009): 77.
143

means to something different.
435
Natality resists this process by erupting the continuity of
biopolitical time with intervals of novelty.
Subjectivity. Contrasts between a biopolitical understanding of life and natality
are also evident along the dimension of subjectivity. Giorgio Agamben discusses Hannah
Arendt’s concern with the private realm infiltrating the public and contributing to the rise
of the social in terms of the classical distinction between the categories of bios, or
political life, and zoe, or biological life. It is the merger of zoe into the public sphere, or
“the politicization of bare life” which characterize the contemporary state of
biopolitics.
436
This zoe life, or “bare” life, deals with the biological life of a population
and the means of sustaining and reproducing it
437
. As Agamben sees it, there is no way
for contemporary humans to understand anything about the former distinction between
zoe and bios; no way exists in which to fathom the differences “between man as a simple
living being at home in the house and man’s political existence in the city.”
438
The two
modes of subjectivity have become totally blurred, as bios becomes infused with zoe via
biopolitical means.
Others have elaborated upon the consequences to subjectivity under biopolitics.
For example, according to Rosalyn Diprose, “the spread of biopower tends to reduce the
body open to potentiality (and thus agency) to bare life (or at least to zoe) and to the

435
Braun, “Biopolitics and Temporality,” 11, 17, 15.
436
Giorgio Agamben. Homo Sacer: Sovereign Power and Bare Life. (Stanford: Stanford University
Press, 1998), 4.
437
Ibid., 127.
438
Ibid., 187.
144

biological determinism this implies.”
439
Braun holds that biopolitics engenders the
“political zoeification of humans.”
440
This conclusion is written as if it were supportable
as a universal claim. This is not the case. Biopower invites resistance. Natality
complicates generalizations of “zoeification” to the human condition. Because natality is
a theory of action grounded in biological process, it does not provide a means of
recovering a distinction between the two modes of subjectivity. However, natality does
present opportunities to explore potentially liberating aspects of their merger, as opposed
to looking on the infiltration of zoe into bios as a unilaterally negative phenomenon.
From the perspective of natality, the interplay of zoe and bios may potentially function as
a productive space of creative action. This leads to a consideration of biology.
Biology. Biopolitics and natality ground different pictures of biology and the
potential therein. Biopolitics is of course intimately concerned with the management and
regulation of biological processes, as has already been discussed. Natality, despite the
fact that it resists reduction of humans to bare biology, is far from being anti-biological.
The theoretical concept of natality is, of course, rooted in the biological event of birth.
Some have warned against taking up a too-literal and reductive “gynocentric”
interpretation of natality
441
– and rightly so. Arendt clearly never meant for natality to be
“just” about birth. The fact that she does begin with birth merits consideration. While
Arendt places heavy focus on political action and the life of the mind, she also evinces
concern for a human race eager to escape the Earth; hence, escape their own nature. In

439
Diprose. "Women's Bodies," 83.
440
Braun, "Biopolitics and Temporality," 8.
441
McAlister. "Natality Vs. Mortality," 303.
145

fact, the human desire to escape the earth is a major part of Arendt’s conception of
alienation.
442
The biological fact of birth is the beginning of our capacity for political
action and within it is held the potentiality for all other action. Biology is not something
to escape or transcend; rather, it is a source of power. Here we can see what McAlister
has observed as the potential within Arendt for a feminist ethic centered on “embodiment,
difference, and radical possibility.”
443
While biopolitical frameworks are biologically
deterministic, treating the body as something given that can be readily normalized and
generalized, natality posits a space of biological potentiality. In and through human
biology—and in this case, birth—lies the potential for novelty, new beginnings, and
freedom through action.
This view aligns with what might be termed a “pro-biological” turn in feminist
theory. Whereas much second-wave feminist thought was underpinned by a clear and
necessary distinction between “sex” and “gender,” subsequent work has demonstrated the
limits of this conception. Radical feminism, for example, rejected the liberal notion that
women could gain equality by playing by the rules of the man’s world, while
perspectives termed “difference” feminism go even further toward advocating a
celebration of femininity or the “affirmation of female power.”
444
Alongside these
theoretical developments which have worked toward deconstructing a sex/gender divide,
“anti-biologism” is a legacy that endures in much feminist critique, and distinctions

442
Arendt, Human Condition, 6.
443
McAlister, “Natality vs. Mortality,” 301.
444
See, for example, Catharine A. MacKinnon, Feminism Unmodified: Discourses on Life and Law
(Cambridge: Harvard University Press, 1987), 33; Carol P. Christ, “Why Women Need the Goddess,” In
Laughter of Aphrodite: Reflections on a Journey to the Goddess (San Francisco: Harper and Rowe, 1987):
117-132.
146

between a biologically given sex and a culturally formed gender entrench a dualism that
can be severely limiting. According to Claire Peta Blencowe:
Anti-biologistic feminism was framed in terms of an opposition between ‘nature
and nurture’ or ‘biology and social-construction,’ an opposition frequently
presented as mapping onto a political choice between ‘being (born) and
becoming,’ ‘determination and contingency,’ or ‘conservatism and
transformation.’ The latter terms in the opposition were associated with feminism,
resistance and political progress.”
445

The former, of course, were considered conservative. Natality offers a way out of these
dualisms by providing a theory of agency that draws upon biological potential as a
disruption rather than a determination. This view neither casts biology as determined or
given, nor does it limit itself to “just” biology. It avoids casting the mind in opposition to
the body and instead allows for a more holistic vision of action.
Ways in which these three dimensions – time, subjectivity, and biology – are
expressed through home birth narratives will now be considered. In these writings,
mothers advocate for natural birth, putting into narrative form the experience as a
virtually-always positive, and often empowering life moment. Analysis of the stories
demonstrates that this positive and empowering valence is achieved in at least three
ways: first, birthing women subvert linear time; second, they negotiate and work through
a mind-body relationship; and third, they draw upon the biological body as a source of
malleable power. These narratives give life to the resistance to biopolitics, found in the
theory of natality, as outlined above. This analysis seeks to demonstrate the ways in

445
Claire Peta Blencowe. "Biology, Contingency and the Problem of Racism in Feminist Discourse."
Theory, Culture & Society 28, no. 3 (2011): 5.
147

which, in the context of birth, “the battle for equality and justice is a battle over time and
the body.”
446

Natural Birth Narratives and Natality
Narratives recount personal experience. Janet Schwegel’s Adventures in Natural
Childbirth: Tales from Women on the Joys, Fears, Pleasures, and Pains of Giving Birth
Naturally and Ina May Gaskin’s Ina May’s Guide to Childbirth constitute important
evidence of modern outlooks toward childbirth. Schwegel’s book contains a collection of
thirty-nine narratives from individual women who have given birth naturally with either
a midwife, a doula, a physician, or alone. Gaskin’s book contains forty-four narratives
from women who gave birth to their babies either at home or on a commune called The
Farm, located in rural Tennessee. Gaskin has long been a resident of the commune and
head of a number of midwives who practice therein. Stories in these volumes date from
1970 – 2000.

The Story of Natural Birth
Numerous women commented upon their varying experiences with childbirth.
Nevertheless, it is possible to synthesize the themes discussed to present a representative
anecdote of the natural childbirth narrative. First, something occurs which leads the
woman to want to pursue a natural birth. This could have been a prior bad experience
with a birth in a hospital, a desire to maintain a “natural” life, or the influence of family
or friends. Once the woman has decided to pursue a natural birth, some form of

446
Diprose, “Women’s Bodies,” 70.
148

“naysayer” often intervenes to try and derail the plan; this could be an obstetrician or
other doctor, a nurse, someone leading a birthing class, a family member or friend.
Remaining resolute, the woman moves forward with the plan to birth naturally, despite
the doubts that have been raised by the naysayer. When labor begins, things occur
according to the woman’s design. The environment is safe, comfortable, and calming.
She surrounds herself only by those whom she chooses – a husband, partner, family
member, trusted midwife or doula. However, at some point during labor, the woman
experiences doubt and fear. She allows pain to overtake her or she becomes distracted
from her plan, and suddenly she is unsure whether she will be able to complete a natural
birth. Just as doubt and fear are about to defeat her, something happens to reestablish the
woman’s control and confidence. This could be an interaction with a midwife or other
attendant, an image, a word, or some other strategy that helps the woman refocus her
energy. At this point, with a renewed sense of strength and purpose, the woman forges
on, transitioning from labor to pushing, utilizing greater strength than she knew she
possessed, to complete a successful natural birth. Immediately after the baby is born, she
is placed upon the woman’s chest to begin bonding. At this point, the woman is
exhausted, deliriously happy and serene. Because the woman was not subjected to any
drugs or medical procedures she recovers rapidly, and any injury or tearing of tissue that
occurred during the birth is quick to heal.
Not every narrative hits upon each and every one of these points, of course.
Nevertheless, a comprehensive consideration of the collected stories provides this
plotline as an overall takeaway. The compelling tale of overcoming cultural adversity and
the weaknesses of one’s own body makes a strong case for natural birth on a practical
149

level. Close examination also reveals how women who practice natural childbirth
simultaneously resist various axes of biopower. In the following sections, I examine the
ways in which time, subjectivity, and biology are expressed through the narratives, and
how these expressions run counter to the biopolitical control of medicalized birth. By
bringing to life expressions of time, subjectivity and biology that indicate a theoretical
stance aligned with natality, the narratives make the case for natality as an alternative or
corrective to theories of biopolitics. Finally, I will assess the feasibility and limitations of
a politics of natality realized through natural birth.
Disrupting Time. Evidence drawn from the narratives provides concrete
expression for the alternative conception of time apparent in the concept of natality.
Numerous stories reflect a sense of being removed or apart from standard linear time
during labor. This removal from linear time manifests in the narratives in four primary
ways which are not mutually exclusive; women discuss timelessness, vividness,
transcendence, and cross-time connection.
“Timelessness” is reflected in stories that treat birth as outside of a chronological
ordering of events. The experience of birth is described by Heidi Rinehart as not
“hav[ing] a clear chronology” and by Sue Topf as having “no time sequence.”
447
Rather,
the birth is remembered as a “jumble of great excitement.”
448
Time is also described as
“very fluid and loose.”
449
Others had the feeling of being “suspended” in time or

447
Heidi Rinehart, “Julianna’s Birth – March 6, 1993,” in Ina May’s Guide to Childbirth, by Ina May
Gaskin (New York: Bantam Dell, 2003), 117; Sue Topf, “Lisa’s Birth – April 22, 1983,” in Ina May’s
Guide to Childbirth, by Ina May Gaskin (New York: Bantam Dell, 2003), 93.
448
Topf, “Lisa’s Birth,” 93.
449
Colette Stoeber, “Colette Stoeber’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 48.
150

otherwise felt as though they lost their sense of the passage of time.
450
Kari Jones
remembers her “mind [going] elsewhere to a place where the only passing is of
contractions.”
451
Others use words like “hazy” and “blurry” to describe their sense of
time during birth.
452
For some, linear time is collapsed: Carol Nelson says that
“Timelessness lets you see clearly what a very fine line there is between birth, life, and
possibly death…”
453
Here, all three are present in the space of one interval. For other
women, the passage of time remains chronological, but the rate of passage is fluid. The
difference in rate of passage varies among women; for some time seemed to slow, while
for others it sped up. One mother wrote, “even though I pushed for forty-five minutes, it
felt like only five or ten. Where the rest of that half hour went is beyond me.”
454
Thus, in
the midst of giving birth, women describe the sensation of being somehow apart from the
linear progression of time in ways that allow time to be manipulated, disordered,
collapsed, or stopped. These statements reflect a sense that time is not an unchanging
constant; rather, birthing women function within intervals that are timeless in their
removal from the quantifiable progression.
The subversion of linear time is also reflected in discussions of the “vividness” of
birth. Women recall that, during labor and birth, the sights and sounds around them were

450
Carol Nelson, “Mariahna Margaret’s Birth – October 2, 1980,” in Ina May’s Guide to Childbirth,
by Ina May Gaskin (New York: Bantam Dell, 2003),102; Kari Jones, “Kari Jones’s Birth Story,” in
Adventures in Natural Childbirth, ed. Janet Schwegel (New York: Marlowe & Company, 2005), 26.
451
Kari Jones, “Birth Story,” 27.
452
Katherine Domsky, “Katherine Domsky’s Birth Story,” in Adventures in Natural Childbirth, ed.
Janet Schwegel (New York: Marlowe & Company, 2005), 45; Rinehart, “Julianna’s Birth,” 117.
453
Nelson, “Mariahna Margaret’s Birth,” 102.
454
Jones, “Birth Story,” 26; Domsky, “Birth Story,” 45.
151

heightened and enhanced. For example, during a mid-labor walk outdoors, Tracey Sobel
noted that “the trees and flowers and plants were very vivid and alive. It was the most
real experience I’ve been through – so in-the-moment and so bright.”
455
During labor,
progressive time comes to a standstill and fades into the background while particular
moments erupt into the foreground. Sue Topf remembers “experiencing a remarkable,
heightened sense of awareness – colors seemed brighter, crisp and clear.”
456
Kim Trainor
felt as though “every sound, scent, and color [were] illuminated and heightened.”
457
This
sort of amplified awareness reflects a feeling of moving outside of the forward march of
time, wherein people, events and things become part of a generalizable and averaged
mass. The expression of “vividness” indicates that something special is happening; that
these women are experiencing a sacred and unique moment which does not make sense in
the context of linear time. Particular moments are set apart, stretched, heightened,
amplified, and hold an ever-present meaning apart from the passage of time due to their
eminence.
For some women, vividness gives way to transcendence. Patricia Lapidus recalls
that holding on to her husband was the only thing keeping her “grounded in physical
reality,” while Karen Keogh remembers the feeling of being “in outer space.”
458
Beth
Colton writes, “my mind really let loose, things got real floaty, and I didn’t feel like me. I

455
Tracey Sobel, “The Most Painful, Most Wonderful, Most Beautiful Experience – A Birth on the
Farm – May 17, 1997,” in Ina May’s Guide to Childbirth, by Ina May Gaskin (New York: Bantam Dell,
2003), 40.
456
Sue Topf, “Lisa’ Birth,” 93.
457
Kim Trainor, “Otis Francisco’s Birth – July 2, 1980,” in Ina May’s Guide to Childbirth, by Ina May
Gaskin (New York: Bantam Dell, 2003), 22.
458
Patricia Lapidus, “Samuel’s Birth Story – July 18, 1979,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 44; Domsky, “Birth Story,” 45.
152

felt like a cloud.”
459
All these memories indicate the feeling of a disjuncture between the
ground and the spaces above. Transcending the earth becomes a means to step outside of
linear time and the progressive passage of events in the day-to-day. Above the earth, the
passage of hours and days in accordance with the planet’s rotation loses its significance.
Courtney Crow Wyrtzen echoes this when she writes, “I left the bed and went outside my
bedroom window and up onto the telephone wire in my backyard, where a bird sat
perched watching the festivities. I remember thinking, ‘Why can’t I just go up there for a
minute with that bird; I think I will…’”
460
As the event of birth happens on the ground,
the mother is able to travel outside of her corporeal body to gaze back upon the events
from a place removed. Once again, linear time loses its control over the body of a woman
who is able to transcend its influence.
Cross-time connection is another way in which the subversion of linear time is
expressed in the narratives. Charmaine O’Leary says, “The twelve hours of labor were
for me a magical time of feeling connected. I had a strong sense of being linked to every
other woman who had ever given birth before me.”
461
Angela Miller remembers, “I felt
what so many women have felt before me: I am not alone, I am part of the whole, and I
can do this.”
462
For these women, partaking in natural birth affords the opportunity to step
outside of linear time to connect with other women across time and space. The passage of

459
Beth Colton, “Heaven Morgaine’s Birth – December 22, 1990,” in Ina May’s Guide to Childbirth,
by Ina May Gaskin (New York: Bantam Dell, 2003), 60.
460
Courtney Crow Wyrtzen, “Courtney Crow Wyrtzen’s Birth Story,” in Adventures in Natural
Childbirth, ed. Janet Schwegel (New York: Marlowe & Company, 2005), 110.
461
Charmaine O’Leary, “Climbing Out of Despair,” in Ina May’s Guide to Childbirth, by Ina May
Gaskin (New York: Bantam Dell, 2003), 82.
462
Angela Miller, “Angela Miller’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 102.
153

years becomes meaningless, as these women are giving birth in fundamentally the same
way that women have been giving birth since the beginning of humanity. Advances in
technology and practice occurring over linear time are inconsequential for women who
choose to renounce these advances. Emma Hutchinson remembers envisioning
connections with:
…strong, powerful women, quiet women, loud women, dancing women, squatting
women, kneeling women; women alone, with their partners, with their children,
with other women; women in water, in the ocean, by a river – all fully capable of
giving birth in their own beautiful ways.
463

In this sense, a woman’s experience of birth is not reduced to a utilitarian reproduction of
the species, and reproduction is not a medical process that subsumes the lives and
experiences of individual women. Instead, the opposite occurs as the interval of the
individual birth is punctuated and connected to other such moments across time and
space.
Each of these forms of linear time subversion bring to life theoretical resistance to
biopolitical control and management of reproduction. Wherein the standard hospital birth
is timed according to hospital efficiency and routine, the home birth is not beholden to
any of these limitations. In the hospital, a birth not progressing according to standard
chronological conventions which demarcate the three stages of labor is sped up with
Pitocin, helped along with an episiotomy, or usurped by a Cesarean-section. In stark
contrast to this, a woman birthing at home finds herself in an insulated realm of interval
time. Not only is she not subject to the forward march of hospital procedure, but she is

463
Emma Hutchinson, “Emma Hutchinson and Jonathan Schut’s Birth Story,” in Adventures in
Natural Childbirth, ed. Janet Schwegel (New York: Marlowe & Company, 2005), 112.
154

removed from her own daily schedule and routine. During the event of birth, she removes
herself from the control of all systems of linear time and operates within a novel interval
that demarcates a new beginning.
Negotiating Subjectivity. Birth narratives speak of a natural birth experience that
complicates the assertion of “zoeification”—a condition in which women are subjected to
the expert knowledge and control by the medicalized system of childbirth. A complex
negotiation of subjectivity takes place within and through natural birth narratives, and the
relationship between zoe and bios generates a variety of different expressions. The
bios/zoe negotiation finds expression through discussions of a dynamic mind/body
relationships, and the nature of these relationships stretches across a spectrum of
possibilities. These may be illustrated in four ways. First, many women talk of the
necessity of a mind and body working in harmony; second, others speak to the trouble
that may arise when the mind and body are not working in concert; third, some elevate
the body over the mind as primary and controlling; and fourth, others seem to emphasize
zoe to the near negation of the mind. These four perspectives in which the negotiation of
subjectivity plays out in the narratives exhibit how natality comes into being. As is
indicated by the various possibilities just listed, the narratives do not articulate one
particular sort of bios/zoe merger that empowers; rather, the narratives express the
overlapping if not common themes of women working through the relationship between
the two, grappling with the mind and the body together and simultaneously working to
subvert dichotomies like the “mind/body dualism” which have so thoroughly placed
women at odds with themselves. Mind and body are entered into a cooperative dialogical
155

address in multiple ways, as opposed to dialectical opposition that puts either one or the
other in a position of dominance.
Many women describe the birth experience as one that brings the mind and body,
bios and zoe, together in harmony. As Kathleen Rosemary writes, “This birthing turned
out to be my first major proof that mind and body are one.”
464
For Christy Kramer, this
oneness took the form of mind aiding body: in a moment of exhaustion, when she is
unsure whether she will be able to complete her natural birth, she says, “My rational
mind broke in… and told me that I could do it.”
465
Some describe this oneness as the
unidirectional focusing of all intellectual and corporeal energy. For example, Katherine
Domsky says, “The whole of my mind and body was committed to the effort of creating a
birthing canal for our baby, and I was very strongly aware of that”
466
Suzy Jenkins
Viavant says, “I realized I had to keep my attention on staying open, form my mind all
the way through to my cervix, so that I would be like a hollow tunnel for the energy of
life to pass through.”
467
Angelika Engelmann indicates that having the right “attitude”
was important to the success of her birth experience.
468

Some women detail the importance of preparing both the mind and the body to
work together during birth. Barb Silvestro, for example, writes, “I read and read and read.

464
Kathleen Rosemary, “Joel’s Birth Story – July 6, 1973,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 68.
465
Christy Kramer, “Christy Kramer’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 246.
466
Domsky, “Birth Story,” 44.
467
Suzy Jenkins Viavant, “Robin’s Birth – July 24, 1983,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 77.
468
Angelika Engelmann, “Angelika’s Story – June 18, 1991,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 48.
156

I talked with other mamas. I found a midwife to work with who supported my decision
for a natural birth after cesarean. I read on the Internet, and at the library. I read birth
stories. I prayed. I meditated. I practiced squatting and moving and moaning.”
469
In this
case, accumulating intellectual knowledge about birth in concert with preparing the body
physically is necessary for a successful birth experience.
For others, the cooperation of mind and body is achieved through strategies
before and during labor and birth that allow the mind to focus on and intellectually
process what the body is experiencing. For example, several women speak to the
usefulness of watching the birth progress in a mirror – bringing together corporeal feeling
with intellectual seeing.
470
For others, visualization exercises help to get the mind and
body working together. Lois Stephens says, “I credit daily visualization during my
pregnancies for much of the reason why I was able to have fast, easy births… I would lie
in bed, imagine being in labor, and imagine encouraging the sensations and welcoming
the opening process. I would picture the baby’s head pressing on the cervix and the
cervix steadily opening.”
471
By experiencing the birth in her mind prior to experiencing it
physically, Stephens puts her mind to work to ease the hardship on her body. Others echo
the importance of thought in manifesting material reality.
472

469
Barb Silvestro, “Barb Silvestro’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 207.
470
Bernadette Bartelt, “Brianna Joy’s Birth – June 20, 1995,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 14; Sobel, “The Most Wonderful,” 38; Suzi Mitchell, “The
Birth of Dylan Zade – March 1, 1991,” in Ina May’s Guide to Childbirth, by Ina May Gaskin (New York:
Bantam Dell, 2003), 63; Jennifer Chipman, “Jennifer Chipman’s Birth Story,” in Adventures in Natural
Childbirth, ed. Janet Schwegel (New York: Marlowe & Company, 2005), 38.
471
Lois Stephens, “Lois’ Story – May 7, 1977,” in Ina May’s Guide to Childbirth, by Ina May Gaskin
(New York: Bantam Dell, 2003), 79-80.
472
Rosemary, “Joel’s Birth,” 69.
157

In addition to internal thought and visualization, spoken language and word
choice play a role in many experiences of birth. Midwife Ina May Gaskin understands
that language can condition physical responses; because of this, she replaces the word
“contraction” with the word “rush” with the goal of helping women replace rigidness and
tightness with motion and expansion.
473
Gaskin adds that “the very act of making positive
statements is empowering.”
474
Experiences of mothers reflect this: Lois Stephens writes,
“I knew that when I was in labor, I could say ‘I just want to open up’ or ‘I can integrate
this’ and that reality would sometimes follow the statement.”
475
Sue Robins says, “I was
very, very excited. I kept thinking, “Yes, yes, yes, the baby is coming.’ With [prior
births] I had thought, ‘No, no, no, make the pain go away.’ Thinking ‘yes’ made all the
difference in the world.”
476
Here, the persuasive use of language actually molds the ways
in which the body is able to work physically.
While many women speak of the benefits of a mind and body working in concert,
the experiences of others indicate problems when the mind takes too active a role in the
birth process. Some, for example, purposefully avoid knowledge. Kathryn Van De Castle
heeded advice from her sister, who told her to not read any books about birth and to avoid
writing a birth plan: “She explained that too much reading could interfere with the ability
to flow with what your body is telling you.”
477
In the same vein, Gudrun von Selzam says

473
Ina May Gaskin, Ina May’s Guide to Childbirth (New York: Bantam Dell, 2003), 33.
474
Rinehart, “Julianna’s Birth,” 120.
475
Stephens, “Lois’ Story,” 80.
476
Sue Robins, “Sue Robins’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet Schwegel
(New York: Marlowe & Company, 2005), 142.
477
Kathryn B. Van de Castle, “The Joy of Delivering Grace – April 30, 2000,” in Ina May’s Guide to
Childbirth, by Ina May Gaskin (New York: Bantam Dell, 2003), 24.
158

that most books about birth she encountered focused on everything that could go wrong,
so she simply stopped reading them.
478
Heidi Rinehart recalls her mother’s approach:
“When she was pregnant with us, she refused to listen to the terrifying stories other
women wanted to tell. My mother chose to be ignorant about birth over being in fear.”
479

