Improving Birth

D.C. birth activists rally in front of U.S. Capitol

In more than 170 cities in the U.S. Japan, Australia and Canada, birth activists held Labor Day rallies to advocate for "evidenced-based care for all moms and babies." Organized by volunteers on behalf of, more than 12,000 people were expected to come out in support of improved maternal healthcare in the U.S., which ranks 45th in maternal safety, according to the United Nations.

Two of the local coordinators were Nicole Bruno, a doula and Bradley Method teacher, and Kelli Atangan, mother of two, expecting a third. Atangan was about six weeks pregnant with her first child when she contacted Sharon Stevenson of Yoga Birth and Beyond in Alexandria, Virginia about yoga and hypnobirthing classes. When Atangan asked for names of doulas for her birth, which she planned to occur at Inova Fairfax Hospital, Sharon hesitated, not having many names to recommend to her of doulas who attended births at that location at that time.

This lit up a lightbulb in Katangan's head that perhaps the hospital was not the ideal location for the birth she envisioned. After watching the documentary The Business of Being Born, she and her husband attended the BirthCare beginnings class at BirthCare and Women's Health, a free-standing birth center with a team of midwives offering birth center births and homebirths, as well as well-woman care. The next day, Atangan's husband urged her to call to claim one of two remaining spots available for her due date month.

"We are lucky we saw the light bulb early," said Katangan. She had the first two children with BirthCare and, now that she's moved further away from Alexandria will work with Certified Professional Midwife Marilee Pinkleton of

In her former career of speech pathology, "evidence-based practice is what counts," Katangan said: you don't employ techniques that are not proven to work. wants people to understand the "drastic difference between evidenced-based care (practices proven best by science for mothers and babies) and the care women receive in labor and delivery rooms." Among the concerns of the organization and the activists participating in rallies include the fact that profits, convenience and liability are drivers of maternity care in the U.S.

In many areas of the country, including Washington, D.C., nearly a third or more of all births are c-sections. The highest recommended rate suggested by the World Health Organization is 15%. According to Dawn Thompson, president of, "Nine out of 10 American women receive care that increases the risks of harm to them and their babies. We must do better."

Another one of the coordinators of Monday's rally in front of the U.S. Capitol building was Rachel Doster, a Bradley Method childbirth educator and doula. She previously had a birth center delivery in Dayton, Ohio, where midwives are not licensed, making it difficult to have a home birth. When her husband, who is in the Air Force, got stationed at Bolling Air Force Base, Doster was excited to move because homebirth midwives are licensed in Virginia. "The care I received was much more personal, less clinical," she said of her homebirth, adding, "It was such a beautiful and empowering birth."

A fellow with the American College of Nurse-Midwives (ACNM), Zora Javorska attended the rally as part of her 4-month investigation into community care to see how midwifery care works in the U.S. Javorska hails from the Czech Republic, where she is a doula and activist with a non-profit organization challenging laws in her country like those banning midwives from legally attending homebirths. There are 56 fellows with the Community Solutions Program, in which Javorska is focusing on women's rights.

Mairi Breen Rothman from DC-based M.A.M.A.S. midwifery group based said of the current state of affairs, "In some ways, things are changing for the better and in others not. This is a moment of great opportunity to improve maternity care through the implementation of new policies" with Obamacare. Among the questions she'd like to ask are: "Will they cover midwifery? Will vaginal and cesarean coverage be the same? Will there be advantages given to doctors who lower their cesarean rate?"

Rothman felt strongly that "midwives and consumers need to be at the table. There is a disconnect between what policymakers think consumers want and what they actually want." Most women, she said, "really care about autonomy."

One clear area of improvement, Rothman offered, is for skin-to-skin contact between mother and baby after a c-section rather than the baby being kept apart from the mother and quickly taken away. "There is no reason on earth that it can't be the way things are done. If we really think about the health and well-being of mother and baby," post-birth skin-to-skin care is what we would do.

M.A.M.A.S. regularly has to turn women away because there are not enough of the midwives to meet demand. That, she said, is because there are so many barriers, the first of which is licensure of midwives. Second is coverage of midwifery by insurance and Medicaid. Third is the difficulty finding preceptors to teach student midwives. All of these issues are "keeping women from having choices," Rothman. said

Also helping to organize the D.C. rally was Pamela Lurie, who had her second and third children at home after having had a cesarean with the first and has been active in the Northern Virginia chapter of the International Cesarean Awareness Network (ICAN). "The only way to fix the problem is from the inside," she said. "The more women know about how to ask for what they want," the better off they will be.

About Jessica Haney

Jessica Claire Haney is a freelance writer and HBAC mother of two living in Northern Virginia. Her work has appeared in The Washington Post, Hip Mama, Mothering magazine, the Journal of Attachment Parenting International, and most recently in the new breastfeeding anthology: Have Milk, Will Travel: Adventures in Breastfeeding from Demeter Press. Jessica is the founder and co-leader of the Arlington/Alexandria chapter of Holistic Moms Network. She is working on her first novel. Her website is, and her blog is Crunchy-Chewy Mama: Living naturally, most of the time.