For these women, certain types of knowledge breed fear rather than strength. As
indicated by the narratives, this oftentimes includes knowledge of the possible ways in
which birth can go wrong—the pathologies of birth. Focusing on the potential medical
hazards of birth may have the potential to place women in a frame of mind wherein they
begin to more readily accept birth as pathological, and doubt their chances of being able
to birth without medical intervention. For these women, the knowledge they seek to avoid
is this “wrong” kind of knowledge, constructed by those who are not in line with their
ways of thinking regarding birth. The wrong kind of knowledge can set the mind working
against the body rather than with it. Knowledge of this sort breeds fear rather than
insight.
According to some women’s experiences, a mind full of fear can prevent the body
from successfully completing natural birth. Sara Jean Schweitzer writes, I didn’t want
fear to prevent the baby from coming, so I tried not to dwell on thinking about the birth
experience. I thought, If I have to jump off a cliff, why think about how I’m going to do
it? Just jump.”
480
Unfortunately for Schweitzer, simply ignoring fearful thoughts proves

478
Gudrun von Selzam, “Gudrun von Selzam’s Birth Story,” in Adventures in Natural Childbirth, ed.
Janet Schwegel (New York: Marlowe & Company, 2005), 59.
479
Heidi Rinehart, “M(idwife in) D(isguise),” in Ina May’s Guide to Childbirth, by Ina May Gaskin
(New York: Bantam Dell, 2003), 112.
480
Sara Jean Schweitzer, “Sara Jean’s Story – December 5, 1999,” in Ina May’s Guide to Childbirth,
by Ina May Gaskin (New York: Bantam Dell, 2003), 29.
159

impossible. She recalls how anxiety overtakes her the night before the birth, which
precedes a labor and birth replete with all sorts of unwanted interventions.
481
Kathleen
Rosemary remembers, “Deep inside I had hidden some fears about my new role as a
mother and about David’s willingness and emotional ability to support this new family. I
had to verbalize these feelings, evidently, in order to free up my body to allow this baby
to come out.”
482
Others, including Valerie Larenne, utilize the techniques of hypnosis to
“release [the] mind” and prevent it from holding the body back during birth.
483
Once
again, the mind has the ability to work against the functioning of the body if it is
preoccupied with the wrong sorts of feelings and thoughts.
Sometimes fear is not caused by too much information or an anxious mind; rather,
obstructive fear can be triggered by popular representations and understandings of birth.
Kathleen Rosemary remembers being “caught up in my belief that I really was
uncomfortable and that I was supposed to complain like they do in the movies!”
484
Reiko
Jodi Halperin agrees, writing, “In the United States, the media bombards us with
screaming women in labor, their legs in stirrups, while their husbands have that panicked
deer in the headlights look. It is no wonder that first-time mothers are apprehensive about
the whole birthing experience.”
485
Dana Ovcharenko writes:

481
Schweitzer, “Sara Jean’s Story,” 31-32.
482
Rosemary, “Joel’s Birth,” 68.
483
Valerie Larenne, “Valerie Larenne’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 203.
484
Rosemary, “Joel’s Birth,” 68.
485
Reiko Jodi Halperin, “Reiko Jodi Halperin’s Birth Story,” in Adventures in Natural Childbirth, ed.
Janet Schwegel (New York: Marlowe & Company, 2005), 169.
160

I see now that our upbringing as modern women (read: control freaks) makes
childbirth intimidating and, especially during the process, frightening because we
do not have any experience with it. This fear, combined with the strong
consumerist tendency in Western culture to avoid pain, completely eliminates the
possibility for us to remain calm in the face of the unknown and have the faith to
handle it.”
486

Of course, this fear does not arise exclusively from media representations; as Robin
Johnson indicates, it is nurtured by the medical establishment: “With labor and delivery
being treated as an emergency, as a dangerous and fragile situation, it’s no wonder that
it’s hard to face it with anything but fear.”
487
Women acknowledge a system wherein
media function in implicit cooperation with the medical establishment, and which throw
their minds out of synch with their bodies.
Fear encroaches some experiences, but it does not define the experience. To avoid
the fear and failure the medical-capitalist complex engenders, many women recall ways
in which they were able to make their minds quiet. For Kathryn Van De Castle, this
involved privileging feeling over thinking. She writes:
I noticed that when I tried to look at things, it put me more in a thinking mode, but
when I was listening, I was more in a feeling/instinctive mode. For instance,
hearing that I was all right really made me feel better. If it had been written down
and I was reading it, it would not have made me feel good. Thinking was scary.

486
Dana Ovcharenko, “Dana (Ksenia) Ovcharemko’s Birth Story,” in Adventures in Natural
Childbirth, ed. Janet Schwegel (New York: Marlowe & Company, 2005), 211.
487
Robin Johnson, “Robin Johnson’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 31.
161

Feeling wasn’t. When I was in feeling mode, things didn’t seem so
overwhelming.
488

Jill Koziey expresses a similar understanding when she writes, “despite the pain I find
myself feeling in awe of my body and how it is doing exactly what is necessary. It is so
liberating to stop thinking and to simply let the natural flow of events take over.”
489
For
these women, the act of thinking becomes connected with all the negative ideas
surrounding birth purported by the medical industry. Where traditional thinking ends is
where liberation begins.
For some women, reflections become problematic when something happens to
activate the mind during birth. For example, Jennifer Chipman’s need to “remain focused
within” herself is almost derailed when she reaches down to touch her baby’s head as it
emerges.
490
Jill Koziey’s meditative and mindless chanting is also derailed by an
interruption; she writes:
At one point the obstetrics nurse suggests to me that I save my energy for pushing
by breathing instead of vocalizing. Suddenly I am confused. Do I need to
conserve my energy? I have never done this before. Will I run out of steam when
it comes time to push? I stop my spoken words to my baby and instead focus on
my breath. The pain becomes overwhelming, and my confusion intensifies. The
sounds coming out of me are now high-pitched. I have lost touch with the
grounding force that was within me. Seeing me in this state, Ivy leans over and

488
Van de Castle, “Delivering Grace,” 25.
489
Jill Koziey, “Jill Koziey’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet Schwegel
(New York: Marlowe & Company, 2005), 138.
490
Chipman, “Birth Story,” 38.
162

gently whispers that I should do whatever I need to do. I am grateful for this
simple sentence, and I relax my mind and let my body take over once more.
491

Janel Schwegel has a similar experience, and writes:
If our mind is busy on the outside, it is hard to hear the inside. For example, in
one of my birth experiences, someone said, “Push.” This caused an alert button to
go off in my brain. I couldn’t understand why someone would try to direct me
unless there was danger. I had to process whether or not something was wrong. I
felt pulled away from the flow of birth. I felt fear and confusion wanting to enter
my sacred space. I went within and asked my inner source if everything was okay.
In doing so I had to travel deeper into the earth’s belly than I had ever been
before. I felt peace wash over me as nature’s love dissolved my being and told me
everything was more than okay.
492

For these women, the framework of harmful thinking is so powerful that it only takes the
slightest of triggers to set the whole system back into motion. One small word or phrase
activates a web of associations that threatens to pull the woman back into a mindset
geared toward pathological birth. It is a powerful and persuasive pull, having been
cultivated over time by a host of intersecting authorities. Resisting requires a fully
concerted effort on the part of the birthing woman.
Finally, this generative discursive dialogue of the mind/body relationship pushes
the role of the body to the near negation of the mind. Some women claim to experience
retreat inside the body. Rosemary Larson remembers, “I was completely inside my body.

491
Koziey, “Birth Story,” 140.
492
Janet Schwegel, Adventures in Natural Childbirth (New York: Marlowe & Company, 2005),234.
163

I didn’t feel like ‘me’ at all.”
493
Alyson Jones has a similar experience, writing, “For the
next hour, my parents tried to talk to me and get some feedback as to how I was feeling
and what stage I was in, but I was deep within myself and couldn’t communicate with
them.”
494
Stacy Smith’s experience reflects a similar annihilation of communication; she
says, “[My husband] was asking me questions, but his voice and everything else going on
around me faded into the background. All I could feel was this giant force within my
body completely overtaking me, and I told him, rather sharply, not to talk to me until the
contraction was over.”
495
Jennifer Chipman used a mirror to watch her birth happen, but
says, “I was so internally focused that I didn’t even see her emerge in the mirror!”
496
For
some women, totally letting go of the mind’s ability to see or speak becomes a necessary
part of the birth process.
Others go even further, when discussing their body as if it were an outside force
with a will and agency of its own. Suzi Mitchell writes, “I started pushing. It wasn’t a
conscious effort. My body just took over.”
497
Tracey Sobel expresses a similar feeling,
recalling, “I had to bend my knees during the peak of each contraction; otherwise, it
would have hurt worse. I couldn’t have kept from bending my knees if I’d wanted to. My

493
Rosemary Larson, “Rosey’s Storey – September 20, 1994,” in Ina May’s Guide to Childbirth, by
Ina May Gaskin (New York: Bantam Dell, 2003), 36.
494
Alyson Jones, “Alyson Jones’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005),67.
495
Stacy Smith, “Stacy Smith’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet Schwegel
(New York: Marlowe & Company, 2005),162.
496
Chipman, “Birth Story,” 38.
497
Suzi Mitchell, “The Birth of Dylan Zade – March 1, 1991,” in Ina May’s Guide to Childbirth, by
Ina May Gaskin (New York: Bantam Dell, 2003), 63.
164

body was just doing what had to be done.”
498
Lois Stephens’ body “took over” both
physical actions and vocalizations; she writes, “My body just took over when I started
pushing and I loved it! Great, low grunts came from my throat while I pushed. I didn’t
even try to make the sounds.”
499
Kari Jones similarly remembers, “At some point the
laboring is over and the pushing begins. I have no control over this. My body happens.
My mind goes along.”
500
Christy Kramer writes, “I had no control over my body
anymore. It was only what it was and not what I wanted it to be,”
501
while Patricia
Lapidus similarly remembers not having any control over her muscles during birth.
502
For
some, it seems, a sort of self-zoeification occurs wherein the intellect is totally
surrendered to the needs of the body.
Occasionally, women write of attempting, and failing, to engage their minds
during labor and birth. Charlotte Russel, recalling her water birth, writes, “I knew
intellectually that I didn’t want to get into the water at only four centimeters because it
could stall my labor, but my intellectual was not in control at the time.”
503
Anna Stewart
similarly gave in to her body: “My mind was trying to tell my body to follow the

498
Sobel, “The Most Wonderful,” 40.
499
O’Leary, “Climbing Out,” 81.
500
Kari Jones, “Birth Story,” 27.
501
Christy Kramer, “Christy Kramer’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 245.
502
Patricia Lapidus, “Samuel’s Birth Story – July 18, 1979,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 45.
503
Charlotte Russell, “Charlotte Russell’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005),97.
165

childbirth schedule from my class, but my body was clearly the one in charge.”
504

Finally, Stacy Smith remembers, ““There was no way I could think myself through this.
My body was completely in control. My whole mind, body, and soul were consumed
with the power and force of each contraction.”
505
These experiences evince an interesting
internal negotiation of subjectivity, wherein the woman perceives different aspects of her
person to be in contention with one another and the body is fixed with its own agency and
able to take control when necessary.
Moving one more step, to the extreme of the negotiated mind/body spectrum, are
more instances of what might be called a type of self-zoeification. Here, women make
plain their perceived status as animals. Various women talk of feeling like a cow,
506

horse,
507
lion,
508
gorilla,
509
or just an animal in general.
510
Janet Schwegel writes, “Most
laboring animals do much better if they are not moved and their need for space is
respected. Sometimes we forget that we, too, are animals, but most of us will do well if
given similar respect.”
511
At the same time, many women describe the experience of

504
Anna Stewart, “Anna Stewart’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005),215.
505
Smith, “Birth Story,” 166.
506
Kim Trainor, “Lily Rose Heart’s Birth – November 20, 1976,” in Ina May’s Guide to Childbirth, by
Ina May Gaskin (New York: Bantam Dell, 2003), 21; Lapidus, “Samuel’s Birth,” 45.
507
Mitchell, “The Birth of Dylan,” 63.
508
Diana Janopaul, “Evan’s Birth – January 24, 1998,” in Ina May’s Guide to Childbirth, by Ina May
Gaskin (New York: Bantam Dell, 2003), 55.
509
Engelmann, “Angelika’s Story,” 50.
510
Smith, “Birth Story,” 162.
511
Schwegel, Adventures, 230.
166

natural birth as “primitive,” “primal,” or “primeval.”
512
These types of statements
indicate a complete absence of a rational mind; the animal body is all that exists.
In the realm of mind/body negotiation and tension, women are seen to be
grappling with issues relating to something of a zoe and bios distinction. Some evince a
subjectivity where the mind works actively alongside the body. However, when the
relationship becomes unbalanced or troubling the body seems to always win out. In this
way, women appear to be self-zoeifying, discounting their own intellect and agency in
favor of an animal instinct. Importantly, however, this seeminly zoeified body is
attributed with agency. The body is active, not passive; for these women, self-zoeification
for purposes of achieving a great physical goal is not the same as being reduced to your
biology for purposes of mechanization and control from above. Moreover, putting the
active body to work for purposes of working toward a political goal, as these women do,
demonstrate that the infusion of bios with zoe does not have to be unilaterally destructive
of political agency.
Claiming Biological Agency. The narratives I have offered present strong
resistance to anti-biological treatments of the body. The biological should not be
confused with biopolitics, however. These narratives wholly reject notions that the body
is an unchanging “given,” and that this given body is something to be overcome or
transcended through regulation. Women discuss bodily changes and describe the
malleability of both sensation and physical form. The changeable nature of the body is
located as a source of power (as opposed to a static body that may only hinder

512
Koziey, “Birth Story,” 140; Smith, “Birth Story,” 166; Kramer, “Birth Story,” 245; Sobel, “The
Most Wonderful,” 41; Rebecca Salonsky, “Moment of a Miracle – December 23, 1986,” in Ina May’s
Guide to Childbirth, by Ina May Gaskin (New York: Bantam Dell, 2003), 88.
167

empowerment). The narratives also offer a critique of the ways in which this power is
stymied by technology seeking to regulate and control the body. Consider the generative
qualities of birth experience in relation to self-perceived changes in the body,
accommodation of pain, meaning of movement and the recollection of empowerment and
transformation. The achievement of agency in these cases is remarkably expressed.
First, evidence drawn from the narratives indicates that many women do not feel
that their body is static, given, and unchangeable; rather, they tell of the ways in which
their bodies were able to change, adapt and reform to accommodate birth. One clear way
this is evident is through discussions of the body’s ability to regulate or change the
sensation of pain during birth. Beth Colton writes, “I really believe now that you don’t
need drugs during labor, because your body makes its own.”
513
Angela Miller echoes this,
writing, “I was so filled with the warm fuzzy feelings produced by my body’s natural
endorphins that I didn’t need a thing [for the pain].”
514
Corrine Hepher remembers feeling
“natural painkillers pulsing through [her].”
515
According to these women’s experiences,
the body is able to compensate for extreme pain by producing its own chemicals.
In addition to these natural painkillers, women are able to draw on other bodily
resources to lessen the experience of pain. Lois Stephens writes that she was able to
breathe in such a way that her “rushes [contractions] didn’t hurt but felt strong and
pure.”
516
Others rely on breathing for pain management as well; Ellen Coss writes, “As I

513
Colton, “Heaven Morgaine’s Birth,” 60.
514
Angela Miller, “Angela Miller’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 103.
515
Corinne Hepher, “Corinne Hepher’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 152.
516
Stephens, “Lois’ Story,” 80.
168

looked into their [midwives’] eyes, we would breathe calmly as one, and the discomfort
would fade.”
517
Carol Nelson remembers that she was able to keep the pain manageable
by “keeping [her] face and neck muscles relaxed and making low-toned noises.”
518

Jennifer Chipman also used “moaning as [her] main method of pain control.”
519
For
Alyson Jones, understanding that the discomfort she experienced was a “working pain,”
and helping her progress toward the goal of a successful birth, made the pain
manageable.
520
Similarly, Katherine Domsky felt her pain all but disappear as she
transitioned from contractions to the work of pushing.
521
These descriptions give meaning
to notions of natural pain management, and acknowledge that experiences of pain are
capable of being shaped and changed.
Other women describe birth as relatively pain-free without giving a clear reason
why. Karlene Taylor says, “Was it painless? Yes, it was beautiful! Pain would never be
the word I would use to describe my experience.”
522
Valerie Larenne describes a similar
experience, writing:
I had no feelings of discomfort when my midwife reached in to help fully open
my cervix. I had no feelings of discomfort when my son crowned. There was no
ring of fire. Nothing. The only discomfort I experienced during this time was the

517
Ellen Coss, “Sebastian’s Birth – July 12, 1986,” in Ina May’s Guide to Childbirth, by Ina May
Gaskin (New York: Bantam Dell, 2003), 86.
518
Nelson, “Mariahna Margaret’s Birth,” 103.
519
Chipman, “Birth Story,” 37.
520
Alyson Jones, “Birth Story,” 67.
521
Domsky, “Birth Story,” 44.
522
Karlene Taylor, “Karlene and Jim Taylor’s Birth Story,” in Adventures in Natural Childbirth, ed.
Janet Schwegel (New York: Marlowe & Company, 2005), 136.
169

work my abdomen was doing to help push the baby out, kind of like overdoing it
on the ab machine at the gym.
523

For Karie Dundas, the only “real” pain came when her midwife had to reach inside her to
help pull the baby out, while the rest of the sensations were “just powerful movements
that [her] body knew how to do.”
524

In addition to the body being able to change, lessen, or completely do away with
the experience of pain, women describe their bodies as undergoing significant physical
changes in form as well. Some of these changes in form involve different visualization
exercises, again representing the mind/body connection. Tracey Sobel followed the
advice of her midwife and found it was useful to “imagine a flower blooming.” She says,
“I kept thinking of that image – a huge, beautiful flower opening and the baby coming
out.”
525
Kari Jones writes of another type of visualization, “I pictured myself at the top of
a rapid, my kayak bouncing underneath me, my mouth wide open as I yell in terror and
exhilaration. I envision navigating the waves until I am out the other side, shouting still,
this time in joy.”
526
Emma Hutchinson remembers, “The sun was a perfect circle in the
hazy sky, and I imagined its rays coming down and helping the muscles in my uterus pull
up and open my cervix.”
527
Mary Shelton writes:

523
Valerie Larenne, “Valerie Larenne’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 206.
524
Karrie Dundas, “Liza’s Birth – Esalen, Big Sur, California – September 19, 1990,” in Ina May’s
Guide to Childbirth, by Ina May Gaskin (New York: Bantam Dell, 2003), 106.
525
Sobel, “The Most Wonderful,” 39.
526
Kari Jones, “Birth Story,” 27.
527
Hutchinson, “Birth Story,” 113.
170

I fastened on a particular word and meaning: surrender. I began having
contractions and feeling big waves of energy moving. I visualized my yoni
[reproductive organs] as a big, open cave beneath the surface of an ocean, with
huge, surging currents sweeping in and out. As the wave of water rushed into my
cave, my contraction would grow and swell and fill, reach a full peak, then ebb
smoothly back out. I surrendered over and over to the great oceanic, engulfing
waves. It was really delightful – very orgasmic and invigorating.
528

These women all put their imaginations to work in the service of helping their bodies
work through the changes necessary to achieve natural birth. Another woman has an even
more astonishing experience; Anna Stewart writes:
I am surprised when Alice [midwife] tells me that I am losing too much blood and
that I need to stop it now. She makes me look at her and tells me I have to stop the
bleeding right now. I close my eyes and remember my uterus, which has held my
baby so well these nine months. I visualize the bleeding stopping and my uterus
finally resting. It works, and they decide not to give me Pitocin and new blood. I
am reconnected now, my mind in harmony with my body, my heart in bliss with
my partner and my son.
529

For Stewart, a mind and body working in concert have almost mystical powers and are
able to control events, such as bleeding, that are thought of to be uncontrollable in this
manner.

528
Mary Shelton, “A Story of Sisterhood – February 13, 1972,” in Ina May’s Guide to Childbirth, by
Ina May Gaskin (New York: Bantam Dell, 2003), 10.
529
Anna Stewart, “Anna Stewart’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet
Schwegel (New York: Marlowe & Company, 2005), 216.
171

Other times, women experience the physical changes of birth being facilitated by
various types of bodily movement. Kim Trainor took a hike in the woods during labor, so
that the movements and gravity would help her “open up” in preparation for birth. She
writes that she could “feel [her] baby move [her] open.”
530
Jennifer Chipman was advised
by her midwife to “crawl around on [her] hands and knees and to lie in an exaggerated
sideways pose” to help move her baby into a favorable position for birth.”
531
Mary
Sievers remembers, “Moving around a lot – I ‘danced’ through some contractions – and
making low, strong sounds made a big difference… Toward the end I squatted through
some contractions, and that helped me open up and relieve the pressure.”
532
Celeste
Kuklinsky writes that she helped her body through the birth by “squat[ting], bend[ing]
over, walk[ing] around…or danc[ing] like a whooping crane.”
533

Some women recall observing real physical changes in their bodies, as Jeanne
Madrid writes that she can “remember hearing [her] pelvic bones squeaking open” as she
pushed.
534
Charmaine O’Leary likewise remembers observing with wonder the “elastic
and powerful… bodily changes” as her labor progressed.
535
Kari Jones felt her body
changing shape, “centimeter by centimeter,” as her baby moved.
536
While this range of

530
Trainor, “Otis Francisco’s Birth,” 22.
531
Chipman, “Birth Story,” 36
532
Mary Siever, “Mary Siever’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet Schwegel
(New York: Marlowe & Company, 2005), 264.
533
Celeste Kuklinski, “Harley’s Birth – October 19, 1995,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 9.
534
Jeanne Madrid, “Mulci’s Birth – October 13, 1974,” in Ina May’s Guide to Childbirth, by Ina May
Gaskin (New York: Bantam Dell, 2003), 76.
535
O’Leary, “Climbing Out,” 82.
536
Kari Jones, “Birth Story,” 27.
172

bodily changes certainly demonstrate that the body is not static, what is perhaps more
interesting is how the enactment of this malleable body, through natural birth, is
translated into a source of power in the narratives.
For those who advocate natural birth, the “empowering” nature of the experience
is a key factor, and women who undertake natural birth are framed as “powerful.” Many
women recall picking up on this theme through interactions with their midwives. Rita
Winningham says that she accepted her midwives’ attitude “that birth was a
strengthening rite of passage for women.”
537
Robin Johnson says that, under the care of
her midwife, “I would be the one doing the delivering. Case in point: Noreen [midwife]
was establishing me as the expert when it came to my own body and birth. It was very
strengthening and liberating.”
538
She remembers how her midwife carried this theme
through the birth, telling her over and over again that she was a “strong and powerful
woman.”
539
Bernadette Bartelt similarly recalls her midwives talking of her strength,
during the birth.
540
Alyson Jones writes, “By showing me how to be in control of my own
body and pregnancy, Angela [midwife] helped me feel more powerful and confident than
I ever had before.”
541
Janet Schwegel reinforces these feelings; she says, “The concept of
power is key in natural birth. A woman wanting a natural birth needs to take ownership
of her body, her baby, and her birth experience. She must adopt the attitude that she is in

537
Rita Winningham, “Harry’s Birth – August 2, 1976,” in Ina May’s Guide to Childbirth, by Ina May
Gaskin (New York: Bantam Dell, 2003), 72.
538
Johnson, “Birth Story,” 31.
539
Ibid., 30.
540
Bartelt, “Brianna Joy’s Birth,” 14.
541
Alyson Jones, “Birth Story,” 66.
173

charge and that what she wants is more important.”
542
Within the overall framework of
“empowerment,” women describe different feelings of and relationships to power over
the course of their birth experiences.
Many women recall the power they felt, in their bodies, during contractions.
Midwife Barbara Wolcott insists, “This is your opportunity to remember your power as a
woman, inhibitions not allowed. Those contractions are power surges.”
543
Kathryn Van
de Castle remembers, “I felt scared to feel so much power in my body.”
544
Patricia
Lapidus says, of labor, “I had an amazing feeling of energy that I was ready to use in a
big way!”
545
Stacy Smith recalls, “The force that was going through me was absolutely
amazing.”
546
Important to note here is how, at this stage of labor, women largely describe
power as something that is happening to them. They feel the power within them, building
and moving, but they do not interpret themselves as taking an active role in its production
or use – some even feel afraid or overwhelmed by the power they feel inside. To further
illustrate, Heidi Rinehart remembers:
The scary part was the power. It felt like I was running along a railroad track and
a steam locomotive was bearing down on me, and I was about to be run over. I
didn’t realize at the time that unleashing the power made the labor progress and

542
Schwegel, Adventures, 17.
543
Barbara Wolcott, “Barbara’s Reflections,” in Ina May’s Guide to Childbirth, by Ina May Gaskin
(New York: Bantam Dell, 2003), 28.
544
Van de Castle, “Delivering Grace,” 24.
545
Lapidus, “Samuel’s Birth,” 44.
546
Smith, “Birth Story,” 166.
174

that I was in no danger of ‘being run over.’”
547
However, she goes on to say,
“You’re not going to fall off and get run over, but the ride requires that you have
faith and surrender to the power of it.
548

Robin Johnson describes her feelings during labor: “The intensity was overwhelming. It
was more than pain; it was pure energy […] It was not the chorus of chaos that I had
feared but a song of strength and surrender.”
549
An important transformation occurs in the
description of power as women transition from contractions to pushing. It is at this point
that women stop describing themselves as passive in relation to power.
Pushing, for many women, becomes an opportunity to actively use the power that
has been building within their body. While Kathryn Van de Castle was “scared” of the
power she felt during contractions, she says, “Pushing was absolutely exhilarating. I
loved it. I began making incredibly deep, loud cries that helped me move Grace down. I
was ecstatic as I pushed Grace out.”
550
Pushing gives her the chance to wield the power
of her body. During her transition from contractions to pushing, Katherine Domsky was
“rejuvenated.” She says, “My body was doing what it knew how to do, and I once again
felt fully confident that I could do this. I could do this!”
551
Mary Ann Curran describes
the feeling of being “really geared up to push away.” She says, “This is the good part, I
was thinking. And it surely was. Pushing was HARD work. Don’t get me wrong; It was

547
Rinehart, “Julianna’s Birth,” 119-20.
548
Ibid., 120.
549
Johnson, “Birth Story,” 32.
550
Van de Castle, “Delivering Grace,” 25.
551
Domsky, “Birth Story,” 44.
175

so rewarding and fulfilling, I can’t explain it.”
552
Rebecca Salonsky remembers that she
felt “so strong.” She says, “I experienced a trust in my own body that I’d never known
before.”
553
Other women describe the experience of pushing as “really beautiful,”
554
“a
glorious feeling,”
555
and “a huge party.”
556
For Robin Johnson, the discovery that the
intensity she was feeling translated to strength brought “a sense of freedom, freedom
from fear.”
557
For these women, the realization that they were able to essentially grab
hold of and deploy the power within their bodies brought on feelings of joy and liberation
amidst intense work and struggle.
In the aftermath of this great exertion of power, women describe their feelings of
satisfaction and transformation. Mary Ann Curran writes that she felt “accomplishment,
wonder, thrill, and relief.”
558
Kim Trainor recalls feeling “strong and powerful” in the
aftermath of her natural birth.
559
Susan Levinson says, “I was really proud of myself for
giving birth the way I did, and I look at my children’s births as major highlights of my
life.”
560
Jody Francis writes, “Birth experienced the way I experienced it is so amazingly

552
Mary Ann Curran, “Shannah’s Birth – May 22, 1985,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 28.
553
Salonsky, “Miracle,” 88.
554
Colton, “Heaven Morgaine’s Birth,” 61.
555
Coss, “Sebastian’s Birth,” 86.
556
O’Leary, “Climbing Out,” 82.
557
Johnson, “Birth Story,” 34.
558
Curran, “Shannah’s Birth,” 28.
559
Kim Trainor, “Lily Rose Heart’s Birth – November 20, 1976,” in Ina May’s Guide to Childbirth, by
Ina May Gaskin (New York: Bantam Dell, 2003), 22.
560
Susan Levinson, “Felicia’s Birth – November 21, 1973,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 65.
176

empowering, such a wonderful, satisfying experience. I can only wish that all women
could experience birth in such a positive way. Labor in childbirth is hard work but is
most definitely worth it!”
561
Diana Janopaul speaks to the transformation she underwent
during natural birth: “The most amazing change I have noticed is how much stronger I
feel as a person.”
562
She goes on to say, “My first two births were not at all empowering.
I felt defeated, dejected, and discouraged afterward, and the disappointment was almost
unbearable. After Evan’s birth, I was physically sore and tired. But I felt so victorious
and strong inside…I felt so powerful.”
563
Kathryn Van de Castle, who was able to
transform her fear of the power of her contractions into feelings of exhilaration as she
pushed, sums up her experience:
Through the process of childbirth, I gained a lot of confidence in myself… I have
felt incredible energy and life force through my body, and I have really been
reborn a happier, healthier, and more confident person. I have learned that I can
choose to focus on the darker side or the lighter side of all that is around me. I
choose the lighter side and have the discipline to keep it up.
564

The intensely difficult nature of labor gives way to feelings of accomplishment, alongside
the attainment of power. Accomplishment and power are regarded as results of choices
made by the woman, including the choice to birth naturally and many choices to not give
up along the way. However, this choice is sometimes painted as one of perception rather

561
Jodi Francis, “Jodi Francis’s Birth Story,” in Adventures in Natural Childbirth, ed. Janet Schwegel
(New York: Marlowe & Company, 2005), 54.
562
Janopaul, “Evan’s Birth,” 56.
563
Ibid., 56.
564
Van de Castle, “Delivering Grace,” 25-26.
177

than material reality, as in the prior excerpt, wherein choice ultimately boils down to
choosing where to place focus.
Finally, accompanying testimonies of empowerment through natural birth are
contrasting stories of disempowerment through medicalized birth. Women sometimes
describe the ways in which medical technology, in general, works against the natural
functioning of their bodies. The hospital environment and doctors cause undue
apprehension, and the entire experience removes control from the mother. This can lead
to feelings of guilt and failure, as evidenced by the narratives.
Doctors accompanied by a retinue of birth “experts” made them feel
uncomfortable. Mary Ann Curran writes that, in the aftermath of telling her obstetrician
of her desire to birth naturally, the (male) doctor became noticeably and physically
rougher and discourteous to her during exams.
565
Valerie Larenne remembers her
experiences with a condescending doctor, writing:
I was already becoming very protective of my baby and less confident that the
doctor was interested in what I had in mind for my birthing. With each visit to this
‘expert,’ my sense of unease grew. He seemed dismissive of me in general and
cautioned me not to talk to my mother or girlfriends about any questions or
concerns I had. With a wink and a smile he said, ‘If you have a question, talk to
me. When you start talking to other people, you’ll just get confused.’
566

Suzy Jenkins Viavant remembers taking a childbirth class where the instructor seemed to
want to “drill it into [students’] heads that labor would be a very painful, long, traumatic

565
Curran, “Shannah’s Birth,” 26.
566
Larenne, “Birth Story,” 201.
178

experience.”
567
Having already had one natural home birth, Viavant knows this to be
untrue; yet she says that in the absence of this experience, the class would have caused
her to become uptight and expecting the worst of birth.
568
Njeri Emanuel also remembers
a heavy focus on pain in her labor class, which she says initially led her to want to avoid
pushing – the “hardest part” – by having a Cesarean section.
569
Katie Hurgeton
remembers being on the receiving end of similar fear-mongering from her own mother,
who was constantly dismissive of her decision to not have an epidural, and insisted on
repeatedly telling stories women who “would have died” during childbirth had they not
been at a hospital.
570
Robin Johnson writes, “The journey to get [to birth] always seemed
to be portrayed as horrible, so horrible, in fact, that it was best to avoid it, with drugs,
induction, cesarean section, whatever, just to get that baby out quickly and with as little
pain as possible.”
571
For Dana Ovcharenko, biomedical culture perpetuates a fear of
childbirth. She writes:
Our upbringing as modern women (read: control freaks) makes childbirth
intimidating and, especially during the process, frightening because we do not
have any experience with it. This fear, combined with the strong consumerist

567
Suzy Jenkins Viavant, “Vanessa’s Birth – January 21, 1990,” in Ina May’s Guide to Childbirth, by
Ina May Gaskin (New York: Bantam Dell, 2003), 78.
568
Ibid., 78.
569
Njeri Emanual, “Ramez’s Birth Story – May 30, 2003,” in Ina May’s Guide to Childbirth, by Ina
May Gaskin (New York: Bantam Dell, 2003), 11.
570
Katie Hurgeton, “Abigail Rosalee’s Birth – April 21, 2000,” in Ina May’s Guide to Childbirth, by
Ina May Gaskin (New York: Bantam Dell, 2003), 15.
571
Johnson, “Birth Story,” 31.
179

tendency in Western culture to avoid pain, completely eliminates the possibility
for us to remain calm in the face of the unknown and have the faith to handle it.
572

In the narratives, these events and ideas are presented as obstacles which were overcome
by women dedicated to the natural birth experience.
Many also describe their prior experiences of giving birth in a hospital setting,
and the ways in which the environment contributed to problems during and after birth.
Karen Lovell describes her experience: “The hospital gowns and masks meant to create a
more ‘sterile’ environment were just that – sterile, cold, and intimidating. Also I had to
labor on my back because of the [fetal] monitor and ended up with a big episiotomy and
forceps delivery.”
573
In Lovell’s opinion, if she had not been required to submit to fetal
monitoring she could have given birth in another position and likely avoided the
additional interventions. Kim Trainor describes the traumatic experience of her first birth,
which took place in a hospital and is almost more suggestive of a scene from a horror
film than a real-life birth experience. She writes that she was “told to stay still,” “strapped
on [her] back,” “scolded by nurse[s]” for trying to squat, put under the glare of bright
fluorescent lights, “left alone to labor, strapped on [her] back,” “knocked out with ether,”
“given a standard-procedure episiotomy [which required] twelve stiches,” “hauled off by
a couple of ward attendants” when she tried to visit her newborn, and then subsequently
given “a powerful sedative that kept [her] awake but unable to move.”
574
Trainor writes,
“This was an incredibly traumatic experience. I came away from birth bruised and

572
Ovcharenko, “Birth Story,” 211.
573
Karen Lovell, “James’s Birth – November 16, 1986,” in Ina May’s Guide to Childbirth, by Ina May
Gaskin (New York: Bantam Dell, 2003), 6.
574
Kim Trainor, “Autumn Apple Windseed’s Birth – November 11, 1970,” in Ina May’s Guide to
Childbirth, by Ina May Gaskin (New York: Bantam Dell, 2003), 19-20.
180

battered, drugged and ripped off of my nurturing instincts and sense of confidence. After
such a trauma, I knew I would never again give birth under such inhumane
conditions.”
575

The standard procedures of hospital birth, even when not intensely traumatic, are
described as subordinating the woman’s needs, desires, and agency. Heidi Reinhard
writes, “The language everyone used [in the hospital] reflected where control lay: ‘We let
her eat, walk, not have an I.V. etc.,’ and ‘They let me keep the baby all night.’”
576
Diana
Janopaul recalls her first birth, during which she agreed to take Pitocin to speed up labor.
This, however, led to the oft-cited “cascade of interventions” which became necessary
because of the initial dose of Pitocin, wherein she was attached to a fetal monitor and
given the narcotic Stadol, intravenous antibiotics, an epidural, and finally a Cesarean
section. She writes, “[I] felt totally out of control and defeated.”
577
Reinekke Lengelle
recalls a similar experience, wherein she agreed to an initial intervention which then left
her feeling out of control. She writes:
Saying ‘yes’ to the epidural was quite possibly the most difficult decision I had
ever made. The right half of my body was completely dead (my leg lay like a log
that didn’t belong to me)… Soon I was completely dilated and felt the faint urge
to push. By about six PM I started pushing with the help of the monitor that
showed the contractions because I had only a vague awareness of them.
578

575
Trainor, “Autumn Apple,” 20.
576
Heidi Rinehard, “M(idwife in) D(isguise),” 114.
577
Janopaul, “Evan’s Birth,” 53.
578
Reinekke Lengelle, “Reinekke Lengelle’s Birth Story,” in Adventures in Natural Childbirth, ed.
Janet Schwegel (New York: Marlowe & Company, 2005), 57.
181

Reiko Jodi Halperin echoes this, writing, “I have never felt so helpless in my entire
lifetime. I vowed to never be at the mercy of medication again.”
579
Suzi Mitchell
expresses the lack of control this way: “Not only do they take the pain away, they take all
the feelings away, and ultimately they take the baby away.”
580
Although medical
intervention is oftentimes framed as a “choice” to relieve pain or ease the difficulties of
birth, these women’s experiences indicate that the choice to allow one intervention
forestalls any additional moments of choice during the birth.
Professional medical intervention during birth led some women to express guilt or
a sense of failure in the aftermath. Diana Janopaul, whose agreement to Pitocin ultimately
led to a Cesarean section, remembers, “The feelings I experienced after this ranged from
inadequacy to failure to anger. I found myself apologetically explaining my cesarean to
complete strangers.”
581
Thus, while the ability to take control of and wield the power of
biology is regarded as a liberating action, the giving over of one’s biology to outside
control is something to be ashamed of. Taken together, the narratives paint a compelling
vision of a body that is malleable and productive, and able to produce power. This power
is a source of liberation for some women, and is realized as such on two levels. First, the
body’s power serves a self-actualizing function for the women writing the narratives; and
second, it raises political consciousness and prompts women to recount their experiences
for purposes of encouraging others to resist hospital birth in the same way. Here, identity
derived from biology translates into political agency.

579
Halperin, “Birth Story,” 171.
580
Mitchell, “Birth of Dylan,” 63.
581
Janopaul, “Evan’s Birth,” 54.
182

Assessing the Narratives
Natality is pervasive among narratives of natural birth. With regard to time, the
specialness of the interval of birth overtakes linear time. Natural birth is not subject to the
rules of linear time – it takes its own time and happens in its own time. In this way,
natural birth present opportunities to subvert the forward march of progressive time, and
thwart the reduction of reproduction to the service of progress. When natural birth breaks
progressive, processual time, it makes birth about birth for its own sake and frees it from
the process of remaking the species in an orderly and normalized fashion again and again.
Limits do exist, however, particularly in regard to natality’s ability to subvert
biopower. Arendt has, after all, been critiqued for presenting natality as spontaneous
thought and action that is somehow free from history.
582
The interval time of natality
cannot function in total opposition to processual time, as intervals reside in contexts. As
such, natality does not free an agent from context. This does not, however, necessarily
limit the usefulness of natality as understood in terms of what it does to time; but rather,
reminds us of the importance of remembering that “…the very possibility of this
disruption of historical time (and, hence, the contestation of the tradition that conditions
us) depends upon the provision of a space in which ‘natality’ is welcomed.”
583
In
contexts supporting at-home and natural childbirth, women are afforded the freedom of
subverting biopower through alternative conceptions of time, but these subversions may
not be easily transferrable to contexts controlled by processual time.

582
Diprose, “Women’s Bodies,” 78.
583
Ibid.
183

These limits notwithstanding, natality offers ways to understand how birth
narratives provide opportunities to subvert both a mind/body dualism and the zoeification
that accompanies birth in a medicalized setting. These opportunities meet with mixed
success. Natality persists in representations of the mind and body working in harmony.
These seem to offer the most promise; together both function as part of a mutually
bolstering relationship, wherein the mind can help keep the body on track while the body
contributes its own form of knowledge to be harnessed. Thus, natality moves nature in
the direction of a whole subject who rejects the entrenched binary between the mind and
the body and thereby reduced the body to zoe. Even when narratives emphasize the body
over the mind, they do so in such a way that is integrative of the mind and infuses the
body with agency.
However, at least some of the evidence cited from the narratives could also be
interpreted as reinforcing the binary and reinscribing what has been observed to be a
problematic woman-as-body characterization.
584
Rosalyn Diprose argues that whenever
zoe and bios are treated as distinct and separate aspects of humanity, the body is
necessarily removed from politics and relegated to the private sphere.
585
Some women,
who emphasize a need to “turn off” their minds in order to let their bodies work might
edge into dualism. From traditional critical standpoints that deconstruct conceptions of
men as “thinkers” and women as “feelers,” the sentiments expressed in these narratives
would undoubtedly be troubling, as women exhorting other women to “stop thinking so
much” seems in line with long-standing systems of female oppression.

584
Susan Bordo, Unbearable Weight: Feminism, Western Culture, and the Body, (Berkeley: University
of California Press, 1993).
585
Diprose, “Women’s Bodies,” 81.
184

Anti-intellectualism is tempered by pro-biological feminism. Such a feminist
would hold that critiques decrying essentialism are often painted in overly-broad strokes.
At the same time, such a stance does not seek to limit women to their biology. Rather, it
acknowledges that biology is one part of a woman that need not be discounted and
denigrated in the interest of liberation. In the case of natural birth narratives, a corrective
is offered to anti-biological feminisms, in that the non-essential body is demonstrably a
source of power and liberation for some women. At the same time, the narratives at times
seem to sink too readily and too comfortably into the opposite polarity, by treating the
body as a singular source of power. This is perhaps why so many skeptics deride the
notion that natural birth can be empowering, and treat women who claim to be
empowered in such a way as delusional. Indeed, cursory readings of the narratives would
likely give the impression that the body is elevated to a degree a totally negates the mind.
However, more thorough interpretation reveals, in most cases, expressions of the mind
working alongside the body and the translation of biological power into political agency.
So, while more familiar modes of critique coupled with particular narrative emphases
might cause some to be extremely skeptical of the empowering nature of natural birth, it
is more readily understood within frameworks that reject binary oppositions.
Another troubling consideration is that the narratives repeatedly describe power as
being realized through “surrender.” Narratives indicate that the mind must “surrender” to
the body, the woman must “surrender” to the power of her contractions, and so forth. The
notion of empowerment through surrender is vaguely reminiscent of a Schlafly-type
argument which holds that women’s true happiness is to be found in the service of a man.
Following this notion of power through surrender comes the equally troubling insistence
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that choice is all about perception. When Kathryn Van de Castle says that she “can
choose to focus on the darker side or the lighter side” she makes it sound as though her
only true “choice” is the choice to perceive already-existing conditions in differing ways.
Statements such as this also hearken to traditional modes of female oppression, and
images of men being able to go out into the world and act and shape their own existences
while women are limited to the ability to choose how to perceive what has been placed
before them. Despite the emphasis on empowerment, the narratives belie an undercurrent
of traditional feminine roles and stereotypes. As it is undoubtedly quite clear by this
point, the narratives present a picture of female empowerment that is mixed and
sometimes even seems contradictory. Still, it seems reasonable to conclude that the bonds
of biopower—a “rational” system built upon efficiency and sameness—will not be
broken by the very disembodiment that contributes to their construction. For women to
deny their biology and the potential power derived therein would be to deny the very
grounds for resisting biopower in the first place. As this analysis has endeavored to
demonstrate, the theoretical resources of natality offer a potential path out of the either-
or’s of both biopower and traditional modes of critique.

186

Chapter Four
Birth Advocacy Online: Birth Rape, Symbol Stealing, and the Possibility of Natality

In recent years, the debate over birth place and practice has moved online.
Numerous websites and blogs are devoted to advocating for natural birth. Many also
work to debunk the claims of natural birth advocates. The following chapter analyzes
materials collected from such websites in order to explore how birth advocacy takes
shape online. On the web, a host of voices chime in to the debate – mothers, midwives,
doulas, nurses, obstetricians, as well as many who do not necessarily have a personal or
material connection to the controversy. In this context, debates deal with not only the
benefits and drawbacks of engaging in or supporting one particular type of birth or
another, but also with the ways in which language may be used to shape the realities of
birth and the advocacy surrounding it. Here, another layer to the question of agency with
regard to birth is encountered. Opposing parties struggle for the freedom to talk about
their experiences of birth in ways they deem appropriate, in spite of contrary argument.
Specifically, this chapter turns attention to provocative and polarizing displays of
contested language within the debate online over what is alleged to be “birth rape.”
Online debate presents many interesting dimensions not present in prior, text-
based case studies. Opinion and sentiment network together in blogs which constitute
sites in conversation with one another across vast distances. For example, authors and
activists contribute to the debate from places like Australia, Africa, and the U.K., as well
as the United States. Terms and concepts are introduced, appropriated, and disseminated
across a variety of internet platforms. For the past few years, the concept of “birth rape”
187

has been picked up and discussed in a variety of online forums. The relative accessibility
of internet forums allows for a greater variety of voices to be heard, or at least provides a
context wherein anyone with access to an internet connection has the opportunity to
participate in the debate. Of course, it is important to not be overly-optimistic about this
participation. While many people, who may not otherwise have had the means to
participate in debates over birth, are able to join in the conversation by starting their own
blog or website or participating in online discussion, it is important to emphasize that
access to these forums is still highly class-based. Data from the World Bank show that, in
rich countries, around 80% of the population tends to have access to the internet—and in
some nations the percentage is much higher. However, in poor and developing nations
access is much more limited, resulting in an overall percentage of global internet access
of 32.7% in 2011.
586
The rate of access has been steadily rising; however, vast inequity
obviously persists. So, while it is important to acknowledge the opportunities for
advocacy that the web engenders, it is also prudent to not paint a misleadingly-rosy
picture of accessibility.
On the web, individuals encounter forums wherein they may freely share their
experiences and opinions. Oftentimes, discussions and debates develop around a concept
or term that is introduced, shared, linked to, repeated, and otherwise tossed about among
various actors in what G. Thomas Goodnight has called a “network imaginary,” wherein
ideas are lit up and fused across time and space.
587
The concept of “birth rape” has

586
“Internet Users (Per 100 People),” The World Bank (2013)
http://data.worldbank.org/indicator/IT.NET.USER.P2/countries/1W?display=graph.
587
G. Thomas Goodnight, “The Metapolitics of the 2002 Iraq Debate: Public Policy and the Network
Imaginary,” Rhetoric & Public Affairs, 13, no. 1 (2010): 69.
188

developed in such a way; the term appeared on the web as part of individual women’s
experiences of birth, and became animated as others responded, elaborated, contested,
and drew connections to it. The development of birth activism to include terms such as
birth rape and the heightened emphasis placed upon symbols and language choice points
to the need to consider theory that accounts for meaning, naming, symbol stealing, and
identification; thus, this chapter will turn its theoretical focus to the work of Kenneth
Burke. As with prior chapters, concepts from Burke will be juxtaposed with elements of
Arendt’s natality in an effort to unpack the significance of both the artifacts in question
and the utility of Arendt’s ideas in the realm of social change rhetoric. The following
chapter proceeds to (1) describe the context of natural birth advocacy online; (2) outline
relevant theoretical concepts from Burke and Arendt; (3) explain the meaning and use of
the term “birth rape” as it has manifested over the past few years and analyze web-based
documents centering on the concept and language of birth rape; and (4) discuss the
significance of “birth rape” within the overall topical trajectories of birth activism.
Ultimately, this chapter advances the notion that the uses of birth rape represent an
example of novel meaning that can be understood as an expression of natality.

Birth Advocacy Online
In recent years, websites about birth, motherhood, and so-called “mommy-blogs”
have become a familiar feature of the internet. Whereas expectant mothers may have, in
prior decades, consulted books like Heidi Murkoff and Sharon Mazel’s “What to Expect
When You’re Expecting” to prepare for birth, nowadays a deluge of information is no
more than a click away. For example, expectant parents are now likely to visit and
189

explore websites like babycenter.com, thebump.com, and everydayfamily.com, as well as
the online counterpart to the ever-popular book, whattoexpect.com. Additionally,
expectant parents are now able to consult pregnancy and birth-related smart phone
applications such as “Sprout” and “Babybump Pregnancy.” Documenting the extent of
these websites and applications is outside the scope of this chapter, but a recent ABC
News article gives some indication of their prevalence. The piece, titled, “Pregnant? Use
Your SmartPhone: 12 Best Pregnancy Apps” lists tools to aid with fertility tracking,
nutrition, exercise, buying products for the construction of an eco-friendly nursery,
knowing what to pack in the hospital bag, as well as applications containing lots of
general information about fetal development, changes in the pregnant body, and how to
prepare for labor. Also included are applications for monitoring and timing contractions
during labor. In an effort to leave no segment of the market unserved, the article also
notes an app called “m-Pregnancy,” specifically geared toward expectant fathers “who
might roll their eyes at the idea of reading pregnancy books.”
588
This heteronormative
and hegemonically masculine app reportedly “shows the fetus’ development in
increments a man can understand. For example, it tells you that a 10-week-old fetus is 1.2
inches long, or about the size of a beer cap.”
589

Pregnancy websites provide tools for tracking the development of the fetus,
advice on how to prepare for the birth, and advertising products. They also frequently
include blog or discussion sections where women can recount their own experiences with

588
Lauren Effron, “Pregnant? Use Your SmartPhone: 12 Best Pregnancy Apps,” ABC News, March 14,
2013, http://abcnews.go.com/Technology/pregnant-smartphone-12-best-pregnancy-
apps/story?id=18713241#13 (Accessed May 23, 2013).
589
Ibid.
190

pregnancy and birth. On these cites, women are able to tell their own personal birth
stories and provide advice as to how to have a smooth and successful birth. Sometimes,
however, birth cites become a place for women to debate various methods of giving birth
and even to share birthing “horror stories.” It is largely from this latter category that the
materials for analysis in this chapter are drawn.

The Natural Birth Debate Online
Existing as a subset within the larger set of pregnancy and birth-related websites
are those devoted specifically to discussing and debating the merits of natural and home
birth. Numerous sites and blogs are devoted to advocating for natural birth and espousing
home birth. Others exist solely to argue against this advocacy, simultaneously
championing hospital birth and bemoaning a perceived selfishness and self-righteousness
among women who birth naturally. On the pro-natural birth side, sites like
theunnecessarean.com and birthingwithoutfear.com seek to provide women with
information which will help them achieve the most natural birth possible, with little to no
medical intervention. The Unnecessarean is a self-described patient advocacy website
that “illuminates the experiences of women who have been harmed by the aggressive
practice of defensive medicine.”
590
Birthing Without Fear offers tools which “provide
women with the ability to be fully prepares for a natural birth experience that minimizes
the necessity for medical intervention.”
591

590
Jill Arnold, The Unnecessarean: Pulling Back the Curtain on the Unnecessary Cesarean Epidemic,
www.theunnecesarean.com (accessed March 28, 2013).
591
Jana Allmrodt, Birthing Without Fear: Hope for the Next Generation,
http://birthingwithoutfear.com/about/ (accessed March 28, 2013).
191

On the anti-natural side, sites like hurtbyhomebirth.blogspot.com and
skepticalob.com encourage women to be skeptical of the joyous stories told by natural
birth advocates. Hurt By Homebirth is described as “a safe place where women can tell
the stories of the babies who died or who were left injured by homebirth.”
592
Skeptical
OB contains acerbically written posts about, for example, “homebirth idiocy” and the
ways in which Ina May Gaskin is just like a cult leader.
593
Instead of trying to get a
comprehensive grasp of these and other sites like them – a virtual impossibility in an
ever-expanding digital sphere – this chapter traces the use of one term that has been
particularly controversial in the debate over the past few years: birth rape. Online,
artifacts of study become fragmented as ideas and arguments chain out over and through
various web spaces. Because of this, it makes sense to trace and analyze the debate over a
particular term at various times and in various contexts. The debate encapsulates many of
the larger issues and questions that continue to circulate in controversy over where and
how birth should happen. It would be nearly impossible to obtain a comprehensive grasp
of the entire online debate; however, through analysis of a representative anecdote we can
construct a “text” of meanings around a particular term and analyze some of the
important contours of the debate as it moves forward.

Birth, the Internet, and “Choice”
As Sara Hayden and Lynn O’Brien-Hallstein indicate in their anthology on
communication and motherhood, the present appears to be an era of relatively free choice

592
Amy Tuteur, Hurt by Homebirth, http://hurtbyhomebirth.blogspot.com/ (accessed March 28, 2013).
593
Amy Tuteur, The Skeptical OB, http://www.skepticalob.com/ (accessed March 28, 2013).
192

when it comes to decisions about pregnancy, birth, and parenting.
594
Indeed, significant
increases in the number of home births and midwife-attended births in the past few years
indicate that women might now have more options than ever when it comes to birthing. A
woman preparing for birth today can read up on her options and plan to have the sort of
birth she wants. But, unexpected and sometimes horrible things still happen, and in this
era of individual choice, women may be left feeling isolated, unable to discuss their
experiences, and having no way to adequately express the pain they feel related to their
birth experience in a context wherein their choices were ostensibly “free.” Although in a
liberal society we are wont to believe that more options equals greater choice and hence
greater freedom, this is not always the case. Hannah Arendt herself rejected the notion
that freedom was a something found in choices between existing alternatives; to her, true
freedom was found only in the creation of something new.
595

Of course, even “choice” between existing alternatives is not granted equally, and
some women have access to freer choice than others. As discussed in the first chapter of
this volume, between the years 2004 and 2009, the number of home births in the United
States increased by twenty-nine percent.
596
However, this increase was accounted for
almost entirely by “non-Hispanic white” women. In 2006, about one in every one-

594
Sara Hayden & D. Lynn O’Brien Hallstein, Contemplating Maternity in an Era of Choice:
Explorations into Discourses of Reproduction (Lanham: Lexington Books, 2010).
595
Arendt, Origins of Totalitarianism, 479.
596
Marian F. MacDorman, T.J. Matthews, & Eugene Declerq, “Home Births in the United States,
1990-2009,” U. S. Department of Health and Human Services, Centers for Disease Control and Prevention,
National Center for Health Statistics, NCHS Data Brief, No. 84, January 2012.
193

hundred and sixteen white women gave birth at home,
597
in 2009 one in ninety,
598
and in
2010 one in eighty-four.
599
By contrast, between 1990 and 2009 the number of home
births among “non-Hispanic Black” and “Hispanic” women decreased slightly. Black
women were also significantly more likely to have a cesarean section, at a rate of 35.5%
compared to 32.6% of white women.
600
Furthermore, some health insurance providers are
hesitant to cover a birth that takes place anywhere but a medical facility; and of course,
the options for women living without insurance are even more limited.
601
Correlations
have also been shown to exist between for-profit hospitals and increased instance of
cesarean section – which costs significantly more than vaginal birth.
602
Additionally, data
indicate that births are less likely to take place, in hospitals, on Saturdays and Sundays –
indicating that women’s bodies are sometimes beholden to induction when it is
convenient for doctors.
603
In any case, data such as these coupled with the frustrated and
angry voices of women suggest that the availability of more options does not always

597
Marian F. MacDorman, Fay Menacker and Eugene Declerq, “Trends and Characteristics of Home
and Other Out-of-Hospital Births in the Unites States, 1990-2006,” U. S. Department of Health and Human
Services, National Vital Statistics Reports, Vol. 58, no. 11, March 3, 2010.
598
Ibid.
599
National Vital Statistics Reports, U. S. Department of Health and Human Services, Vol. 61, No. 1,
August 28, 2012.
600
Ibid.
601
For example, Aetna considers home births “not medically appropriate”; however they state that
“coverage of home births will be considered when mandated by law under plans subject to state mandates.”
Clinical Policy Bulletin: Home Births, http://www.aetna.com/cpb/medical/data/300_399/0329.html.
602
Maureen Baker, “Childbirth Practices, Medical Intervention and Women’s Autonomy: Safer
Childbirth or Bigger Profits?” Women’s Health and Urban Life 4, no. 2 (2005): 33.
603
U. S. Department of Health and Human Services National Vital Statistics Report, Vol. 61, No. 1,
August 28, 2013; The average number of births, by day, in the United States in 2010 are as follows:
Monday 11,662; Tuesday 12,821; Wednesday 12,629; Thursday 12,493; Friday 11,960; Saturday 8,006;
Sunday 7,110.
194

easily translate to greater material choice for women. And those who count themselves
among the more than 98% of women who “choose” hospital birth are still subject to the
constraint of standard hospital routines.

Maintaining a Movement
Despite the fact that so much observable inequality still exists, it is a trend in
social movements that oppositional – and even some sympathetic – voices may become
obstinate, and the movement more difficult to sustain, once it is perceived that a large and
measurable goal has been achieved. Clear examples of this may be seen in movements
for both racial and gender equality. Because (many) legally-sanctioned forms of
discrimination have been rendered illegal, it becomes easy for some to claim that
problems of, for example, racial and gender discrimination have been adequately dealt
with. Indeed, over the course of the presidency of Barack Obama, arguments for why his
election to the highest office in the land marks a new “post-racial” era have abounded.
Although these arguments have been roundly debunked by scholars and social critics
alike, significant segments of the population seem unable to grasp the reality that the
election of a Black president by no means marks the neat ending of systemic and
internalized racism in the United States. Similarly, some make claims that amount to
telling those who support a continuing feminist movement that they should “quit
whining,” as women’s legal equality has been largely achieved. In a society so firmly
engulfed in the ideology of neoliberalism, it is difficult for many to see how alleged
“equal access” does not equate to actual equality of opportunity. Furthermore, it can be
difficult for those who have been wronged to find the language to describe their
195

experiences in a context wherein the inability to achieve “equality” is so easily dismissed
as a personal failing.
This phenomenon finds corollaries in contemporary activism for natural birth.
The perception that abuse no longer happens within hospital walls and that women have
greater access to varying methods of birthing leads some to claim that women who are
unhappy are just whining, or being control freaks, or expecting too much out of birth.
Others fail to understand why a medicalized birth within a hospital might not be
desirable, and are dismissive and harsh toward those who seek to maintain or facilitate
greater agency for mothers throughout birth.
604
Indeed, there seems to be a fairly
widespread understanding that the birth “horror stories” of the mid-twentieth century
which prompted the early movement for home birth are a thing of the past – woman are
seemingly no longer abused, restrained, or drugged against their will on a wide scale, so
those who continue talking about these issues are seen to be belaboring an already settled
point.
In a context such as this, birth advocates must find language that effectively
conveys the need for continued activism and outrage. Hence, a term that has become a
provocative and polarizing tool for advocates and the subject of heated debate online is
“birth rape.” This term, having first appeared on the web about a decade ago, has
experienced a period of increased attention and scrutiny on the internet for the past three
years. It is the subject of articles and blog posts written by midwives, doulas, nurses and
mothers. It is referenced in personal birth narratives written by women in various online

604
Amy Tuteur, “Can You be Empowered by a Normal Bodily Function?” The Skeptical OB (blog).
January 4, 2012, http://www.skepticalob.com/2012/01/can-you-be-empowered-by-normal-bodily.html
(accessed May 30, 2013).
196

forums. Some women claim that use of the term is the only way for them to adequately
describe their birth experiences. Others claim the term is inappropriate and downright
offensive.
Internet platforms allow for the expression of diverse voices – no longer are
debates about birth restricted to medical experts or those who are able to get their words
published in print form. Now, an average citizen who wishes to share their experience
and contribute to the conversation is free to do so. Of course, not every voice is granted
equal hearing – some with access to more mainstream online publications will
undoubtedly enjoy larger audiences. However, anyone with internet access is able to
contribute their arguments, and comment functions as well as the ability to link to other
sites and blogs creates the feeling of an extended conversation and may also serve to
increase the audience for opinions that might not otherwise be heard. The discussion
about birth rape has largely developed on the internet in this way. A collection of birth-
related and feminist websites have explored the topic, offering definitions, explanations,
arguments, and stories, all while referencing one another and debating the problems
within the childbirth industry as well as the merits of the term itself.
The debate about birth rape is, primarily, a contest over who may properly use
what language to describe a particular experience. To use Kenneth Burke’s terminology,
it is a context of symbol stealing, wherein the term “rape” is appropriated and deployed
for alternative purposes. In the following pages, I will argue that birth rape is a
provocative and divisive term precisely because it stretches the familiar frame
surrounding birth and allows for and creates new ways of imagining the experience. The
identifications made are troubling and incongruous, which spurs resistance and anger
197

from some. However, the term reorganizes values and permits women the space to
reshape the hierarchy of birth, and provides productive grounds from which to form new
arguments about childbirth practices. Here, questions of choice and freedom are central in
debates over how women are allowed to think and speak about their birthing experiences.
After all, acting within the context of birth is about more than a mother simply choosing
where and how she is going to push. In this chapter, we see ways in which mothers’
freedom to speak about and understand their experiences are subject to constraint and
control. The following section will review relevant concepts from the works of Burke,
and also provide indications as to how aspects of natality might contribute to our
understanding of texts about birth rape.

Naming, Identification, and Natality
Kenneth Burke defines humans as the “symbol-using animal.” This view grounds
his overall theory of dramatism which similar to natality features language as a mode of
action. Burke’s theory is useful for analyzing the significance of the term “birth rape” and
the function it plays in birth activism online. Strategies of naming, form and frame, piety,
identification and action are key to analysis. To these symbolic moves, natality brings
focus to the novel use of terms in this instance, as well as the ways in which these terms
contribute to identification within an ever expanding discursive frame.
“Birth Rape” constitutes a rupture in the fabric of the debate over natural birth and
choice in birth. It is a startling term; one that jerks the reader out of complacency and
forces them to re-order meanings and understandings. For a critic, this term provides an
invitation to Burkean analysis, as, according to Burke, “discontinuities in procedure… are
198

particularly valuable as ‘leads’ for the critic who would track down the meaning of
symbols.”
605
Important in terms of this “lead” is something that Burke has implied many
times over the course of many books: that the way a thing is named has everything to do
with how it is perceived. Terms are chosen and subsequent associations and dissociations
are made. Burke writes:
In any term we can posit a world, in the sense that we can treat the world in terms
of it, seeing all as emanations, near or far, of its light. Such reduction to a
simplicity being technically reduction to a summarizing title or ‘God term,’ when
we confront a simplicity we must forthwith ask ourselves what complexities are
subsumed beneath it.
606

In this instance, the ways in which the events and elements of birth are named provides
meaning and organization to the entire experience. Some terms are elevated to “god
term” status, thereby affecting the sorts of meanings and understandings that are possible
all the way down the line. In naming ‘birth rape,’ a particular circle of writers and
activists posit a new set of meanings and associations which are up for discussion and
debate. By looking to language used to name and describe birth rape, the subsumed
complexities of the term should be revealed by examining what-goes-with-what in the
texts. Burke says that what-goes-with-what may be revealed, for example, by “charting
clusters” of terms, whereby “we get out cues as to the important ingredients subsumed in
‘symbolic mergers.’”
607

605
Burke, Attitudes, 194.
606
Burke, Grammar, 105.
607
Burke, Attitudes, 233.
199

For Burke, humans live within large frameworks of meaning, constituted by
symbol use over and across long periods of time and shaped by the particularities of how
things are named. Burke finds his inspiration for this conception of society in literature
and the well-known literary frames of comedy, tragedy, and epic, among others. To
Burke, literature is “equipment for living,”
608
thus he finds that human modes of
comprehending and making meaning in the “real” world correspond to the ways in which
humans are able to make sense of literature based on its familiar forms. According to
Burke, form in literature, theatre, art, and so forth is “the creation of an appetite in the
mind of the auditor, and the adequate satisfying of that appetite.”
609
Form “involves
desires and their appeasements.”
610
Thus, humans recognize and take pleasure in familiar
forms in both literature and life. In our lives, we are surrounded by webs of meaning that
take shape in particular and familiar ways. In is within these familiar contexts of
language and events that we are able to order our lives and function as members of a
society. Humans take pleasure and comfort in moving in familiar forms within a well-
rounded frame.
Furthermore, within frames, which Burke also describes as “orientations,” actors
engage in naming and the production of symbolic mergers. It is within a particular
orientation that terms find meaning and “make sense.” Burke describes an orientation as
“a bundle of judgments as to how things were, how they are, and how they may be… For
in a statement as to how the world is, we have implicit judgments not only as to how the

608
Kenneth Burke, The Philosophy of Literary Form (Berkeley: University of California Press, 1971):
293.
609
Kenneth Burke, Counter-Statement (Berkeley: University of California Press, 1968), 31.
610
Ibid.
200

world may become but also as to what means we should employ to make it so.”
611
Thus,
a given group’s ways of understanding “how the world is” provides context and meaning
for symbols, while symbols give, renew, and stretch meaning and understanding within a
frame.
Each frame contains its own structure of “piety,” which, according to Burke, “is
the sense of what properly goes with what.”
612
In enacting the piety of a particular frame,
humans work toward perfecting themselves within the guidelines of the frame. As Burke
says in his Definition of Man, humans are “goaded by a spirit of hierarchy and rotten
with perfection.”
613
In other words, humans have a desire to improve themselves, to strive
to be something better than they are, or to achieve measureable success. Burke visualizes
this as a climbing of the hierarchy. We work our way up the ladder (or fall away from it)
by virtue of how well we are able to act in accordance with the piety of a given frame.
For human beings who take pleasure in the recognition of and enactment of
familiar forms of acting and communicating, deviations from or violations of the form
can be painful. If an experience does not match up with what we know to be true about
the world, we are left struggling to find ways to make sense of it. Similarly, if we fail to
uphold the piety of our frame, we may be punished for it. Indeed, the pain of deviating
from the familiar or dominant frame may be such that we continue to operate under it,
even when it is no longer rational. Burke describes it as such:

611
Burke, Permanence, 14.
612
Ibid., 74.
613
Burke, Language, 16.
201

If people persist longer than chickens in faulty orientation despite punishment, it
is because the greater complexity of their problems, the vast network of mutually
sustained values and judgments, makes it more difficult for them to perceive the
nature of the re-orientation required, and to select their means accordingly. They
are the victims of a trained incapacity, since the very authority of their earlier
ways interferes with the adoption of new ones.
614

In other words, humans are limited by the familiar patterns in which they operate. Even
though an alternative way of understanding or framing the world and its elements might
be more efficient or beneficial in some other way, humans will continue to operate in
ways that make sense to them because of their familiarity.
Importantly, Burke’s notion of how frames function in society does not cast them
as an enigmatic force, existing everywhere and nowhere at once, which controls our
thoughts and actions in a top-down sort of manner. Rather, frames are grounded in
symbols and created and maintained by people, and frames are actively constructed.
According to Burke, “Men seek for vocabularies that will be faithful reflections of
reality. To this end, they must develop vocabularies that are a selection of reality. And
any selection of reality must, in certain circumstances, function as a deflection of
reality.”
615
As humans create the world via symbols, they actively choose which symbols
and meanings to accept and which to reject. Burke says, “Frames of acceptance’ are not
the same as passiveness. Since they name both friendly and unfriendly forces, they fix
attitudes that prepare for combat. They draw the lines of battle – and they appear

614
Burke, Permanence, 23.
615
Burke, Grammar, 59.
202

‘passive’ only to one whose frame would persuade him to draw the lines of battle
differently.”
616
Frames are not imposed upon us as negative and controlling forces; rather,
we need frames to make sense of the world. Moreover, we actively work to maintain our
frame, symbolically manipulating and stretching its boundaries to accommodate new
meanings. This type of “casuistic stretching”
617
is employed in the interest of maintaining
the frame, as breaking it would be difficult and painful. Burke says, “As a given historical
frame nears the point of cracking, strained by the rise of new factors it had not originally
taken into account, its adherents employ its genius casuistically to extend it as far as
possible.”
618
As society progresses and humans are faced with unprecedented situations,
they work to make sense of such situations within familiar frameworks of meaning. Even
when a new situation seems to demand new ways of understanding, we will do
everything we can to try and fit the unprecedented into our already well-established
symbolic patterns of organizing the world. For example, at a time when capitalism seems
to be benefitting an ever-shrinking portion of the population, even many among those
who are hurt by the system will continue to defend it.
Furthermore, humans find their place within a particular frame and in the world
through the process of identification. We feel connected with a given frame because of
the ways in which we identify with it and with others within it. It is by identifying with
people and meanings, and thereby sharing substance with them, that we are able to act in
society. Burke writes, “A is not identical with his colleague B. Insofar as their interests

616
Burke, Attitudes, 20.
617
Ibid., esp. 229-32.
618
Ibid., 23.
203

are joined, A is identified with B. Or he may identify himself with B even when their
interests are not joined, if he assumes that they are, or is persuaded to believe so […] To
identify A with B is to make A ‘consubstantial’ with B.”
619
Through symbol use, humans
find common ground – meanings and ideas over which they may agree. Burke considers
identification as inseparable from action. He writes, “A doctrine of consubstantiality,
either explicit or implicit, may be necessary to any way of life. For substance, in the old
philosophies, was an act, and a way of life is an acting-together; and in acting together,
men have common sensations, concepts, images, ideas, attitudes that make them
consubstantial.”
620
The notion of identification is central to Burke’s overall philosophy of
human nature. Humans, as the primarily symbol-using animal, find their greatest purpose
in connecting with one another, to act, through symbolic communication. We find and
create our place in the world through symbolizing with and in relation to one another.
Of course, we can never be perfectly identified with another, nor would we want
to be, as division is an ever-present and necessary counterpart of identification. Burke
writes:
In pure identification there would be no strife. Likewise, there would be no strife
in absolute separateness, since opponents can join battle only through a mediatory
ground that makes their communication possible, thus providing the first
condition necessary for their interchange of blows. But put identification and

619
Burke, Rhetoric, 20-21.
620
Ibid., 21.
204

division ambiguously together, so that you cannot know for certain just where one
ends and the other begins, and you have the characteristic invitation to rhetoric.
621

In this passage, pure identification and the accompanying elimination of strife are not to
be understood as achievable, or desireable, goals. Instead, to be perfectly identified with
someone would be to forget the capacity to act. Humans are not of the same substance
and never could be perfectly the same, therefore division is inevitable. It is identification
in the midst of division that allows us to act, but the division that remains is what keeps
us ever-mindful of action’s necessity. Identification and division are in perpetual tension;
and it is this interplay that prompts us to pursue ever-greater solutions to our mutual
problems. Burke writes, “Identification is affirmed with earnestness precisely because
there is division. Identification is compensatory to division. If men were not apart from
one another, there would be no need for the rhetorician to proclaim their unity.”
622
Perfect
identification will always be, necessarily, just beyond reach.
This continued capacity to act is what concerns Burke, overall, in his writings. We
see this throughout his discussions of the potential for and limitations of symbolizing
within frames, his treatment of identification and its counterpart division, and in his
overall explanation of the dramatistic character of rhetoric. Perhaps his most direct
discussion of the potential for action comes in his explanation of the pentad. In Burke’s
discussion of the dramatistic pentad, he explains his conception of the five elements
present in any rhetorical event; the act, the scene, the agent, the agency, and the purpose.
He discusses the inter-relation of these five terms, and the ways in which the terms affect

621
Burke, Rhetoric, 25.
622
Ibid., 22.
205

and control one another. Burke understands that the scene is a particularly controlling
feature, as circumstances and context carry heavy weight over the potential of action.
However, he also points out something of an ineffable quality he finds to be present in
any act; and it is here that we may begin to find connections between Burke and Arendt.
Burke writes:
…the resources of the pentad invite us to locate some motives of action under the
heading of Act itself.
There would thus be a modicum of novelty in the act, to the extent that the
act could be said to have an ingredient not derivable from the other terms. And
insofar as the act was derivable from the other terms, it would not possess
novelty, but would be a mere unfolding of the implicit into the explicit.
623

In this passage, “a mere unfolding” refers to what Burke would describe as “motion.”
Motion is not action; however, it can masquerade as action or be confused for action. For
Burke, this distinction between action and motion is crucial, and a recurrent theme
throughout his writings. If a human is entirely constrained by their situation or scene,
their frame, or by being in too-close identification with another person, group, or
organization, their potential for action is reduced to motion. For action to occur, there
must be an element of novelty, of doing something that was not an inevitable result of
other forces.
Arendt would concur. For her, the human ability to act is our chief faculty.
Moreover, it is by virtue of our beginning at birth that we are able to continue the pattern
of action through beginning over and over again. She writes, “Since we all come into the

623
Burke, Grammar, 68.
206

world by virtue of birth, as newcomers and beginnings, we are able to start something
new; without the fact of birth we would not even know what novelty is, all ‘action’ would
be either mere behavior or preservation.”
624
Without a capacity for novelty, there would
be only motion. Without being beginners of action, we are only carrying out orders.
From an Arendtian perspective, natality is a category which corresponds to the
spirit of Burkean thought with regard to action. She would, of course, agree that any
action requires an element of novel unpredictability. It is apparent that Arendt’s category
of natality is fleshed out in a much more substantial way than Burke’s passing references
to the novelty of action; indeed, natality is the core orientation around which Arendt
organizes her entire political philosophy. However, while Burke does not provide an
explanation for the roots of novelty as does Arendt, he provides an elaborated explanation
for the ways in which this novelty plays out through language. Although Arendt states
that the two faculties of novelty and language are what most radically distinguish humans
from other animals,
625
she does not provide an explanation for how novelty finds concrete
expression through language. Because of this, the pairing of Burkean thought with the
ideas of Arendt may be useful for rhetoricians.
Connections may also be drawn between natality and Burkean identification.
According to Patricia Bowen-Moore, “The question of beginning, of natality, is
ultimately linked to one’s sense of communal identity, that is to say, linked to one’s sense
of belonging and to one’s way of comporting oneself in a world inhabited by and shared

624
Hannah Arendt, “On Violence,” Crises of the Republic (San Diego: Harcourt Brace & Company,
1972), 179.
625
Ibid.
207

with others.”
626
Natality is, at its core, a communal enterprise. While a new beginning
might intuitively seem to be a creative act performed in unique isolation from the world,
this is not the reality of natality. For Arendt, the human urge to begin depends upon a
love for the world and an enduring commitment to the world’s future existence.
627

Because of this, our beginnings should always be oriented toward the world and toward
others. Beginnings must always happen in concert with others, and for Arendt, it is
though natality that we are able to realize the necessity of human interconnectedness.
628

In Arendt, we see a well-developed explanation of the significance of novelty as
central to action and as a constitutive component of the human purpose. However, Arendt
does not provide us with a clearly mapped out path for action to take, via rhetoric – which
is where Burke becomes quite useful. By combining Arendt’s notions of the significance
of beginnings with Burke’s theories of how language may be used in novel ways, we are
able to get a distinct picture of how agency might take shape in a variety of contemporary
contexts.
It may be unclear why the present example of “symbol stealing” in the context of
debates over birth rape represents natality in language; after all, symbol stealing would
seem to indicate a borrowing of words, a recycling of terms and ideas that would be the
antithesis of natality. However, it is the contention of this chapter that “birth rape”
presents us with a novel form of appropriation and a revitalized grounds for action within
the context of childbirth advocacy. Oftentimes, appropriation or symbol stealing involves

626
Bowen-Moore, Philosophy of Natality, 9.
627
Ibid., 55.
628
Ibid., 39.
208

dissociation with former meanings and associations with new meanings. In this instance,
the term “birth rape” carries with it all the baggage of other instances of the term “rape,”
and it does so intentionally. The grotesque association of “birth” with “rape” is a
“perspective by incongruity,” which holds the potential to snap auditors out of
complacency.
629
At the same time, many feel compelled to disparage the term as an
inappropriate symbol for the event it is purported to describe. Here, we see contention
between those who seek to maintain the familiar frame of meaning which surrounds birth,
and those who seek to intentionally break the frame in order to build a new set of
meanings and new potential understandings of what can happen during birth. In the
following section, I will explore the uses of the term birth rape and the controversy
surrounding it, with a goal of weaving together Burkean and Arendtian ideas in the
interest of understanding how the term functions. We see, on one side, a desperate need
for novelty to give voice to the traumatic experiences of some women. On the other side,
we see manifested the pain and anger that is dredged up as familiar meanings are called
into question and subverted.

Considering Birth Rape
Debates over birth rape provide a particularly stunning case study relating to
natural birth advocacy online, in recent years. In a sense, the term is a capstone for all the
arguments that have come before it; a sort of last-ditch punctuation to what has been a
growing and increasingly-frustrated chorus of voices over the past few decades. The term
first appeared online about a decade ago, but debate over the term has largely taken off in

629
Burke, Attitudes, esp. 308-11.
209

the past three years. Participants in the debates over birth rape can be organized into two
general camps: on one side are those who either advocate for the use of the term or use
the term themselves to describe their own experiences; on the other side are those who
find the term to be offensive or otherwise inappropriate. The following section will
provide description and analysis of arguments coming from both sides. The materials in
this chapter are drawn from numerous online articles and blog posts focusing on birth
rape. Materials span from 2004 through 2013; however, the bulk are drawn from a
moment when the debate ramped up in September of 2010. At this time, numerous
authors were writing on the topic, referring to each other’s posts and debating the concept
back and forth. In total, examples for the analysis are drawn from twenty-six different
articles and posts about birth rape. Of course, many more exist, but after extensive
reading on the subject I have determined that the pieces provide a sufficient
“representative anecdote” for the overall debate.
630
Any more materials would be
redundant.

Describing Birth Rape
The term birth rape has been used by numerous authors to describe what they feel
to be gross violations committed against the bodies and minds of birthing women, by
members of the medical establishment. Although birth rape is used by some as a blanket
term to describe any unwanted experience during childbirth,
631
it typically refers to
events much more specific than this. Numerous instances described as birth rape are

630
Burke, Grammar, 59-61.
631
Birth rape is most frequently defined in this way by those in opposition to the term and concept, as a
means of constructing straw-person arguments.
210

recounted online, some by the women who experienced them and some third-person. It is
important to emphasize that all the specific examples cited here have occurred recently;
in other words, although they are reminiscent of the types of “horror stories” that served
as a catalyst for the home birth movement of the 1970s, they are representative of
practices that are still happening today.
Most frequently, birth rape is described as the experience of being non-
consensually penetrated by hands and instruments while giving birth; however, variations
exist. Some women report being given non-consensual episiotomies without warning:
After a half hour of pushing, the doctors gave me an episiotomy without telling
me they were going to or asking my consent. I asked what they were doing and
why it was necessary and got no answer. I screamed at them to stop as they had
not given me any anesthetic and the pain was unbearable. I still remember the
sound of blunt scissors hacking through cardboard.
632

Some report being subjected to non-consensual and unnecessary procedures in the
interest of convenience:
…her midwife rammed a hand up into her vagina to manually dilate her cervix (a
procedure that is very painful and ill-advised) because she had been up all night
and was ‘tired of how long this was taking.’
633

Some report being forcibly restrained:

632
“Natasha’s Story,” Birth/Rape (blog), March 9, 2012,
http://birthraped.wordpress.com/2012/03/09/natashas-story/ (accessed March 28, 2013).
633
Amity Reed, “Not a Happy Birthday,” The F-word: Contemporary UK Feminism (blog), March 7,
2008, http://www.thefword.org.uk/features/2008/03/not_a_happy_bir (accessed March 28, 2013).
211

Desperate for the attack to stop, she lashed out and tried to kick the woman away,
only for another midwife to firmly hold her feet down.
634

Some report being drugged against their will:
I was also told that my baby needed more oxygen and I was told to breathe deeply
in a new mask because it had a better seal on my face… The new mask wasn’t
oxygen, I was gassed against my will. I am unaware of what was done to me from
the time I was gassed until I awoke in recovery. I am assuming that I only had a c-
section. Any further details have not been shared with me.
635

One midwife, who frequently advocates for natural birth on her blog titled Navelgazing
Midwife, reflects upon experiences which encapsulate many of the types of violations
described as birth rape:
As I learned to be a midwife, I did horrible things to women in the name of
education. I have held women’s legs open (‘to get the baby out’) […] I have done
vaginal exams on women who were screaming NO! I have coerced women to
allow me into their vaginas for exams.[…]
As a doula and a student, I stood by and watched as women screamed to
be left alone. I watched midwives with 3 inch fingernails shove cervices from 3-
10 inches in a few minutes. I watched as women had cytotec
636
inserted into their
vaginas secretly. I watched as women unknowingly drank cytotec from Gatorade
bottles. I witnessed Pitocin being secretly injected into the vaginal vault to

634
Ibid.
635
Dawn Luehrs, “VBAC Denied, Horrid Experience…” Babycenter, April 4, 2012,
http://community.babycenter.com/post/a26519895/vbac_denied_horrid_experience (accessed March 13,
2013).
636
Drug used to speed up labor.
212

projectile a baby in second stage arrest. I witnessed Pitocin begin put on gauze
and put in women’s vagina’s without their knowledge. I watched as the gauze was
put in their rectums without their knowledge. I have seen women sutured who
might not otherwise need it simply because someone needed training. I have seen
OBs cut an episiotomy because they are in a hurry.[…] I have seen and heard
women be screamed at to shut up, grow up, that she asked for it by opening her
legs 9 months ago, that she gets what she deserves. I have seen a woman slapped
by a midwife.
637

In general, then, birth rape has been adopted as a term to describe penetrations of and
procedures performed on a woman’s genitals, during birth, without consent. In the
process, women are sometimes drugged or restrained against their will. Other times, they
feel coerced by doctors and midwives in expert positions who lead them to believe they
have no other choice. Women who use the term to describe their births claim that it
accurately describes their experiences and the feelings connected with those experiences.
Some say that they had no way to adequately talk about their experiences until
discovering the term.
The following sections will detail the arguments for and against the term birth
rape made by opposing sides of the debate. I demonstrate how those in favor of the term
work to define it in comparison to more readily accepted definitions of “rape,” reframe
the hierarchy of birth, and identify birth rape with feminism. In contrast, I then
demonstrate how those who argue against the term seek to divide the experiences claimed

637
Barbara Herrera, “Birth – Rape and Otherwise,” Navelgazing Midwife (blog), July 7, 2004,
http://navelgazingmidwife.squarespace.com/navelgazing-midwife-blog/2004/7/8/birth-rape-and-
otherwise.html (accessed March 28, 2013).
213

to be birth rape from “real” rape, claim that birth rape takes away from victims of real
rape, and cast doubt as to whether birth rape can or does exist. The purpose of this section
is to unpack the significance and usefulness of the term with regard to its natality by
exploring what the novel use of this term does for women and the role it might play in
natural birth advocacy.

Defining “Birth Rape”
In articles which argue in favor of the term as an accurate descriptor of women’s
experiences during birth, authors make at least three rhetorical moves. They argue for the
appropriateness of the term, by defining the experience of birth rape and comparing it to
established understandings of the word “rape.” An implicit and important recognition that
runs through these definitions and descriptions is that in order for “birth rape” to exist as
a concept, it must exist in language. They also argue for a reordering of the hierarchy of
birth by advocating for the recognition of birthing women’s feelings and desires. In order
for women to claim the agency to make meaning around their own birth experiences,
there must be recognition of the notion that women’s voices actually matter. Furthermore,
they attempt to build a foundation for identification between sufferers of birth rape and
feminists by claiming that birth rape is a feminist issue and should be recognized as such.
Implied here is an awareness of the interconnectedness of issues of reproductive and
women’s justice; the silencing and ignoring of women’s voices in the birthing room
overlaps and intertwines with other injustices across time and context.
Most articles and posts about birth rape begin by defining and describing the term.
There is implicit agreement among authors that the term requires explanation and in some
214

cases justification. Definitions of the term vary; however, all contain some degree of
connection with established cultural understandings of the concept of “rape.” The term
rape, in a general sense, refers to the forced sexual violation of another’s body. However,
when debate over the proper use of the term commences, disagreements over the
specificities of meaning are revealed and vagueness gives way to arguments over what
the true meaning should be. Blogger Zion Lights writes that birth rape is a term used by
“Women whose rights are taken away from them during their birthing experiences,
whose bodies are violated by unnecessary procedures.”
638
The author adds, that “This
term is also being used by women who are fed up with the impact of a medical
establishment that focuses on the weaknesses of women’s bodies, rather than the
strengths.”
639
In the first statement, reference is made specifically to a violation of the
body, which, although non-specific, does not diverge from widely-held notions of what
rape is. In this case, “unnecessary procedures” take the place of the attacker’s sexual
organs or other implements of attack. The second statement is vaguer and moves away
from a specific definition to indicate the sort of person who might use the term. Here, we
see an implied lamenting of the perceived frailty of women and their potential for
victimization. A body which is raped is weak as opposed to strong, and is acted upon as
opposed to acting.
Another unnamed blogger is more explicit and concrete in her definition. She
writes, “When a woman is forced to lie down with her legs up in the air in stirrups, spread

638
Zion Lights, “It’s Time to Start Recognizing Birth Rape,” Huffpost Lifestyle (blog), The Huffington
Post, November 20, 2012, http://www.huffingtonpost.co.uk/zion-lights/birth-rape_b_2155384.html
(accessed March 28, 2013).
639
Ibid.
215

wide for all the world to see, and strangers walk in and out of the room and promptly,
presumptuously, repeatedly, and unnecessarily insert their invasive hands and
instruments into her vagina during labor – THIS IS RAPE!”
640
In this definition,
emphasis is placed upon unwanted penetration and force – both well-recognized elements
of rape.
Others evince a desire to carefully delineate the boundaries of what does and does
not constitute birth rape. Jennifer Zimmerman writes:
Women do not term just any birth intervention ‘rape.’ ‘Birth rape’ is a term used
to describe a situation where a care provider fails to provide informed consent and
uses their position of power to pressure or force the woman, who is in a
vulnerable position, to submit to the proposed procedure. The provider likely used
manipulation, coercion, or force to get the birthing woman to do what the
provider wished her to do. Often times, in the moment the woman feels her or her
baby’s life is at risk, but later discovers that the medical necessity of the
procedure is questionable. Even in cases where the procedure was clearly needed,
the woman often feels that if she had been allowed to consent to it she would not
have felt violated or traumatized.
641

Furthermore, Zimmerman adds:
It is only birth rape when a birthing woman is pressured to the point of feeling she
has no other choice than to accept the procedure, or when she is actually

640
“Birth Rape – Calling a Spade a Spade,” Birth of a New Earth (blog)
http://ecstaticbirth.wordpress.com/articles/birth-rape-calling-a-spade-a-spade/. (accessed March 28, 2013).
641
Jennifer Zimmerman, “What Feminists Should Know about Birth Rape,” Birth Activist (blog),
November 29, 2010, http://www.birthactivist.com/2010/11/what-feminists-should-know-about-birth-rape
(accessed March 28, 2013).
216

physically forced to undergo a procedure she did not want or choose. Some
women even scream and fight but are physically restrained or otherwise forced to
submit. This is very different than being traumatized by an actual emergency that
arises during childbirth.
642

In the previous excerpt, the author appears to understand the need for precision in a
definition, in an effort to head off oppositional criticism. Indeed, broad or vague
definitions of the term provide openings for opponents to claim that women who report
having been birth raped are simply upset over not having been able to have the totally
natural birth they desired, and in their frustration are describing the experience in ways
that are excessive and inaccurate. By excluding “just any birth intervention” from the
definition, Zimmerman is careful to indicate that many interventions, although perhaps
ultimately unwanted, do not constitute rape by virtue of their medical necessity and the
woman’s consent. For a birth rape to have occurred, a woman needs to have been acted
upon without her consent – and oftentimes in the face of her blatant objection. This
author is also careful to delineate between what she considers to be birth rape and
“trauma” – as a common means of opposing the term birth rape is to suggest that the
events described as such instead be called trauma. Birth rape is traumatic, indeed, but to
be birth-raped is to be violated in a way that exceeds what we might understand as a birth
that was traumatic because of some type of medical emergency.
Other authors also demonstrate the need to define birth rape in terms of specific
actions and behaviors. For example, Amity Reed writes:

642
Ibid.
217

…fingers, hands, suction cups, forceps, needles, and scissors… these are the tools
of birth rape and they are wielded with as much force and as little consent as if a
stranger grabbed a passer-by off the street and tied her up before having his way
with her. Women are slapped, told to shut up, stop making noise and a nuisance of
themselves, that they deserve this, that they shouldn’t have opened their legs nine
months ago if they didn’t want to open them now. They are threatened,
intimidated and bullied into submitting to procedures they do not need and
interventions they do not want. Some are physically restrained from moving, their
legs held open or their stomachs pushed on.
643

In this description, even though the physical implements of birth rape may differ from
more commonly-understood forms of rape, the key elements of force and non-consent
remain the same. Notions of the physically and mentally abusive dimensions of rape are
also highlighted. Reed describes the event more succinctly in a later piece, where she
writes, “…birth rape is when an instrument or hand is inserted into a woman’s vagina
without permission, after which the woman feels violated.”
644
Here, an emphasis on
unwanted penetration provides a clear connection to more established understandings of
rape.
The prior definitions hold implied similarities to various elements of more
established and commonly understood forms of rape.
645
Some focus on general violations

643
Amity Reed, “Not a Happy Birthday,” The F-word: Contemporary UK Feminism (blog), March 7,
2008, http://www.thefword.org.uk/features/2008/03/not_a_happy_bir (accessed March 28, 2013).
644
Amity Reed, “It’s not RAPE Rape.” The F-word: Contemporary UK Feminism (blog), September
30, 2010, http://www.thefword.org.uk/features/2010/09/its_not_rape_ra (accessed March 28, 2013).
645
In early 2012, the United States Department of Justice announced a revision to its definition of rape,
which had previously been unchanged from the 1927 “the carnal knowledge of a female, forcible and
against her will.” The new definition states that rape is, ‘The penetration, no matter how slight, of the
218

of the sovereign body or penetration specifically, while others emphasize issues of
consent or violence. However, authors also make more explicit connections to established
understandings of rape as well as to the difficulties of defining different sorts of rape.
Zion Lights writes, “Rape is really to do with having your body disrespected, contorted
against your wishes, without your consent. The way the medical establishment sees it,
when you’re on the hospital bed, you have already given consent. Some men say the
same thing about the marital bed, or any bed that you get into with them.”
646
She goes on
to say, “In some countries marital rape is still technically legal and socially acceptable,
and there was a time when rape was not recognized as a concept or a crime in the UK.
Now it’s time that we took another step in the right direction, and stood up for birthing
women’s bodies…”
647
Lights avoids connecting specific types of violations with the term
rape, and instead focuses on the meaning of consent. In this way, she can make a
powerful analogy to prior difficulties faced by women who are victims of marital or date
rape. This author seeks to make a direct comparison between the former “impossibility”
of a woman being raped by her husband to the present “impossibility” of a woman being
raped by a medical professional. In this way, accepting the existence of birth rape
becomes another progressive step toward justice and liberation for women.

vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without
the consent of the victim.” http://www.justice.gov/opa/pr/2012/January/12-ag-018.html.
646
Lights, “Recognizing Birth Rape.”
647
Ibid.
219

Another author, identified only by her first name, Natasha, describes her own
experience of birth rape, and writes, “I would describe my birth experience as as hurtful
as rape. As violating. As abusive.”
648
She continues:
I am aware that many people do not agree with the term, ‘birth rape’ and believe
there is no way the two could be comparable. I have experienced both. What
happened to me during the birth of my twins honestly effects (sic) me as deeply
and as painfully as the other. I felt just as violated, just as abused. I had all control
and any choice about what happened to my body taken from me. My cries of,
‘Stop! Please stop!’ were ignored. My questions about the necessity of these
interventions was (sic) ignored. I was physically restrained. I was forcibly cut,
stitched, fingered, fisted, pushed, grabbed and hurt without my consent and
despite my desperate pleas to stop. The long term effects so far prove to be just as
painful and debilitating as those of rape. I am suffering PTSD as a result of the
violations I was subjected to during the birth of my twins.
649

In this instance, Natasha uses her own painful experience as evidence to demonstrate the
similarities between rape and birth rape. In this example, she touches upon the issues of
consent, of physical violation, and of mental after-effects, claiming that all three
dimensions of birth rape are comparable to rape.
Amity Reed weighs in on the definition of birth rape again, giving further
description of the ways in which birth rape and rape are comparable. She writes:

648
“Natasha’s Story.” Birth/Rape (blog). March 9, 2012,
http://birthraped.wordpress.com/2012/03/09/natashas-story/ (accessed March 28, 2013).
649
Ibid.
220

…we often picture rape as an act of demented sexual anger or misogyny,
perpetuated by sick individuals. In fact, rape is more frequently a display of
power and control, a way to subjugate another human being. And it doesn’t just
happen in dark alleyways, bedrooms tinged with the smell of alcohol and ‘mixed
signals’, or in war zones. It can (and does) happen in some of the most respected
and revered institutions in the land – hospitals.
650

In this description, we see the question of perpetrator motives come into play; which,
incidentally, anticipates some of the coming criticisms of the concept of birth rape. Rape
is widely understood to be a crime that is inextricably tied with sex; here, the author
attempts to break that association to a degree. She claims, as others have, that rape is a
crime which, despite being acted out upon the sexual organs of the victim, has very little
to do with sexual gratification. Rather, she claims that rape is better understood as an
abuse of power; therefore, a doctor is able to carry out such an abuse upon a patient
without having any overtly sexual motivation.
In another article, Reed continues in this vein by drawing analogies to difficulties
faced by other rape victims in the past. She writes, “The crux of the argument against
‘allowing’ women to use this term is that while, of course, instances where mothers are
abused or assaulted during birth are horrible and unacceptable, it was not ‘RAPE
rape.’”
651
The reason that some feel birth rape is not real rape, according to the author, is
that birth is wholly apart from sex and sexual pleasure. However, she continues, “As we
all know, non-consensual penetration is most often not a quest for sexual pleasure but

650
Reed, “Not a Happy Birthday.”
651
Reed, “It’s not RAPE Rape.”
221

actually an effort to control, terrorise, humiliate, punish or oppress the victim(s).”
652
In
this way, the author dissociates rape from sex and is thereby able to make the claim that
non-consensual penetration during birth is the same as rape. Furthermore, she asserts that
arguments against the existence of “birth rape” seem to be “the same arguments used
when we first starting hearing women say they were date raped or raped by their spouse
or partner.”
653
Again, we are to understand birth rape as the next progressive step toward
defining and eliminating all forms of rape.
Overall, advocates for the term birth rape argue for the appropriateness of the
term largely based upon comparisons to more well-established understandings of rape. In
this way, proponents of the term attempt to simultaneously stretch the frame of meanings
surrounding both “rape” and “birth,” to the point where they are able to overlap.
Definitions focus on the issues of consent, physical violation, and mental repercussion.
With regard to consent, advocates claim that the presence of a woman’s body on a
hospital bed is not equivalent to consent; therefore any procedure done without verbal
confirmation of her consent or in the face of enthusiastic non-consent can be considered
birth rape. Most definitions also indicate that birth rape consists of non-consensual
procedures performed specifically on a woman’s genitals; sometimes, this occurs while
the woman is begin physically and forcibly restrained by hands or straps. Finally, some
indicate that the mental after-effects of a birth rape are the same as rape, with women
reportedly experiencing symptoms of post-traumatic stress disorder. By defining these
elements of birth rape and emphasizing the elements of sameness that exists between

652
Ibid.,
653
Ibid.,
222

birth rape and rape, these authors attempt to establish the legitimacy of the term by
stretching the conception of rape to include the possibility of birth rape. Along with this
symbolic reframing, the advocacy centering on birth rape also points toward two other
reconfigurations which must occur in order for birth rape to be accepted. First, changes in
the hierarchy of values which surround birth must take place; and second, feminists must
broadly acknowledge birth rape as a problem worthy of attention.

Remaking the Hierarchy of Birth
Included in many articles describing birth rape is the recognition that widespread
acceptance of the term, and any progressive action to better the experiences of all women
during birth, will necessitate a revised understanding of the predominant value hierarchy
surrounding the event of childbirth. Zion Lights writes:
The birth raped women stay mute about their experiences, unable to speak of a
trauma which has yet to be widely recognized by society. Many of them sink
hopelessly into post natal depression. Others are dismissive of their feelings, sure
that they should instead try to focus on how grateful they are that their babies are
safe and well, even if their bodies are not.
654

In a context wherein the predominant concern among mothers, and society overall, is the
birth of a healthy baby, it is difficult for women to verbalize their unhappiness regarding
birth experiences which ultimately result in healthy babies. When the sole valued element
of any birth experience is a healthy infant, women lack the ability to freely discuss the
dissatisfaction and pain they feel with regard to their own treatment. In some cases,

654
Lights, “Recognizing Birth Rape.”
223

events which would otherwise be obviously understood to be criminal violations (such as
non-consensual penetration) are seen as necessary, even if undesirable, actions taken in
the interest of what is ultimately the only thing that matters – the resulting living infant.
Similarly, Natasha begins her post with a phrase in quotation marks: “Your babies
are here, safe and sound – That’s all that matters”
655
and then writes of her experience,
“When I first tried to speak about the way that I was feeling… it very quickly became
obvious that nobody understood. I was left feeling guilty, like everybody felt that I was
being silly and should just ‘get over it’ and be grateful that my babies are safe and
well.”
656
The notion that any and all needs and desires of the mother are less important
than those of the baby creates a context wherein just about anything can be justified as
necessary in the interest of the infant’s health, and wherein it is easy for the legitimate
complaints of mistreated mothers to be dismissed as nothing more than whining from
inauthentic malcontents. She goes on to say, “…birth is about more than an end result –
It’s about more than a baby, although the baby is evidently the focal point. It seems to be
forgotten that there is a woman involved too.”
657
Here there is recognition of the fact that,
in order for women’s complaints of birth rape to be taken seriously, there will need to be
an adjustment regarding the value placed upon the needs of women during birth.
Amity Reed discusses how violations during birth are typically “swept under the
rug” due to the prevailing hierarchy which places baby over mother. She writes,
“Everyone says, ‘Yes, but it’s all in the past now. You have a healthy baby and that’s all

655
“Natasha’s Story.”
656
Ibid.
657
Ibid.
224

that matters.’ As if the women who endured the birthing experience was merely a passive
observer, the emotionless vehicle through which the baby arrived.”
658
The notion that a
healthy baby is all that matters, “leaves us with the disturbing idea that a woman’s bodily
autonomy ceases to exist once she is carrying another life within her.”
659
This statement
alludes to the same need for a reconsideration of the hierarchy of birth, but also aligns the
issue of birth rape with other issues of reproductive freedom. If a women’s autonomy is
unimportant during birth when compared with the life of the baby, then perhaps
considerations of women’s autonomy in cases of abortion merit reconsideration. Readers
are led to draw connections between a woman’s rights to choice with regard to carrying a
pregnancy to term with a woman’s rights to choice during the birth of the baby. Jill
Arnold of The Unecessarean blog notes this prevailing attitude, summed up in the
comment, “She looks fine and the baby looks fine end of story.”
660

The difficulty inherent in these sentiments is that they leave no room for other
values. Instead of the healthy baby simply being placed above the needs and desires of
the mother, it is as if the mother’s interests do not even exist. The life of the baby is
treated as not just the most important concern; rather, it is the only concern. The primacy
of the “healthy baby” is what Burke would call a “God term.” It is promoted to such
standing that its status as the highest value is not even questioned. In our society, the
frame of meanings surrounding birth is very well established and understood, with the
healthy baby at the center of it all. Because of this, those who would seek to question it

658
Reed, “Not a Happy Birthday.”
659
Reed, “It’s not RAPE Rape.”
660
Jill Arnold, “More than Just Rude Behavior: The Rest of Catherine Skol’s Allegations.” The
Unnecessarean (blog), December 17, 2008, http://www.theunnecesarean.com/blog/2008/12/17/more-than-
just-rude-behavior-the-rest-of-catherine-skols-all.html (accessed March 28, 2013).
225

seem almost evil in their attempts; the suggestion that the woman’s rights are also
important appears to be on par with assent to child-murder. As Burke reminds us:
A well-rounded frame serves as an amplifying device. Since all aspects of living
tend to become tied together by its symbolic bridges, each portion involves the
whole. Hence, the questioning of a little becomes amplified into the questioning
of a lot, until a slight deviation may look like the abandonment of all society.
661

Within this sort of frame, it therefore becomes difficult to take mothers’ complaints
seriously, as any suggestion that another concern might also be important can easily
appear as if it is advocating for the wanton murder of infants. The practical problem with
the piety of birth in this instance is that it creates a space of either/or, whereas there is no
actual reason why we should not be able to operate under a system of both/and, when it
comes to birth. Our medical technology should be able to preserve the life of the baby
and the mother, while our basic understandings of human sovereignty and women’s
autonomy should allow us to respect the rights of the mother. The way in which the
symbolic hierarchy of birth is organized, however, makes this difficult to achieve. The
ways in which “reality” is both “selected” and “deflected” makes it difficult to even
imagine other possibilities.

Making Birth Rape a Feminist Issue
Finally, some writers indicate their frustration with what they perceive to be a
desire on the part of mainstream feminism to ignore the issue of birth rape. Says Jennifer
Zimmerman, “Some of these women may term their experience ‘birth rape,’ and have

661
Burke, Attitudes, 103.
226

subsequently suffered a backlash from the feminist movement of which many of them
felt they were a part… [they] do not get the attention they deserve from feminists…”
662

She later writes, “Instead of arguing what words to use, perhaps feminists should try to
understand the abuses that are sometimes occurring against women during childbirth…
[birth rape] should be embraced as a feminist concern, not dismissed because of the
language used to describe the issue.”
663
In this excerpt, the writer is referring to feminist
authors who have written harshly against the use of the term birth rape. The pieces she
refers to will be detailed in the next section; but in short, this author feels as though
feminists who deride the term are being dismissive of the pain of some women (birth
raped women) in the imagined favor of others (raped women).
Similarly, Amity Reed writes, “By recognizing birth rape as institutionalized
violence and a feminist issue worthy of address, we can work towards minimizing and
then ending it.”
664
Reed later writes:
What I find nearly as tragic as birth rape itself is that so many feminists could
ignore, dismiss or outright refute it. It is quite astonishing to see those who fight
tooth and nail for a woman’s right to choose abortion and who argue passionately
for full bodily autonomy then turn around and say that a woman who chooses to
carry a pregnancy to term should hand over the rights to her body for the sake of
the baby. Mothers already feel sidelined and marginalized by the mainstream
feminist movement; when it ignores institutionalized violence against them at

662
Zimmerman, “What Feminists Should Know.”
663
Ibid.
664
Reed, “Not a Happy Birthday.”
227

such a vulnerable and pivotal moment in their lives, the sting of discord is
sharp.
665

She continues, “To minimize birth rape is to minimize the profoundness of birth for many
mothers and, in turn, to minimalize women themselves.”
666
Here, the author reinforces
the prior connections made between the issue of birth rape and other women’s
reproductive concerns. She notes a perceived prejudice against mothers among
“mainstream” feminists, and implores feminists to work in solidarity with mothers.
Motherhood, being a marker of traditional family and gender roles, has an uneasy history
with regard to feminism. In much contemporary feminist thought, however, the notion
that women should have the freedom to choose whatever path they desire and that
motherhood, for example, should not prevent career advancement or vice versa, indicates
that these ideas of feminists and mothers being at odds may be somewhat outdated.
However, the frame is slow to change, and the predominant cultural picture of feminism
still likely places it at odds with motherhood. Therefore, feminists taking up the cause of
birth autonomy would mark a step in direction of closer and more widespread
identification between the two groups. Still, there are those, many of whom are self-
proclaimed feminists, who make impassioned arguments against the term birth rape for
one reason or another. The following section will explore these claims.

665
Reed, “It’s not RAPE Rape.”
666
Ibid.
228

Against Birth Rape
On the other side of the debate over birth rape are those who feel that the term is
an inappropriate and even offensive way to describe a difficult birth. In the following
section, I demonstrate how those opposed to the term argue for distinctions between
“birth rape” and “real” rape. They seek to maintain separate frames of meaning for
“birth” and “rape,” and to break the associations those in favor of the term have tried to
establish. I will also show how opponents claim that “birth rape” denigrates survivors of
“real” sexual assault. By associating rape with birth, some feel that experiences of rape
survivors are devalued. Finally, I will demonstrate how some cast doubt on whether
“birth rape” exists. Notions of this sort stand in paradoxical contrast to those who
understand that for birth rape to exist means that it must be established with language. It
is important to note that most of these writers claim to be sympathetic to the women who
have suffered during birth and to women who desire to maintain their autonomy in the
birthing room. However, they draw the line at birth rape; they are not sympathetic to their
stated needs to talk about and frame their experiences in this particular way. This is made
explicit by nearly every author in some way or another; they feel for the women who are
in pain, yet they insist on a more “appropriate” way of describing the pain.

Not the Same as Rape
While many authors advocating for the term birth rape attempt to highlight the
similarities between birth rape and more widely understood forms of rape, those who
disagree with the use of the term attempt to draw sharp divisions between the two. Jeanne
229

Faulkner, a labor and delivery nurse, reports that she finds the term birth rape “very
disturbing,” and writes an article in which she states:
These birth experiences were horrible, but were these women raped? No. They
may have been abused, manipulated and victims of malpractice, but they were not
victims of sexual violence. That’s what rape means and in deep respect for
women who have been raped, I think the term ‘birth rape’ is inappropriate.
Instead, I’d use the term ‘birth trauma.’ The rage, despair and feelings of violation
some women experience after a traumatic, out-of-control birth are valid and
powerful, but aren’t the same feelings women experience after rape.
667

While she expresses concern and compassion for women hurt during birth, her
compassion does not extend so far as those women who feel the need to describe their
birth experiences as rape. Faulkner’s justification for this division springs from the
conviction that rape victims experience different feelings, in the aftermath, than women
who experience what is described as birth rape. She also indicates that the assertion that
rape can happen during birth, in the way that self-identified birth rape victims describe it,
is disrespectful to those whom she considers to be “real” rape victims. Beyond this, any
concrete explanation for why rape is different and why birth rape, as a concept, is
disrespectful to rape victims, is not given. Her arguments are vague and indicative of the
fact that many will be able to fill in the blanks on their own. Many will undoubtedly
agree with her, having a strong sense that the term birth rape is somehow wrong, and will
not find any need to elaborate beyond this.

667
Jeanne Faulkner, “It’s Not Birth Rape; It’s Birth Trauma,” FitPregnancy. March 17, 2012,
http://www.fitpregnancy.com/labor-delivery/ask-labor-nurse/its-not-birth-rape-its-birth-trauma (accessed
March 28, 2013).
230

Faulkner continues, saying that, as a labor and delivery nurse, she has seen
patients crying after being abused by “jerk-doctors,” but that “usually this doesn’t
happen.”
668
She writes, “Sometimes it’s powerful, overwhelming and yes, even violent,
but that’s not rape – that’s trauma.”
669
For this author, rape is a specific sort of sexual
violence; therefore, other types of violent experiences do not qualify. By advocating for
the term “trauma” instead, this author indicates that she prefers a connotation that does
not necessitate a criminal or abusive element. Trauma is something that may or may not
be the result of an intentional harm. Despite the fact that these incidences take place at
the hands of “jerk doctors,” this author implies that these “jerks” do not hold sexually
malicious intent. This author’s stated solution to the problem is that “those jerk-doctors
usually get their karma returned somehow.”
670
Thus, despite the fact that trauma occurs
as a result of the actions of doctors, these doctors are apparently not responsible and
subject only to the punishment of cosmic forces. If what happens to women during birth
can be classified as rape, then the doctors, midwives, and nurses carrying out the abuses
become rapists – a notion implied to be unacceptable in the writings of this author.
Blogger Amanda Marcotte writes that members of “childbirth empowerment
circles” have adopted the term to describe “the trauma of having doctors poke and prod
your body against your will, or bully you into a procedure you don’t want, or otherwise
assume that your right to autonomy was checked at the door of the hospital.”
671

668
Ibid.
669
Ibid.
670
Ibid.
671
Amanda Marcotte, “Bad Birth Experiences Aren’t Rape,” The XX Factor (blog) Slate, September 8,
2010, http://www.slate.com/blogs/xx_factor/2010/09/08/birth_rape_is_a_misleading_term.html (accessed
March 28, 2013).
231

Interestingly, the image of someone poking and prodding the body of another against
their will sounds quite like a definition of sexual assault and battery; however, this author
is clear in her distinction. She continues:
I really do wish they wouldn’t use the term ‘birth rape’ to describe these
experiences. It’s misleading.
The problem is that actual rapists have completely different motivations
than imperious doctors who inadvertently traumatize their patients by pushing
them around in the birthing room. Actual rapists want to traumatize their victims
– getting off on the power they have over their victims and the fear it instills in
them is the whole point of raping them.
672

Marcotte insists that, though some women are undoubtedly traumatized by their
experiences at the hands of doctors and midwives in the birthing room, she is
“unconvinced” that what women describe as “birth rape” is “sadistic in the way that rape
usually is in the real world,”
673
even though she herself writes that the treatment received
can come from “sexist” doctors, some of whom absolutely “exhibit contempt for women
that’s so serious it fades into misogyny.”
674
Ultimately, this author feels that the problem
with ‘birth rape’ is that it is, in her opinion, defined based on the feelings of the victim
rather than the motives of the perpetrator. She writes, “If the social definition of rape is
rooted in the trauma to the victim and not in terms of what the actual rapist did and why,
we’ve lost our main tool in stopping rape from actually happening.”
675
Why Marcotte

672
Ibid.
673
Ibid.
674
Ibid.
675
Ibid.
232

believes this to be the case is unclear, as she does not provide much elaboration. It is also
unclear as to why she believes the “why” of rape must always be the determining factor
in the definition of rape. Psychologists may research the reasons behind rape and
determine that many are motivated by misogyny or a need to exercise power over another
in an extreme and sadistic way – but this does not mean that these motives are necessary
in order for a rape to have occurred or for a rapist to be guilty. Some, for example, who
commit date rape are likely not “sadistic” in the ways that this author describes. In fact,
by reinforcing the notion that all rapists are sadistic, Marcotte contributes to cultural
understandings that continue to frame date rape, spousal rape, and statutory rape as less
“real” forms of rape. She continues:
The difference between what motivates a rapist and what motivates a bad doctor
is critical when it comes to bringing a halt to horrible birth experiences. If we
want bad doctors to cut it out, we have to define what they’re doing wrong
accurately. In most of these cases, they just don’t respect their patients. That’s the
problem that has to be worked on – getting them to the point where they listen to
and respect their patients. Approaching them like they act out of sadism is simply
going to turn them off.
676

Marcotte’s argument becomes confusing, as a lack of respect for a patient, held by a
typically male doctor toward a vulnerable female birthing woman, would seem to fall
somewhere on the same spectrum as what the author states to be the motivations behind
“real” rape – power and misogyny. Additionally, the way in which the previous excerpt
takes shape makes it seem as though this author is more concerned with the possibility of

676
Ibid.
233

alienating doctors than with acknowledging the pain of women who allege birth rape. Her
emphasis on “accuracy” in definition indicates her desire to make clear divisions between
rape and whatever it is these women have experienced. To this author, there can be no
association between rape and birth, rape and hospital, rape and medical professional.
Writer Tracy Clark-Flory is even more explicit in expressing her concern for
victims of alleged birth rape, but is equally committed to opposing the term. She writes:
Far too many women are being subjected to this kind of medical mistreatment,
and damn straight activists should be making noise about it. The experiences
being described as ‘birth rape’ are undoubtedly harrowing. How awful to feel so
violated while giving birth. What a devastating way to have your child enter the
world. Did I mention that it is profoundly, horribly and tremendously wrong?
Because it is. But here’s what it’s not: rape. It is unbelievably horrific – but it isn’t
rape, and the suggestion that it is seems like a violation in its own right.
677

She goes on to describe why term “rape” cannot apply to birth violations, as rape is “used
as a tool of terror, torture, intimidation and war…” and that “It is a special kind of crime
not only because of what it is, but also because of what it does to the victim.”
678
Of
course, this particular statement runs counter to the argument advanced by Marcotte, who
felt that defining rape based on the victim’s feelings would take away from society’s
ability to effectively fight rape, and suggested that rape must be defined based on the
perpetrator’s motives. However, like Marcotte, Clark-Flory is determined to create a

677
Tracy Clark-Flory, “The Push to Recognize ‘Birth Rape,’” Salon. September 9, 2010,
http://www.salon.com/2010/09/09/birth_rape/ (accessed March 28, 2013).
678
Ibid.
234

barrier between rape and what women describe as birth rape. Rape is “special” and merits
its own language, not to be appropriated for other uses.
Another author, Sierra Black, a self-identified rape survivor and a mother who
experienced a traumatic hospital birth, writes, “A difficult birth, even one that includes
non-consensual medical procedures, is not the same thing as a rape.”
679
She continues, “I
would never claim that a woman being subjected to medical procedures she did not
consent to while in labor is acceptable. It just isn’t rape.”
680
She goes on to say that she is
not claiming that rape is any worse than the experiences being described as birth rape, she
just does not think they are the same. One again, the author in quite clear in her desire to
divide rape from women’s traumatic birth experiences, but she is somewhat vague on the
details with regard to why she finds the two experiences to be dissimilar, as if there is
some ineffable quality about “real” rape that makes it unconscionable to associate the
concept with birth in any way.
Writer Lindsey Beyerstein adds a slightly different angle to the differentiation
argument. She writes, “The idea is that women who are handled roughly, verbally
abused, or bullied into unwelcome interventions during labor are literally being raped by
their healthcare providers.”
681
To Beyerstein, descriptions of birth rape sound more “like
plain old assault and battery or verbal abuse” than they do like rape.
682
The author feels

679
Sierra Black, “Bad Birth Experiences Need a New Name,” Babble. September 8, 2010.
http://www.babble.com/mom/bad-birth-experiences-need-a-new-name/ (accessed March 28, 2013).
680
Ibid.
681
Lindsey Beyerstein, “Birth Rape’ Rhetoric is Ugly, Misleading,” Focal Point (blog) Big Think.
September 10, 2010, http://bigthink.com/focal-point/birth-rape-rhetoric-is-ugly-misleading (accessed
March 28, 2013).
682
Ibid.
235

that women should certainly stand up for themselves in the face of crimes of abuse or
malpractice, but that the term birth rape is problematic in that it sexualizes medical care
and “encourages women to re-frame traumatic experiences in a way that makes them
seem even more traumatic.”
683
Beyerstein agrees with Marcotte and argues that the
“definition of rape should be rooted in the motives of the rapist,” in order to effectively
draw a distinction between those with criminal or sadistic motives and “well-meaning”
medical professionals.
684
She claims, “The concept of birth rape is unhelpful and
misleading,” and that the kinds of violations these women report experiencing cannot be
called rape because they were not sexual in nature.
685
She writes, “It’s not just about
which body parts are involved”; rather, the context of the event and the motives of the
perpetrator must be taken into account.
686
Furthermore, she finds the term to be
problematically “emotionally loaded” and “emotionally manipulative” in ways that
cruelly encourage women to “recast” their experiences as sexual violations, “even when
everyone agrees that the doctor did nothing sexually inappropriate,” hurting both the
woman and the doctor.
687
Rather than being a term that allows women who have
experienced severe violations to their bodies during birth to give voice and meaning to
their experiences in novel ways, Beyerstein feels that the term itself will cause women to
experience even more pain. Mothers, apparently, need to be protected from a term that
will manipulate them into incorrectly making sense of their experiences. At the root of

683
Ibid.
684
Ibid.
685
Ibid.
686
Ibid.
687
Ibid.
236

this argument, it seems, is the notion that birth is not in any way sexual; therefore, any
term that causes a woman to view a violation during birth as an assault of a sexual nature
is harmful and misleading. However, for many women, particularly those who advocate
for a natural birth experience, birth is absolutely sexual. Obviously birth entails the
sexual organs; but more than that, these women see birth as an inextricable part of the
process of sexual reproduction. So, while some feel uncomfortable associating birth with
sex, to many others any attempt to separate the two seems quite foolish.
Finally, Mia Freedman states that if “there is a more offensive term than ‘birth
rape’” she “[hasn’t] heard it.”
688
She sets up a straw person definition of birth rape,
describing it as “the extraordinary name some women use to describe a birth that involves
medical ‘intervention,’ even when it is done to save the life of mother or baby.” While
women advocating for use of the term often do not welcome any intervention, they are
much more specific about the types of practices contained under the heading of birth
rape. Freedman does not understand why anyone would want to paint doctors, hospitals,
and medicine as the enemy, and is “baffled” by a trend toward “demonizing the medical
profession.” Freedman represents the extreme end of those who disagree with the term
birth rape. By defining birth rape in such a broad and non-specific way, she makes it
seem obvious that what women term “birth rape” has no business being compared with or
called “rape.” Also, from this perspective, these practices cannot be rape because they are
committed by doctors – and doctors cannot be rapists. The preceding examples are all
demonstrative of the ways in which advocates against birth rape attempt to draw
distinctions and divisions between rape and what is described as birth rape. The following

688
Mia Freedman, “Comparing Birth to Violent Crime is So Offensive,” Sunday Telegraph. April 8,
2012.
237

section details efforts, undertaken by the same collection of authors, to preserve the
traditional definition of rape.

Defending Rape Victims
Authors also argue that use of the word “rape” in the context of violations during
birth results in something being “taken away” from those who have experienced what is
ostensibly “real” rape. Writer Brittany Shoot, a self-identified survivor of sexual abuse
who claims she “will never give birth,” says, “doesn’t calling an invasive birthing
experience ‘rape’ sort of diminish the experiences of sexual assault survivors?”
689
Shoot
seems to feel that more familiar experiences of sexual assault are worse or of a more
serious nature than the experiences of women who describe having been birth raped; thus,
survivors of more widely-understood forms of rape deserve to keep the term to
themselves. By associating the term rape with birth, the crime of rape seems somehow
diminished in its seriousness and severity.
Sierra Black explicitly states that she does not believe one is worse than the other;
however, she says that “by conflating a bad birth with sexual violence, we do a disservice
to survivors of both experiences.”
690
This disservice, she implies, comes in the form of
being less able to help women recover from abuses due to the imprecise way in which
they are described and discussed. She writes, “To help women heal after trauma, and to
support the activists and organizations that work to protect us, we need to be having

689
Brittany Shoot, “When Giving Birth is a Traumatic Violation, Is It Rape?” Women’s Rights (blog).
Change.org. September 10, 2010.
http://web.archive.org/web/20100916005323/http://womensrights.change.org/blog/view/when_giving_birth
_is_a_traumatic_violation_is_it_rape (accessed March 28, 2013).
690
Black, “Bad Birth Experiences.”
238

nuanced, honest conversations about these experiences. Throwing the word rape into
conversation about birthing practices is like dropping a grenade. It shuts down productive
conversation.”
691
To Black, the problem with birth rape is that it is not precise in its
description. Thinking back to those women who advocate for the term as a descriptor,
however, it seems as though precision is exactly the reason why they have chosen to
name their experience birth rape – because they feel that it describes what they have
experienced more precisely than other terms are able to do. However, for someone who
has difficultly in associating rape with birth, it stands to reason that birth rape would
seem quite imprecise. Language that violates the frame under which someone is
operating would tend to appear inexact in its description of reality. Precision, rather,
would occur when terms and conditions matched in ways that seemed familiar to the
person making the judgment.
Moreover, Black does not provide any elaboration on why she believes the term
“shuts down” conversation. This phrase, itself, has become something of a cliché among
journalists who claim to take issue with polarizing discourse, even while working both
sides by contributing to polarized thinking. Indeed, extreme and polarizing discourse can
sometimes be a deterrent to discussion, compromise, even perhaps democracy; however,
it also serves a specific purpose in certain contexts – particularly in contexts where
individuals have no voice or feel that their voices are being unheard, misunderstood, or
ignored. In cases like this, polarizing discourse from the margins inserts new voices and
perspectives into public discourse and public consciousness. Indeed, in the context of
social movements and discourses of social change, we often observe various actors

691
Ibid.
239

working both from within and from without the established “system.” It is those
discourses coming from without that present us with new possibilities, new beginnings,
new ways of understanding a situation, and new ways of talking about and thereby giving
meaning to an event. Instead of shutting down “productive” conversation, then, perhaps
what this frame-breaking term does is shut down “familiar” or “conventional” or
“comfortable” conversation. When conversation seems to have stalled or is going
nowhere “dropping a grenade” is sometimes necessary to open up new avenues for
rhetorical exploration. Natality, then, is perhaps not possible for those working within the
confines of established and agreed-upon discourse. And natality does not inherently “shut
down” discourse, or anything else. It breaks agreed upon patterns and forces rhetors to
rethink, reorganize, and look for creative solutions to developing problems.
Black concludes by reiterating her sympathy toward those who have had bad birth
experiences and punctuating her argument against birth rape:
Women who’ve been violated by the medical industry are genuinely hurt and
often righteously angry. They’ve been made to feel powerless, disrespected and
dehumanized. They deserve a mechanism to hold doctors who hurt them
accountable, a healing space to recover from the trauma and a way to talk about
what happened so that we can all work to prevent it in the future.
Calling it ‘birth rape’ serves none of that. The word rape is, for better or
worse, taken. It refers to a non-consensual sexual encounter. Women who’ve been
through a traumatic birth deserve their own language, not a term that suggests
they’re a subset of rape survivors.
692

692
Ibid.
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Despite Black’s belief, it would seem that creating their own language and
simultaneously suggesting that they are rape survivors is exactly the point of birth rape.
By appropriating the word rape and connecting it with birth, women who employ the
phrase are suggesting that what has happened to them in the birthing room is equivalent
to a sexual assault, to rape. This is precisely the message they are trying to convey.
Furthermore, “their own language” is just what they are trying to create: by putting
together the two words in question in a novel way they are creating new language to give
meaning to their experiences. It is unclear what sort of language Black would prefer they
make their own. Others, apparently, would prefer they have no language at all – as they
implicitly and explicitly question whether birth rape exists. The following section will
touch upon this claim.

Birth Rape Doesn’t Exist
Some authors make statements that indicate that they do not believe birth rape
exists. Bonnie Rochman rather un-cleverly makes light of the experience, and writes,
“Giving birth is not a modest affair […] As part of this no-holds-barred experience, [a]
doc or nurse occasionally plunges an instrument (not of the musical variety) or his/her
hand into an expectant mom’s vagina… That’s what they get paid to do.”
693
Birth rape
cannot be real, because the practices described as pertaining to the term are part of a
medical professional’s job description. Rochman proceeds to give a brief description of
what others describe as birth rape, before asking, “What do you think? Does birth rape as

693
Bonnie Rochman, “Is ‘Birth Rape’ for Real?” Family Matters (blog) Time. October 5, 2010,
http://healthland.time.com/2010/10/05/is-birth-rape-for-real/ (accessed March 28, 2013).
241

a concept exist?”
694
By posing this question, Rochman encourages readers to consider
their understandings of the frames surrounding birth and rape, and to ponder whether
there might be room for such a concept within established systems of meaning.
Several other authors make similar sorts of statements, questioning whether birth
rape exists. One recent article by Solaade Ayo-Aderele is titled, “Birth Rape: Real or
Imagined?”
695
Another article similarly proclaims its skepticism in the title “Birth Rape:
Real or Just a Reaction to Bad Birthing Experiences?” This piece provides Amity Reed’s
definition of birth rape, quoted previously, before asking whether these actions “can be
considered as sexual affront on a woman?”
696
Here, it seems that the existence of birth
rape depends on whether birth is able to be associated with sexuality, and thereby
whether someone penetrating a woman without her consent during birth can truly be a
sexual assault. If rape is indeed a “sexual affront,” readers are thereby charged to
consider whether a woman’s vagina undergoes a total transformation of quality between
contexts of birth and not-birth. At what point are the woman’s sexual organs rendered
non-sexual? At the onset of contractions? At the moment of conception? A precise line is
not clear or explicitly indicated, but some arguments against the term birth rape imply
that a line must indeed exist, somewhere.
Another poster, disparaging women who complain about their birth experiences
and implying that women who want natural birth are just whining, writes, “When I was

694
Ibid.
695
Solaade Ayo-Aderele, “Birth Rape: Real or Imagined?” Healthwise (blog) Punch Nigeria, February
22, 2013, http://www.punchng.com/healthwise/birth-rape-real-or-imagined/ (accessed June 11, 2013).
696
“Birth Rape: Real or Just a Reaction to Bad Birthing Experiences?” Smart Parenting, December 20,
2011, http://www.smartparenting.com.ph/pregnancy/labor-and-childbirth/birth-rape-real-or-just-a-reaction-
to-bad-birthing-experiences (accessed March 28, 2013).
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told I needed a c-section do you know what I said to my doctor? ‘Get my baby out safe,
she comes first and then me.’ […] You know what my birth plan was? A baby with 10
fingers and 10 toes.”
697
This writer clearly holds the position lamented by some women
in favor of the term birth rape, wherein the end result of a healthy baby is “all that
matters.” From this perspective, if not impossible, birth rape would certainly be
irrelevant. These remarks, which question the existence of birth rape, are perhaps the
most puzzling and yet telling remarks in the whole of the debate. It is as if, instead of
describing their lived experience of being sexually violated while giving birth, these
women were discussing the sighting of a unicorn or a close encounter with a satyr. In
Burkean terms, these authors find that within the scene of a reputable medical
establishment, the act of rape cannot exist. The scene, therefore, is in control and
transforms the act of unwanted and nonconsensual penetration from rape to standard
procedure.

Making Sense of Birth Rape
From a Burkean perspective, the debate over the birth rape can be seen to find
expression through several conceptual tensions. Of course, the question of naming is key;
women have chosen to name their experience “birth rape” because they previously felt
they had no proper means of authentically expressing their feelings. Women either feel as
if they have truly been raped, or that “rape” is the only word that can accurately capture
the magnitude of the violation they have experienced. So they proceed to build structures
of support for their newly-crafted name in the form of identifications. They draw upon

697
“Birth Rape,” Circle of Moms (blog), April 19, 2012, http://www.circleofmoms.com/debating-
mums/birth-rape-693108 (accessed March 28, 2013).
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concepts like vulnerability, exposure, violation, lack of consent, lack of choice, abuse of
power, coercion, force, restraints, and penetration to articulate how and why their
experiences of birth are just like rape. They state their connection to rape victims through
the sharing of physical and mental trauma and post-traumatic stress disorder. They argue
that birth can be sexual but rape does not necessarily have to be. They imply solidarity
with women’s rights advocates in the realms of abortion and birth control in their
insistence that the life of the baby does not eclipse the autonomy of the mother,
demonstrating the viability of their cause as a feminist issue. At the same time, and like
natural birth advocates before them, they work to create divisions between
understandings of medicine and a presumption of care, safety, and goodness. To make it
symbolically possible for a doctor to be a rapist, a significant shift in associations must
occur. Likewise, an entirely new conception of the scene is necessary if the act of rape is
to occur in a hospital.
This choice of name and the sorts of identifications and divisions that follow
clearly pose frame-related problems. Those who resist the term are quite comfortable
operating within a symbolic orientation that places “rape” and “birth” in separate
universes. Birth is a beautiful event, the beginning of a new life, the welcoming of a new
family member, the coming of a blessed and beloved child. Indeed, parents who joyfully
proclaim that the birth of their child was the happiest moment of their lives are not likely
to be exaggerating. Birth is pure, innocent, and sacred to many. Rape, on the other hand,
is a dark and difficult subject, to say the least. Rape is the most horrific crime that can be
suffered by a woman, a violation of the most intimate and damaging kind. The experience
of a rape will physically terrorize the body and forever colonize the mind. The ever-
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present, even if slight, possibility of rape has the power to place women in a permanently
subordinate position. For people who understandably find these two events organized
within separate frames of meaning and experience, a term like birth rape marks a jarring
attempt to break familiar modes of symbolic understanding. The breaking of a frame can
be a confusing, disorienting, and painful experience; thus, it is no surprise that this term
encounters fierce resistance, even among those who might otherwise be supportive of the
general cause. Those who find the juxtaposition of birth and rape abhorrent struggle to
find ways to articulate precisely why the term is so horrifying— in the midst of strongly
entrenched and normative frames of meaning, that bring them to feel very strongly that it
just is.
At the same time, those whose experiences have no form of material expression
within the established frames suffer the pain of having no language to give meaning to
that pain, no voice with which to reclaim a degree of power. Their only recourse is found
in attempts to stretch the existing frames and remodel established meanings in such a way
that they might account for new experiences. In this way, a novel symbolic frame can be
constructed, which might then serve as a basis for fresh and reignited activism with
regard to birth justice. In this instance, however, casuistic stretching must be supported
by sufficiently persuasive claims that successfully associate women’s lived experiences
of birth with accepted understandings of rape. As part of this effort, the value of women’s
experiences during birth must also be given more serious attention, which would likely be
helped by the public support of feminists.
The precariousness of natality becomes apparent when articulated through a
theory of symbolic language. Creating something new is exceedingly difficult; and even
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the novel creators are limited by the materials of existing conventions and material
outcomes commonly held to be reality. These materials, being firmly existent within
familiar structures of meaning, are not easily appropriated. When they are appropriated,
pain and resistance follow. Thus are special difficulties encountered in the natality of
language. Arendt recognized this when she wrote, “Unfortunately…no other human
capacity is so vulnerable, and it is in fact far easier to act under conditions of tyranny than
it is to think.”
698
Indeed, in the words of those opposed to the use of birth rape, we see
over and over again the notion that women should have the freedom to choose how they
will birth and be able to maintain autonomy over their bodies while giving birth.
However, when a violation of this autonomy does occur, no matter how terrible, the same
people who were arguing in favor of autonomy claim that women should not have the
freedom to conceptualize and speak about the term in ways they deem appropriate. In
other words, have all the freedom you want, “just don’t call it rape” when it doesn’t go
how you planned. One writer, of course, even suggested that the term would encourage
women to frame their experiences, in their minds, in ways that would cause them more
pain. Perhaps, what the term is instead doing is allowing women to give adequate
expression to the pain they are already experiencing, by allowing them to think and
reflect upon the events of their birth in ways that make sense. Arendt and other writers
have repeatedly acknowledged the difficulty of beginnings, and the threats to natality that
are threats to our most fundamental freedoms. In this case considered here, the freedom
to make meaning would seem to be the most imperiled of all.

698
Arendt, Human Condition, 324.
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Chapter Five
Homo Natal: Discussing Possibilities and Futures of Birth and Agency

This dissertation argued that agency in childbirth is best understood when
articulated through the language of Hannah Arendt’s theory of natality. This argument is
placed in contrast to popular notions that frame birth as either a bodily function that
merits no further consideration beyond its safe and efficient mechanical achievement; or,
a meaningful event wherein women’s agency is best understood as a choice between
available options for care. Instead, this dissertation demonstrates that the negotiation of
agency in the context of birth is a complex phenomenon that occurs at both individual
and collective levels. It contends that agency is not best conceived as individual free
choice, but rather as a struggle against numerous interconnecting vectors of influence.
The following presents a summary of my findings, as well as a consideration of some
theoretical principles derived from these findings. Following this, I offer directions for
continued research with regard to birth and birth advocacy, together with final thoughts
about the enduring importance of birth within the context of struggles for reproductive
justice.

Synopsis: Birth Activism across History
Three examples of advocacy surrounding birth have been discussed. These
examples are distinct in both era and form. The first, The American Midwife, advocates
for a continued place for midwives within the larger picture of obstetric care by providing
a forum for both professional participation and education among midwives. In contrast,
the narratives of natural birth advocate for reformed ways of thinking about the nature of
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birth and reformed ways of engaging in the birth process. Finally, advocates turn to the
internet to argue for a new terminology to describe bad birth experiences and a remodeled
framework of meaning surrounding birth. The following paragraphs provide a detailed
synopsis of the significant arguments and findings of each case study.
In Chapter Two, a rare and unique example of midwives speaking is examined in
the pages of The American Midwife. In the context surrounding the journal, women’s
rights advocates were speaking out with increasing frequency across the country, in favor
of suffrage, property rights, freedom to divorce, dress reform, and birth control. Prior to
this, women’s voices had been heard mostly in advocacy of abolition, temperance, and
moral reform. Justice for birthing women and their attendants, however, was a different
story. Women were certainly losing control in the birthing room, and this formerly
insulated sphere of limited female autonomy was vanishing. However, birth at this time
in history was also an extremely hazardous endeavor, as both infant and maternal
mortality rates were high. For every thousand live births, about one-hundred infants died
within the first year, while around eight or nine women died from pregnancy-related
complications.
699
The perception that new medical technologies could help women
escape the danger and pain of birth was a welcome change for many women. Suffragists
did not link their political goals with the plight of midwives; some were even advocates
of twilight sleep and other medical interventions, believing that escaping the experience
of birth was a step toward liberation.

699
Marian F. MacDorman and T. J. Mathews, “Recent Trends in Infant Mortality in the United States,”
NCHS Data Brief no. 9 (October 2008): 1; “Achievements in Public Health, 1900-1999: Healthier Mothers
and Babies,” Morbidity and Mortality Weekly Report 48, no. 38 (October 1999).
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For midwives, however, the shift to doctors and hospitals meant the loss of their
livelihood, decreased economic freedom, diminished community influence, and the
denigration of centuries of female-centered folk knowledge. Thus, some sought to protect
what was being lost. Chapter Two employs evolving theories of the public in an attempt
to make sense of midwife voices in The American Midwife. Here, we saw midwives and
others explicitly advocating for midwife education. More implicitly, they advocated for
midwives’ professional and economic survival. When viewed through theories of the
public sphere and counterpublics, we see the attempt and failure of midwives to
participate in a disinterested public. Midwives worked to erase their differences by
performing their aptitude for the medical public and participating in discussions
alongside doctors, adapting to the form, style, and rules for standard of care. At the same
time, evidence of a counterpublic, in its infancy, demonstrates interest in
professionalizing as well as a growing drive toward political consciousness. Both these
efforts—public participation and counterpublic organizing—ultimately failed for
midwives in a material and practical sense, and Chapter Two has demonstrated how
acquiescence to the language and thinking of the oppressors provided for a context that
was ripe for the rise of the social. However, it also argues that the potential for a
beginning, the forming of an alternate trajectory, was evident in moments where
midwives had opportunities to advocate for their own standard of care. This is illustrative
of the Arendtian public ideal, wherein natality occurs as difference is welcomed, and in
fact demanded, in the public.
Alongside these analytical features of the text of The American Midwife, the
other, and perhaps ultimately more important, goal of this chapter was simply to provide
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a serious and detailed look at the voices of early midwives in America, which have been
virtually erased from history. Most midwives did not keep qualitative records of their
practices, or if they did they have been lost. Because of this, most studies of midwifery at
the turn of the century focus on public record and numerical data, or sometimes
newspaper advertisements or records of criminal proceedings. Therefore, this chapter
sought to provide a more widespread means of accessing a very rare and heretofore
largely unknown example of midwife advocate-voice from this era. The voices of
midwives, even in the journal, were sporadic and insulated. However, they indicate a
desire, on the part of contributors and subscribers, to reach out to a larger community,
share knowledge, and build a collective.
In Chapter Three, artifacts representing a home birth movement are examined. In
the years leading up to this, the activism of the Civil Rights, New Left, and Women’s
Liberation movements created a context of massive social unrest and change wherein
long-oppressed groups demanded equality in both nonviolent and violent ways. In the
midst of this, home birthers practiced quiet resistance to medical and technological
domination, by practicing outside-of-the-law natural birth in homes and communes.
Better understandings of hygiene and preventative healthy living made birth far less of a
hazard for everyone; thus, advocates saw no reason for women to continue enduring the
documented indignities and dehumanization of the hospital birth. Home birth, they
argued, was in every way superior to hospital birth. It was healthier for both mothers and
babies—in both physiological and emotional senses—and it was an empowering
experience for the mother.
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Chapter Three shows how biopower invites acts of resistance. Rhetoric is more
than the circulation of signals by systems; rather, natality self-generates oppositional
ruptures that move in alternative directions. That these have yet to be fully realized or
realized in the same way for everyone indicates that the movement is not yet complete.
Yet, on the other hand, I have identified conditions of possibility. Advocacy takes shape
within narratives that articulate the personal experiences of individual women, as part of
a larger community and ideology of home birth. Here, we saw mothers explicitly
advocating for the naturalness of birth and an alternative way of thinking about birth,
while implicitly advocating for the legitimacy of their own experiences and expanded
rights for midwives and doulas.
When viewed as resistance to biopower, we see the possibilities for empowerment
through disruptions of time, negotiations of subjectivity, and reclamations of biology.
These three areas of resistance are strands teased out from natality, as natality opens up
new intervals of time, allows for the merging of bodily and political subjectivities, and
draws upon biological potential as the rhythmic basis for action. Through their personal
narratives, mothers demonstrated the ways in which they experienced power by avoiding
the dehumanizing routines of the hospital and drawing upon their own physical and
mental strength to accomplish the exceedingly strenuous act of giving birth. In this case,
we also see a move toward resistance that is individualized. Any notions of a collective
consciousness seem to be felt in a spiritual, rather than material, sort of way. The
individual narratives, when packaged in book form, become a collective story of
resistance, but there is not much indication that this collectivity transfers to everyday life,
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for most of these women. Exceptions, would of course, be found among those living in
communities such as Ina May Gaskin’s “Farm” commune.
In Chapter Four, the appearance of birth advocacy in online forums is explored
through an analysis of debate over the term and concept of “birth rape.” In the present
moment, “choice” with regard to birth practices is perceived to be relatively free and
growing. A current “WebMD” feature opines that “the old stereotype of delivering you
baby in a cold hospital room with your feet up in stirrups is long gone.” Instead, they say
that “many hospitals provide options that range from practical to plush in order to make
the labor and delivery experience more comfortable.”
700
Despite this assurance that
society has progressed and “everything’s A-OK” in the birthing room now, some women
still walk away from the experience feeling pushed around, beaten down, and abused. In
a context wherein there is a general feeling that things have gotten “better,” it becomes
necessary for advocates to startle people out of complacency, in effect. Hence, women
hurt and traumatized by their experiences of hospital birth, feeling that no language was
adequate to describe their experiences, coined the term “birth rape” in an attempt to give
meaning to the events of their births.
Chapter Four draws upon Kenneth Burke’s theory of dramatism in an attempt to
unpack the ways in which language is contested and agency is claimed in the debate over
birth rape. Advocates of birth rape attempt to casuistically stretch the frames of birth and
rape to accommodate for the meaning they give to their experiences. Those who resist the
term evince the resistance that accompanies violations of familiar frame. While
proponents seek to stretch the possibilities for meaning, the responses of opponents

700
“How Do You Want to Delivery Your Baby,” WebMD (December 2, 2012)
www.webmd.com/baby/features/childbirth-options-whats-best?page=3.
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indicate that they view the term as a shattering of what makes sense with regard to both
birth and the crime of rape. Natality is not an easy endeavor; it must be struggled for
against the strong presumption of the status quo.
Alongside these features of the debate, we see ways in which the internet forum
holds potential for birth advocacy. While opening up participation to more individual
voices, it also provides a place for those voices to meet and coalesce. Unlike the
relatively privileged voices working toward collectivity from Chapter Two and the
insulated individual voices from Chapter Three, here we have the opportunity for citizens
to come together and combine their individual knowledge to form a basis for collective
action. Of course, scholars have been quick to debunk overly-optimistic visions of
utopian internet community and democracy. Michael Margolis and Gerson Moreno-
Riano, for example, decry those who claim that the internet leads to radical changes in
political participation. They argue that “politics on the net is largely a replication—a
mirror image—of politics in the real world.” They continue, “rather than the Internet
possessing some inherent transformative power that turns all that it touches into gold, the
Internet often becomes a conduit for channeling the passions and practices of the actors
of politics.”
701
This is certainly true, in a sense. However, it seems a bit hasty to assume
such a posture of total critique and conclude that it’s all just more of the same. This is
particularly true in light of the case presented here, wherein the new terminology and the
debate and meaning which surrounds it almost certainly would not have taken shape in
the same way were it not for internet forums. Scholars like Michael Cornfield have

701
Michael Margolis and Gerson Moreno-Riano, The Prospect of Internet Democracy (Burlington:
Ashgate, 2009), 150.
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similarly noted instances where the internet did, in fact, make a difference.
702
So, in
addition to unpacking the types of rhetorical processes that accompany instances of
symbolic natality, this chapter provides a look at a sliver of the potential for internet-
based birth advocacy.
Taking these case studies together, we can make a few general observations about
their comparison. First, it seems that birth advocacy is never “just” about birth; it is
always multi-layered. Different goals are made more or less explicit at different points,
but all birth advocacies demonstrate this character of duality. This reflects the dual
character of exigence observed in Chapter One. Women simultaneously express and work
through their own experiences, while connecting those experiences to larger political and
social goals. Thus, and secondly, we see an evolving yet ultimately persistent reliance on
personal experience. This is in keeping with other studies of women’s advocacy. In each
case, it is first-person knowledge of birth, coming from either mothers or midwives,
which almost exclusively provides the evidence upon advocacy is built.
Third, we see an evolving set of issues and motives take shape across time. In
Chapter Two, amidst growing technological incursion and standardization of medicine
alongside thoroughly repressive Victorian patriarchy, just having the opportunity to speak
at all was a victory for midwives and a potential step in the direction of freedom. In
Chapter Three, technological control of medicine has become hegemonic, and women,
though they have a voice, are scarcely able to use it to resist a system that is so
unquestionably dominant; thus, freedom becomes largely a matter of freeing one’s mind.

702
Michael Cornfield, “The Internet and Democratic Citizenship: Theory, Practice and Policy by
Stephen Coleman and Jay G. Blumler and The Prospect of Internet Democracy by Michael Margolis and
Gerson Moreno-Riano,” Political Communication 27, no. 3 (2010): 329-331.
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In Chapter Four, awareness has been raised to a significant degree, and yet adaptations
from a hegemonic system have done much to placate rebellious impulses; thus, freedom
is about being able to give meaning to experiences in a way that may not fit into
established patterns of symbols and ways of understanding the frames of society. Put
differently, agency takes shape on the levels of material action, the mind, and meaning.
At this point, I will transition from discussing general observations and
developments drawn from the case studies to a more concrete discussion of social-
theoretical takeaways. Thus, in the following section, I will discuss what we can deduce
with regard to some principles of natalic agency. Put another way, this section will
explore the possibilities open to the human beginner, homo natal, on the path to freedom.

Principles of Agency in Birth
The primary goal of this dissertation was to explore the ways in which women are
able to claim and realize agency through birth. It did this by exploring different artifacts
of birth advocacy in light of theoretical concepts from Hannah Arendt, placed in
conversation with other, more readily applied, theories of rhetoric. Over the course of the
preceding analyses, several features of agency in this context emerged. First, from the
case studies we can see how, in contexts of birth, women’s agency is threatened and
thereby must be defended on levels of material action, mind, and meaning. Furthermore,
we can synthesize two multifaceted Arendtian principles of agency, which I will attempt
to explain in the following paragraphs. For expediency sake, I will call these principles
Harmony over Dichotomy and Encountering the Unknown.

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Harmony over Dichotomy
In contexts of birth and birth advocacy, agency is better realized in states of
harmony than of dichotomy. This project has called attention to at least five states of
dichotomy which permeate the struggle for birth justice as well as other struggles for
reproductive justice. Stuck within a series of dichotomies, women have no room
whatsoever to move. Anyone not fitting into the narrowly defined categories is erased;
and oftentimes, anyone fitting into the less desirable of the two categories is shunned out
of existence. Despite the fact that, from an argumentative standpoint, these dichotomies
are all false by definition, they are very real in a practical sense for the women who find
themselves caught within.
In the first instance of dichotomy, it is observed that turn-of -the-century
midwives were caught in a dichotomy of dual standard. Obstetricians built this
dichotomy, and midwives, desperate to survive, attempted to demonstrate that they could
occupy the high standard along with doctors. In the process, no room existed for
discussions of alternative conceptions of quality care or for individuals who practiced
midwifery in other ways. Not only did this dichotomy lead to the erasure of midwives,
but it also undoubtedly contributed to decades of what amounted to needless and
dangerous medical and surgical experimentation on women and countless unnecessary
deaths. Even the famous obstetrician Joseph DeLee, who argued for the pathologizing of
birth and recommended that three routine interventions—sedatives and painkillers,
episiotomy, and forceps—be done to every birthing woman, derided the dangers of
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haphazard intervention.
703
Within the dual-standard dichotomy, midwives had their
knowledge denigrated, were pushed out of business, and birthing women were set on a
path that would cause them unneeded suffering for years to come, even though they did
not know it at the time. Of course, the legacy of the dual standard persists today; with the
hospital representing efficiency, sterility, safety and expertise.
Next, this dissertation indicates that another dichotomy exists between
conceptions of control and surrender. Discussions about power in the birthing room
frequently pivot on the issue of control. Prior research has posited that women actually
care more about control than birthing “naturally,” for instance.
704
However, nearly
everyone implicitly acknowledges that control is something like an illusion; women may
frequently be giving the opportunity to “consent” to procedures wherein consent is the
only actual option. Additionally, textual evidence from narratives disparagingly positions
“control freaks” in opposition to women who are able to let go and let their bodies take
control.
705
Women recall focusing on “surrender” as a mantra during birth.
706
When
control and surrender are placed in binary opposition, there is no place for positive
experiences of actual women giving birth to comfortably fit. Complete control over birth,
whether in or out of hospital, is not possible; total control, therefore, becomes a matter of
either self-deception or a source of guilt when not achieved. At the same time, complete

703
Joseph B. DeLee, “Meddlesome Midwifery in Renaissance,” Journal of the American Medical
Association 67, no. 16 (1916); 1126-29; Joseph B. DeLee, “The Prophylactic Forceps Operation,”
American Journal of Obstetrics and Gynecology 34, no 1 (1920); 34-44.
704
See, for example, Bledsoe and Scherrer, "Dialectics of Disruption”, 68; MacDonald, The Field of
Birth, 99.
705
Ovcharenko, “Birth Story,” 211.
706
Shelton, “Story of Sisterhood,” 10; Rinehart, “Julianna’s Birth,” 117; Johnson, “Birth Story,” 33;
Villaneuve, “Birth Story,” 117; Stewart, “Birth Story,” 215.
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surrender of control to either the doctor or the body is also not a desirable endeavor.
Here, the woman becomes either machine or animal. She is not a human participant in
birth and bears no responsibility for it. Thus, within this divide, particularly in the context
of birth, women will always lose; complete control is not possible, and complete
surrender is dehumanizing.
Third, this dissertation points to a constructed dichotomy that exists between the
baby’s life and the mother’s rights. For example, those arguing against the term birth rape
frequently cite the primacy of infant safety as the chief reason why birth rape is not
something that really matters. Others deride mothers who advocate for better birth for
being selfish and acting as though birth is about their own experiences and not about
producing a healthy baby. In Chapter Five it was observed how this particular dichotomy
limits symbolic meaning. In a more general sense, however, this dichotomy facilitates the
image of a birthing environment where every wish of the mother is squelched in the
interest of imagined harm that might come to the baby. At the same time, any desire
realized by the mother seems a self-indulgent and disgusting hazard to the infant’s well-
being. Within this divide, a woman is either selfish or devalued.
Other, perhaps more implicit, dichotomies are evident as well. This dissertation
indicates problems with an enduring dichotomy between reason and emotion. Classical
thinking which considered reason to be the chief faculty has created an enduring legacy
of thought that consistently and predictably favors concepts like “objectivity” and
“rationality”—which ostensibly lead toward truth—while denigrating “passion” and
“feeling”—which are manipulative and deceptive. Indeed, ever since Aristotle set logos
and pathos apart from one another, scholars and citizens have been struggling to put them
258

back together. This dichotomy provides a strong foundation for the scientific
management of birth through biopolitics, wherein an extremely rational and efficient
system is put in place to the total negation of human distinction. Within a
reason=good/emotion=bad divide, arguments against the efficient hospital are painted as
“emotionally manipulative” or “irrational.” To theorists like Chaim Perelman and Lucie
Olbrechts-Tyteca, the privileging of reason severely limits human potential. To these
authors, reason might very well be the enemy of freedom, as it reduces the world to a
series of “facts” which are not up for debate. Only matters with an element of subjectivity
can be debated, and thus choice only becomes a factor when something other than pure
reason is involved.
707
In a paradigm organized around the goodness of reason, however,
emotion is easily dismissed. In a society that predominantly regards women as more
emotional while simultaneously denigrating emotion, and especially in the context of
birth which is obviously and necessarily laden with emotion, the concerns of birthing
mothers are readily dismissed. In terms of the dichotomy, women who are guided by
emotion in any way may appear hysterical, while those who submit to the rationalized
paradigm of birth deny themselves of birth’s vital substance.
Additionally, this dissertation highlights a dichotomy that is parallel to that which
has been previously characterized as the virgin/whore dichotomy.
708
In contexts of birth,
this dichotomy plays out along lines of sexualized versus not sexualized. In this case, any
woman who dares to speak about birth rape sexualizes her birth experience, making her
deviant. Those who argue against conceptualizing abuses that happen during birth as

707
Perelman and Olbrechts-Tyteca, New Rhetoric, 47.
708
See, for example, Sarah Banet-Weiser, The Most Beautiful Girl in the World: Beauty Pageants and
National Identity (Berkeley: University of California Press, 1999), 82.
259

sexual violations are totally appalled by the notion that birth could be a sexual event.
Despite the fact that birth is a product of sexual reproduction, some seem unable to
consider sex and birth as related. Birth, it seems, is more likely to be considered an
antidote to sexual behavior than part of a holistic sexual process. This is no surprise,
considering the primacy placed upon baby over mother. A child is innocent and pure, and
thus any connection to sex seems abominable. Within this divide, any woman who
suggests a sexual dimension to her birth appears perverted. On the other end,
desexualizing the experience renders birth as innocuous as a dental exam and takes away
women’s ability to demand any special degree of respect or sensitivity during the event.
In each of these cases, the choices offered to women are terrible. In terms of the
dual standard, women must either self-denigrate and be forever less-than among the class
of physicians, or be regarded as dangerous and ignorant. In terms of control versus
surrender, women are either self-deceptive or less than human. In terms of the baby’s life
versus mother’s rights, women are either selfish or worthless. In terms of rationality
versus emotion, women are either hysterical or erased. In terms of whore versus virgin,
women are either deviants or sexless. While there is definitely some overlap and relation
between several of these dichotomies, they are not all the same; and yet, they all generate
the same problem of denying agency. In each of these cases, the “choice” placed in front
of women, in terms of what they allow by way of both action and identity, does not seem
much like freedom.
With regard to each of these cases, a more well-rounded means of practicing
harmony instead of dichotomy is vitally needed. Dichotomies take away freedom by
pigeon-holing women and removing any space they might have to move and negotiate
260

themselves and their actions. Here, agency is instead understood to necessitate a
counterpart value of harmony. Perhaps it might be useful to consider the ways in which
an intercultural concept like “adding without contradiction” might guide a path of agency
in this context. Dichotomies are not inevitable; rather, they are part of a learned pattern of
thought.
709
In the work of Hannah Arendt, we can imagine a theory of action wherein the
notion of new beginnings depends upon the transcending of dichotomy. Analyses
presented herein have demonstrated how this might look. In Chapter Two, a midwife
briefly sought harmony in her attempt to create a space for the midwife standard of care
along with the physician standard of care. In Chapter Three, mothers demonstrate a
harmony between control and surrender, by stepping outside the bounds of linear time,
working through and negotiating a relationship between mind and body, and using the
biological as a source of political power. In Chapter Four, women assume a stance that
places women’s dignity on par with infant life, indicating that these two concerns need
not be at odds, all while envisioning modes of identification across issues that might
facilitate group action. In all chapters, midwives and mothers demonstrate their ability
work toward harmony between emotion and reason; even deductive arguments
demonstrating the physiological nature of birth and analogies likening abusive hospital
birth experiences to rape cannot escape from a basis in feeling and the emotion they
undoubtedly inspire among interested audiences. And in chapters three and four, mothers
reject the notion that birth must be separated from sexuality, by placing them in
coexistence in different ways. Natality must be a space of both/and, as agency is totally
impoverished if conceptualized as choice between existing alternatives.

709
Aaron Castelan Cargile, “Adding without Contradiction: The Challenge of Opening Up Interracial
Dialogue,” The Educational Forum 74, no 2 (2010): 133.
261

Encountering the Unknown
The second principle of agency in birth and natality is that it is made real by
encounters with the unknown. Put another way, agency does not exist without
uncertainty. While a choice between existing alternatives may be relatively certain in its
outcome, the prospect of beginning something new has unforeseen and unintended
results. A vital feature of new beginnings is that the results of such beginnings “are
contingent and unpredictable.”
710
Arendt acknowledges that a “character of startling
unexpectedness is inherent in all beginnings.”
711
She emphasizes, numerous times, the
ways in which action is inherently unpredictable.
712
The necessarily unknown outcome of
action exists in the face of a seemingly ever-growing human propensity to give ourselves
over to the comforts of predictability. In contrast to this, we are only truly able to
experience what it means to be free if we are able to set events into motion without truly
knowing what we are doing or where the results of action will end up.
The mystery surrounding experiences of empowerment through birth begins to
fade away when we consider the centrality of uncertainty to agency. In moments where
mothers feel themselves to be on the verge between life and death, the exertion of
strength necessary to bring oneself back from the verge and birth a new life
understandably results in strong feelings of empowerment. However, for natural birth
mothers, it is more than just this physical feat that results in feelings of power. It is the
simultaneous knowledge that they have proven the system wrong; against a powerful web

710
Canovan, “Introduction,” ix.
711
Arendt, Human Condition, 178.
712
Ibid., 191-92.
262

of medical knowledge and institutionally supported fear, they have claimed ownership of
their own bodies and acted in defiance against the predictable outcome of hospital birth.
It is perhaps more difficult to come to terms with this unpredictability in matters of
perceived life and death, such as birth. However, it seems that it is precisely this fact—
that birth is the creation of a new beginning even in the face of death—that makes it so
powerful.
To save humans from the volatility of action’s uncertainty, Arendt highlights the
importance of forgiveness. She writes, “The possible redemption from the predicament of
irreversibility—of being unable to undo what one has done though one did not, and could
not, have known what he was doing—is the faculty of forgiving. The remedy for
unpredictability, for the chaotic uncertainty of the future, is contained in the faculty to
make and keep promises.”
713
Of course, this ties into her insistence that action may only
take place among plural people, working together. She contrasts this picture of action and
forgiveness with a Platonic system of rule, wherein morality is determined by “attitudes
toward one’s self, until the whole of the public realm is seen in the image of ‘man writ
large.”
714
Instead, she says, action and forgiveness presume “experiences which nobody
could ever have with himself, which… are entirely based on the presence of others.”
715

She suggests, quite compellingly, that the free agency of humans is not guaranteed by
human sovereignty; rather, it is guaranteed by exchanges of uncertainty and forgiveness.
The notion that freedom is about individual sovereignty is, Arendt claims, “defeated by

713
Ibid., 237.
714
Ibid., 238.
715
Ibid., 238.
263

reality”; and yet, action “harbor[s] within itself certain potentialities which enable it to
survive the disabilities of non-sovereignty.
716
Those who seek freedom in sovereignty
will not find it; for even if someone achieved sovereignty, he or she would find
themselves entirely without the capacity to do anything in the absence of others.
The mutual relationship between unpredictable irreversibility and forgiveness that
is characteristic of agency also necessitates something like trust. So, under conditions of
non-sovereign freedom, Arendt acknowledges the need for stabilization that can be
satisfied by making and keeping promises. Promises made between people function as
“islands of predictability” amidst a sea of uncertainty.
717
However, it is necessary to
maintain a delicate balance, as too much emphasis on promise over uncertainly is a
misuse of the faculty which can “cover the whole ground of the future” and result in
something that probably looks a lot like contemporary birth care within a hospital. Thus,
in contexts of birth, agency takes shape as the unleashing of unpredictability coupled with
promise and forgiveness. The relationships that exist between a birthing woman and her
partner or family and her care providers exemplify this dynamic.
The conception of agency as both harmonious and unpredictable is exemplified
within contexts of birth. As Arendt indicates, freedom and agency are not easy, and only
hold meaning when understood alongside toil and struggle. Indeed, in each case
presented here, we have witnessed women struggling and suffering in their quests to
begin as they enact harmony and unleash the unpredictable. It will be important for

716
Ibid., 236.
717
Ibid., 244.
264

scholars, moving forward, to continue to examine way ways in which women realize
agency in other contexts of birth.

Additional Avenues of Exploration and Further Research
Continued attention to reproductive justice in the context of birth is crucial.
Despite the fact that birth justice bears much resemblance to struggles for freedom in
other contexts, and despite the fact that birth is one definitive moment in many women’s
lives, rhetorical scholars concerned with women’s rights and reproductive justice have
paid little attention. Those who study advocacy from a rhetorical perspective have
perhaps been hesitant to tackle issues of birth justice because they oftentimes do not
present in familiar forms, or because issues and alliances are far less clear cut. Birth
advocacy does not typically take the form of a traditional movement, and is not typically
grouped along with other movements for social change.
Moreover, mainstream feminist groups are hesitant to tackle the issue of birth. For
example, the National Organization of Women does not seem to consider birth justice a
pertinent issue as they list no material regarding birth on their website. The Feminist
Majority site tells a similar story: their “women’s health” issues are abortion, birth
control, Mifepristone (the abortion pill), and breast cancer. Of course, these are all vitally
important issues. However, just as scholars have observed that the first wave of feminism
largely abandoned the pursuit of more widespread justice in the interest of suffrage,
second wave and contemporary feminism could be said to have done the very same thing
with regard to the issue of abortion. Yes, abortion needs to remain legal and accessible.
But what of those who observe that women of color get abortions more readily than white
265

women, not because they always want to but because they are more economically unable
to care for children? Relatedly, what of those who have looked to both historical and
contemporary examples to draw connections between abortion and eugenics? To be clear,
I am by no means saying that we should stop focusing on the protection of Roe v. Wade;
rather, Roe does not take us nearly far enough. It is only by broadening our focus and the
depth of our concern that we will be able to work toward reproductive justice for all
women.
Much like women’s lives in general, issues of reproductive just have been—in
light of the focus on abortion—dichotomized into a “yes” or “no” question: to have a
baby or not to have a baby?
718
This question ultimately does a disservice to women
because it erases everything else that might be important before, during, or after the
potential birth. It erases the “how” of pregnancy, birth, and motherhood. In other words,
it erases what actually matters for most women. So, we must keep looking to birth justice,
along with other issues of reproductive justice, in order to respect the wholeness and
complexity of women’s lives. This dissertation has sought, in a small way, to do this.
However, the present study barely scratches the surface of the materials waiting to be
analyzed in the interest to shedding further light on the ways in which birth advocacy
contributes to justice on a wider scale. The following represent case studies that could
potentially expand or build upon this work.
For example, “The Big Push for Midwives” is an ongoing campaign that seeks to
promote legal status for Certified Professional Midwives (CPMs) across the country. It
grew from the recognition of a growing trend of arrests and investigations of midwives in

718
Sharon Jarvis, personal communication with author, August 17, 2013.
266

states where legal status was undefined. Currently, CPMs are still not legally authorized
to practice in twenty-two states. Advocates who make up The Big Push represent a host
of regional and statewide midwife groups.
719
This organization considers itself to be in
opposition to The American Congress of Obstetricians and Gynecologists Political
Action Committee (OB-GYN PAC), who seek to elect candidates to political office who
are supportive of the specialty.
720
Scholars could pursue analysis of these organizations in
the interest of exploring the ways in which women’s care is impacted by legal regulation.
Critical analyses unpacking the impact of contemporary professionalization on the
standard of midwife care would also be germane.
Additionally, enduring class- and race-based injustice in the area of birth
necessitates more attention to organizations centered on the goals of promoting greater
access to alternative care for women of color. The International Center for Traditional
Childbearing, for example, is an organization whose stated goal is “to enhance the health
and well-being of women and their families and to develop and preserve the traditional
role of the midwife in the Black community.”
721
Also, Black Women Birthing Justice is a
collective based in Oakland, CA, the goal of which is to “transform the birthing
experience for black women.” They seek to educate people on how to avoid and
challenge “abuse by medical personnel and overuse of medical intervention.”
722
This

719
“The Big Push for Midwives 2013,” http://pushformidwives.org/.
720
“OB-GYN PAC: The American Congress of Obstetricians and Gynecologists Political Action
Committee,”
https://app6.vocusgr.com/WebPublish/controller.aspx?SiteName=obgyn&Definition=Resources&SV_Secti
on=Resources.
721
“Mission Statement,” ICTC Midwives, http://ictcmidwives.org/about-us/mission-statement/.
722
“What is Birth Justice?” Black Women Birthing Justice, http://blackwomenbirthingjustice.org/.
267

organization is currently compiling an anthology which seeks to combine personal
testimony with the work of black feminist scholars. Another organization, called Mamas
of Color Rising, is an Austin, TX based collective of working class and poor mothers that
tackle many cross-cutting issues of social injustice, including birth justice. Recent
initiatives include a fundraising campaign to raise money to open a free pre-natal clinic
for poor women of color in the Austin area, which unfortunately only reached about half
of its needed dollar amount.
Other scholars may be interested in exploring contemporary portrayals of birth in
media. Studies cited in Chapter One looked at midwife portrayals on sitcoms, however in
recent years there have been some examples that differ in many ways to what this author
observed. For example, reality television programs like “19 Kids and Counting” and
“Sister Wives” have portrayed midwife or doula attended home birth. These two shows
both have strong religious conservative undercurrents, and both depicted home birth in a
mostly positive light. Recent documentaries have also tacked issues of natural birth; in
addition to the now well-known Business of Being Born, in 2013 a movie was released
titled Birth Story: Ina May Gaskin & the Farm Midwives. The film claims that it
“captures a spirited group of women who taught themselves how to deliver babies on a
1970s hippie commune, rescued modern midwifery from extinction, and changed the way
a generation thought about childbirth.”
723
Critical analyses of such artifacts and their
relationship to contemporary social ideas about birth would likely provide useful insights
to both rhetorical and cultural scholars.

723
“Birth Story: Ina May Gaskin and the Farm Midwives,” (2013) http://watch.birthstorymovie.com/.

268

These are only a few suggestions for areas of further research; undoubtedly many
more exist. An event like birth, which is so multilayered, necessarily requires careful and
detailed unpacking of its many personal, ritual, religious, cultural, and political
dimensions a piece at a time.

Closing Thoughts
As the final pages of this draft are being written, women’s reproductive rights are
under intense attack across the country. Inspired by template legislation drafted on a
national level by conservative and anti-abortion organizations such as Americans United
for Life (AUL), the American Legislative Exchange Council (ALEC), and the Susan B.
Anthony list, states like Wisconsin, Ohio, North Carolina, and Texas have enacted harsh
anti-abortion legislation that is guaranteed to negatively impact women’s safe and
accessible care if not overturned. As I sat in the gallery of the Texas State Senate on the
evening of June 25
th
, 2013, I was riveted by the resolve of Senator Wendy Davis as she
struggled to maintain a 13-hour filibuster to prevent Texas’ SB1 from coming to a vote. I
was then appalled as I observed the depths Republican senators were willing to sink to in
the attempt to force a vote on ill-conceived legislation designed to limit women’s access
to care.
724
Equal parts anger and exhilaration overflowed as I raised my voice to join the
chorus of protesters making last-ditch disruptive efforts to run out the clock on Governor
Rick Perry’s special session.

724
The author of the House Bill, Representative Jodie Laubenberg infamously defended the 20-week
restriction’s lack of an exception for rape victims by saying, “In the emergency room they have what’s
called rape kits where a woman can get cleaned out. The woman had five months to make that decision, at
this point we are looking at a baby that is very far along in its development.” Laubenberg, who ran for re-
election unopposed in 2012, has been reported to have “difficulty debating bills.” During the second special
session, she held up a pair of baby shoes as she spoke.
269

Just days later, a second Perry-mandated special session was underway and the
bill was passed shortly thereafter. This bill has four key provisions. First, any clinic
providing abortion must be an ambulatory surgical center, which will almost certainly
force the closure of thirty seven of the state’s forty two abortion-providing clinics.
Second, any doctor providing abortion must have admitting privileges at a hospital within
thirty miles, which is a material impossibility for some rural clinics. Third, no abortion
will be allowed, under any circumstances, after 20 weeks gestation. Finally, anyone
seeking the abortion-inducing drug RU-486 must have it administered by a doctor, in
person, at an ambulatory surgical center. This law on its own, not to mention when
coupled with 2011 legislation that requires any woman seeking an abortion submit to a
trans-vaginal ultrasound at least twenty-four hours prior to undergoing the procedure, will
undoubtedly impose undue burden, and make it virtually impossible for many women to
obtain a safe and legal abortion, not to mention cutting off countless women and men
from the other healthcare and preventative services offered by the affected clinics. A
woman living in rural southwestern Texas will have to travel more than 400 miles to the
nearest clinic in Texas, and will then have to stay for at least two days to meet the
ultrasound requirement. Many, undoubtedly, will take a path of less resistance and seek
illegal abortion either stateside or across the border in Mexico. Despite all this,
Lieutenant Governor David Dewhurst astoundingly maintains that the bill “will improve
and better protect women’s health.”
725

725
Morgan Smith, Becca Aaronson and Shefali Luthra, “Abortion Bill Finally Passes Texas
Legislature,” The Texas Tribune (July 13, 2013) http://www.texastribune.org/2013/07/13/texas-abortion-
regulations-debate-nears-climax/.
270

The Lieutenant Governor’s statement demonstrates a feature of this battle that is
perhaps even more troubling than the practical hardships to be placed upon women
seeking to exercise a constitutionally protected right. This more-troubling feature is the
way in which this legislation and its proponents constitute women. Backers of the bill
claim that, in addition to protecting the “unborn,” they are safeguarding the health of
women by preventing them from undergoing abortion procedures at unsafe clinics, citing
the recent Gosnell debacle as example.
726
Never mind the fact that not a shred of
evidence has been presented indicating that conditions even remotely equaling those of a
Gosnell-like clinic currently exist at any of the forty-seven clinics in Texas. Those in
power maintain that they are safeguarding women’s health; but this “safeguarding”
amounts to requiring medically unnecessary invasive procedures and severely limiting
the places women are able to seek care. In this way, justifications for abortion restrictions
begin to sound an awful lot like the paternalistic voices of those in the medical
establishment who wish to keep all births under the watchful management of an
obstetrician.
Furthermore, the utter contempt with which the bill’s backers regard women’s
intelligence is staggering. Governor Rick Perry’s words drip with misogyny and the tone
of a scolding parent toward a child as he remarks that “It is just unfortunate that [Wendy
Davis] hasn’t learned from her own example that every life must be given a chance.”
727

726
For information on this case see, for example, Jon Hurdle and Trip Gabriel, “Philadelphia Abortion
Doctor Guilty of Murder in Late-Term Procedures,” The New York Times (May 13, 2013)
http://www.nytimes.com/2013/05/14/us/kermit-gosnell-abortion-doctor-found-guilty-of-
murder.html?pagewanted=all&_r=0.
727
Jonathan Easley, “Perry: ‘Unfortunate’ Davis Didn’t Learn from her Experience as a Single
Mother,” The Hill (June 27, 2013) http://thehill.com/blogs/blog-briefing-room/news/308219-gov-perry-
unfortunate-wendy-davis-didnt-learn-from-her-experience-as-a-single-mother.
271

Here, as in so many cases where women are left feeling completely out of control during
childbirth, it is unfathomable that a woman might not need to have her own decisions, her
own body, and her own world explained to her by someone else who is culturally and
politically sanctioned to “know better” than she does. Treating women as if they are
equal parts selfish toddler and deranged murderer is a habit among those in positions of
power, and it must stop. Legislators, experts, and doctors have continually constituted the
unrestrained female body as a deadly weapon. Unless carefully managed, controlled, and
constrained, it becomes either a willful or accidental killer of the life inside itself, all in
the interest of its own selfish desires. It becomes, in Arendtian terms, a being-toward-
death. In a social landscape not marred by this preposterous view of women, it might be
fathomable that a woman is likely able to give birth in such a way that simultaneously
maintains her humanity and does not wantonly kill her child. Only if the struggle
continues to demand space for women outside these bounded extremes will we become
more fully able to realize our power as homo natal.

272

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Abstract (if available)

Abstract This dissertation explores the question of agency in contexts of birth advocacy. It posits that Arendtian natality explains action in contexts of professionalized and medicalized birth. Analysis of artifacts drawn from key moments in the historical timeline of childbirth in the United States over the last 120 years demonstrates the ways in which women advocate for autonomy and a legitimate voice in the context of birth. In Chapter One I introduce the social, rhetorical, and theoretical significance of birth based on a review of literature. I put forth the central argument of this project by suggesting that women’s experience of pregnancy and birth mirrors Hannah Arendt’s analysis of modernity and action in more than just metaphorical ways. In Chapter Two, I consider early midwife participation in medical dialogues through a late-nineteenth century professional journal. In Chapter Three, I examine twentieth century narratives of home birth to demonstrate how natality offers tools for resistance to professional medicine. In Chapter Four, I interrogate how women claim power by redefining their experiences of abuse during birth. Chapter Five synthesizes findings to suggest dimensions for a theory of human actors as beginners.

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Asset Metadata

Creator Boser, Beth L. (author)

Core Title Miracles of birth and action: natality and the rhetoric of birth advocacy

School Annenberg School for Communication

Degree Doctor of Philosophy

Degree Program Communication

Publication Date 11/14/2015

Defense Date 08/23/2013

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag agency,birth advocacy,childbirth,natality,OAI-PMH Harvest,reproductive rights,rhetoric

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Lake, Randall A. (committee chair), Goodnight, Gerald Thomas (committee member), Hays, Sharon R. (committee member)

Creator Email bboser@wooster.edu,boser@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c3-347425

Unique identifier UC11296177

Identifier etd-BoserBethL-2151.pdf (filename),usctheses-c3-347425 (legacy record id)

Legacy Identifier etd-BoserBethL-2151.pdf

Dmrecord 347425

Document Type Dissertation

Format application/pdf (imt)

Rights Boser, Beth L.

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Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA