Upstream - Post Capitalist Parenting Pt. 4: Midwifery and Birthing w/ Robina Khalid

Episode Date: September 9, 2025

In this episode, Part 4 of our ongoing Post Capitalist Parenting series, Robina Khalid joins us to talk about the process of birthing from the perspective of a midwife. Robina is a mother of four, a writer, former academic, and activist. In this conversation, Robina shares with us the fascinating history of the field of obstetrics and its white supremacist, colonialist, and capitalist roots. We explore what midwifery is, the role it has traditionally played in society, and how capitalism's devaluing of this important health science and profession has negatively impacted the birthing experience in the contemporary world. Additionally, in this episode, Della shares about her recent birthing experience and Robina describes how we can simultaneously hold an appreciation for modern medicine while being critical of Western medicine under capitalism. Finally, Robina shares with us her vision of what post capitalist birthing could look and feel like and provides some invitations for everyone listening.  Further resources: Small Things Grow Midwifery Small Things Growing (Substack) "Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide," Lancet Mama Sana Vibrant Woman Related episodes: Listen to our ongoing Post Capitalist Parenting series A Socialist Perspective on Abortion with Diana Moreno & Jenny Brown Decolonizing Medicine with Rupa Marya and Raj Patel Post Capitalism w/ Alnoor Ladha Intermission music: "Labour of Love" by Carsie Blanton Covert art: Palestine Poster Project, Naim 1975 Upstream is entirely listener funded. No ads, no promotions, no grants—just Patreon subscriptions and listener donations. We couldn't keep this project going without your support. Subscribe to our Patreon for bi-weekly bonus episodes, access to our entire back catalog of Patreon episodes, and for Upstream stickers and bumper stickers at certain subscription tiers. Through your support you’ll be helping us keep Upstream sustainable and helping to keep this whole project going—socialist political education podcasts are not easy to fund so thank you in advance for the crucial support. patreon.com/upstreampodcast For more from Upstream, visit www.upstreampodcast.org and follow us on Instagram and Bluesky. You can also subscribe to us on Apple Podcasts, Spotify, or wherever you listen to your favorite podcasts.

Both our experiences around birth and our knowledge of birth are deeply embedded in larger racialized, economic, gendered relations of power, right? So what that means is that the root causes of why birth is the way it is in our culture, or white supremacy, capitalism, patriarchy, and misogyny, all, you know, colluding to create a context that is deeply oppressive and harmful to a lot of us. You're listening to Upstream. Upstream. Upstream. Upstream. A show about political economy and society that invites you to unlearn everything you thought you knew

about the world around you. I'm Robert Raymond. And I'm Della Duncan. As we've explored in the first three episodes of our post-capitalist parenting series, parenting under capitalism poses a variety of challenges to both parents and children that range from inconvenient to, well, outright abominations. And unfortunately, and not surprisingly, the same is true for the process of birth itself. Capitalism, patriarchy, and white supremacy.

have all shaped and reshaped the birthing experience in detrimental and dangerous ways. And what we call alternatives, which just happen to be practices that humans have been participating in for thousands of years, held by people in professions like midwifery, for example, these alternative modes of birthing have been pushed aside despite their positive and healthful impacts on babies, parents, and society. Today we'll be joined by Robina Khalid, a mother of four, midwife, writer, former academic, and activist to discuss all of this and more. And thank you to friend of the show Emma Woods for introducing us to Robina's work. And before we get started, Upstream is entirely listener funded.

No ads, no promotions, no grants, just Patreon subscriptions and listener donations. We could not keep this project going without your support. Subscribe to our Patreon for bi-weekly bonus episodes, access to our entire back catalog of Patreon episodes, and for stickers and bumper stickers at certain subscription tiers. Through your support, you'll be helping us to keep upstream sustainable and helping to keep this whole project going. Socialist political education podcasts are not easy to fund,

so thank you in advance for the crucial support. And now, here's Della, in conversation with Robina College. Welcome, welcome to Upstream. We love starting with our guests introducing themselves. So would you mind introducing yourself for our listeners? Sure. And thank you so much, Della. I'm really excited to be here.

I'm a longtime listener and admirer of Upstream, so this is exciting to me. My name is Robina Khalid. I am a mother of four, a midwife. I'm also a first-generation, biracial, Pakistani, American Muslim who grew up in an extended family, multi-generational immigrant household, which I think is kind of relevant to some of the things we'll talk about today. I'm also a writer, a former academic, an unschooling parent, an educator, an educator. and, you know, an activist and general daydream believer and tender of tenderness, as I like to refer to myself. Thank you. And yes, we will weave in all of those themes, I'm sure.

And, you know, we will be focusing more on midwifery and birth. But before we do, the series is about post-capitalist parenting. So what comes to mind when you hear that theme. What does it mean to be a post-capitalist parent or to parent in a post-capitalist way? So when I think of the term post-capitalist parenting, I think about moving from a framework of raising children and more in a framework of being in relationship with children. And one of the things that I think is so important is to try to move away from this idea that I I think is rooted in capitalism of our children as products, right, that we are forming and to get away from this idea of like constantly looking towards the future and thinking

every single thing we do is going to change their productivity and their ability to exist in these systems and to instead sort of root ourselves in like who our children are in every moment in the present and be in relationship with them then. To me, that's like a big part of what post-capitalist parenting would be like is one where we could prioritize just being in relationship rather than, you know, internalizing sort of systems of domination in our parenting. Oh, I love that. Being in relation with our children instead of raising them. And you're right, raising them feels very, you know, directional or very like you're raising them to be certain things. Or there's that end goal in mind, whether in relation with is more, you know, in the present.

and as they are now and as they are unfolding in each moment. Yeah, I think there's this sort of like capitalist focus on product instead of process that we've sort of internalized into our parenting where we think there's like a way to optimize it, you know, there's a way to make it more efficient. There's a way instead of seeing it as being in relationship with another human being that you are also learning from, that you are also growing with, right? Like, we don't have children knowing everything there is to know about the world. I mean, I don't know about you.

But when I had my first baby, I wasn't like, I know exactly what it means to be a human and I am going to impart all of my wisdom and guide them. You know, I'm learning and evolving alongside my children. And so shifting from that product-oriented thinking into this process-oriented thinking where we're both learning from each other and seeing childhood as a valuable and full moment of someone's humanity rather than somebody who's not quite a full human yet, I think is so important. And so today we're focusing on one part of the process of parenting, the birth experience or birthing experience. So maybe before we dive in, you know, are there any phrases or words that would

be helpful to introduce before we dive into this topic? Also anything like by way of, you know, it's helpful to name as we start to talk about birthing and birth experience. So just how do we want to set this up? Well, I guess it's probably important to talk about what a midwife is, because while, you know, midwives like to joke that we are the second oldest profession as a, you know, as a natural consequence of the most old profession, a lot of people don't know what midwives are anymore. And they often conflate them with something like a doula. So a midwife is a clinical, I guess we could say medical provider who has expertise in normal, and we can unpack that term, pregnancy and birth. And one of the things that's really tricky about defining a midwife is that how midwives come to be really vary in different parts of the world, but also in the United States. So one of the things I think we'll be talking about is the history of midwifery here. And I won't dive into it too much now. But midwifery is very fractured in the United States. So every state has different educational requirements, different licensure privileges and different scopes of practices. So it's really hard to define what a midwife can do. For the purposes of my work, I'll say I practice in, you know, unseeded Lenape land in,

New York City. And New York State has pretty great education and licensure and integration of midwives insofar as we are independent providers that are licensed to take care of people across the lifespan. So we can be primary care providers. We can obviously take care of people in pregnancy, birth, and postpartum. We can also take care of people during menopause. We are licensed to take care of neonates. We can prescribe prescriptions. So my day-to-day probably doesn't look that unlike what people imagine as an obstetrician besides that I don't do surgery and that I particularly practice in a home birth setting right now, although I have practiced in a hospital settings before. Thank you for that introduction. Yeah. And yeah, Dula, midwife, homebirth. These are all

kind of topics, themes that we'll weave into this conversation. And yeah, just to share, you know, you mentioned you're in New York City. I'm in Aloneyland, San Francisco. And what? And what? where I gave birth, they don't employ midwives, or actually they will be hiring their first midwife ever there. And so, you're right. There's totally different relationships with midwives and that dynamic. And we will go more into the history of that. Anything you might say more about what it means to be a doula versus a midwife or even homebirth, what that means? Dulas are professionals who are educated about birth, pregnancy, and postpartum. And I think the best way to think about a doula, although maybe doulas would take

issues with me saying this, but I'm going to, I'm going to say it anyway, because I think it's a relatable way to understand the role, is that, you know, once upon a time prior to really like the 1930s, most people had some lived experience of birth and what birth looked like, even, even, you know, people who identified as men, you know, because it was happening in the home. It was happening in the community. Sometimes the midwife was there. Sometimes the midwife didn't make it. It was also like somewhat of a social event. So people had their communities with them during birth. You know, children were there. So they were growing up around birth. But once birth got siloed into a hospital setting, which happens, you know, between 1900 and 1930, that knowledge becomes really like arcane. You know, like nobody really

understands birth anymore. And so when people are trying to support each other in birth, they don't really know how. And so this profession of doulas kind of came up from that lack. And so it's people who take the place of what once would have been naturally filled in by community members. And so they provide emotional support and physical support during the times of labor and also postpartum, typically. Very helpful. Thank you. And you are a midwife. So tell us about that journey. You also said you were a former academic, and I know you're also someone who's doing homeschooling, unschooling. So tell us about your own journey to becoming a midwife. Why? And how did that happen? Yeah. So it's a little bit of a circuitous journey, which actually is not that unusual

for midwifery. It's a, it's a profession or a calling that many people here sort of later in life with some life experience. But I'll say that my first career was in academia. And, you know, from the standpoint of me as a middle-aged person who's now been an academic and a midwife, I think that I was really drawn to academia because I wanted a life where I could think and write and have curiosity about the world and interesting conversations as a profession. But at the time, I sort of left college and was like, what am I good at? I think I'm only good at school. So I guess I'll just keep going to school. And I had some, like, judgment about myself for that where I was like, I must be lazy because I don't want to work in nine to five. Now I realized that was just

like an innate post-capitalist impulse that I just wanted to like live a world where I could be curious. But anyway, so I started my PhD pretty quickly out of undergrad. I like spent a year doing applications and working in publishing and then pretty much immediately started at the City University of New York Graduate Center doing a interdisciplinary. plenary Ph.G. in the English department. And I did that sort of throughout my 20s. And along the way, I started specializing in black literature primarily before like the 1920s. And what ended up happening in some of my research is that I came across stories of midwives, you know, in the Antebellum South. And I became really fascinated by that tradition.

and sort of started doing more research about the history of midwifery. And it led me to a lot of like the black feminists of the 70s like Audrey Lord and June Jordan and they're writing about motherhood. And I just became fascinated by the whole process, you know, and this reframing really of what I had heard in my youth about like birth and parenting and what it means to people. And, you know, I should say here that throughout my teens and 20s, I was also really involved. in a lot of activist spaces, a lot of like anti-capitalist and anarchist spaces. So I was simultaneously while pursuing this PhD, working it as an activist and feeling like something was missing for me

in academia. I was really struggling with, I really loved teaching. I love teaching in the public university system. I found that very liberatory or potentially liberatory. But there was something that felt, I felt very separate from culture, you know. I felt like I was in my life. I felt like I was in my little ivory tower talking into an echo chamber writing articles that, you know, maybe 10 people would read or something. And so I was trying to figure out how to balance all of that. Then I became very focused on having a baby, kind of early. Like when I was like 25, I think it was all the research I was doing. I was just so fascinated by everything I was reading that I felt really called to get pregnant. And I did. And I did. And

had my first child in probably the most, like, radicalizing, transformative experiences of my life, and it changed sort of everything I thought about the world. And I realized that part of my fascination about midwifery had been some calling to practice it. And once I had given birth myself, I felt more empowered to do that. So I had another baby, finished my dissertation, And a week later, started community college classes to do the prerequisites for midwifery school, which felt like kind of a joke in the universe, but was fine. And then I enrolled in midwifery school, graduated, worked in a public hospital because I wanted to do some public health, because that felt like a good intersection of some of my activist work and midwifery. But after a couple of years of working in that setting, I found myself really morally injured by taking. part in what I found to be violence and abuse. And so I left that system and opened my own

home birth practice, which is where I practice to this day. Thank you for sharing your journey. Sorry, it's very long. No, and it's exactly where I'd like to go, which is, you know, when you think about birth, what is it that breaks your heart? So you talked about this, you know, moral injury and this violence that is created. And, of course, you studied it. different ways, both personal experience, study of it, and also the anthropological or like literature study of it. So tell us about when you feel into birth and the birthing process, what is it that breaks your heart? Oh, Della, there is so much I could talk about here. I mean, and I think maybe we'll touch on lots of these points from the racial disparities in maternal and infant mortality

in this country to like our lost ancestral midwifery knowledge because obstetrics kind of eradicated midwifery and then we kind of came back to sort of that the isolation that most people are entering pregnancy and birth and parenthood with but I'll start with like my two biggest heartbreaks which are interrelated so the first is related to you know what you just brought up about me practicing in the medical industrial complex and and frankly being traumatized by it which is that you know one in three American birth givers report having a traumatic birth and what's important to understand here is that those births aren't traumatic because of life-threatening emergencies or any clinical factors most of the time. 20% of those, 20% of birthgivers

overall say their births were traumatic because of obstetric harm and mistreatment. And those numbers unsurprisingly rise for people of color, right? So it's 30% of black birth givers, 29% of Hispanic, as the study defines it, birthgivers and 27% of multiracial. birth givers. And that's a heartbreaking statistic, right? That like so many people are leaving their births traumatized. I also think it's really important to notice how much it mirrors the statistics around sexual violence in our culture, right? One in five women experience sexual violence during their lifetimes. And that's like sort of a staggering and sobering reflection of how obstetrics is embedded in the larger society because obstetric violence is sexual violence.

But the reason why I find it like so profoundly heartbreaking is not just that it's heartbreaking for people to experience trauma, but that because these traumas are the result of like cultural beliefs and inequities rather than individual choices or actions or individual bodies. But because birth is such an intimate, vulnerable, and also really significant moment in people's lives that they experience as like, uniquely personal to them. Many people leave their traumatic birth, believing that it was them individually who failed to have the birth that they wanted or who caused their trauma in some way. And that's something that really imprints on you

because it is such an important birth. So it inflexs the experience of parenting and one sense of self for a long time. And so my second heartbreak is related to that, which is the loss of how profoundly radicalizing pregnancy, birth, and parenting can be for people. I've witnessed this in the people I care for, and I have experienced it myself, as I alluded to. I mean, I don't like to totally separate birth and pregnancy from parenting, because actually, like, obstetrics

and medicine have made us think those two things are separate, but really pregnancy and birth are part of parenting. You know, like, that is why we become pregnant and give birth, is to become a parent. It is our first act of parenting. And so all three of those things can help us relearn on like very cellular intimate levels, like what it means to be interdependent, what it means to be interconnected, what it means to be creative, right? Because we are like creating the future when we're parenting. What it means to live according to mutuality and reciprocity and like orienting ourselves around a blueprint of care and around the most vulnerable members of a society. So it's like a conduit to not just, potentially learn those things, but also to like disrupt certain foundational narratives we may

hold about ourselves or the world, like our own capacity, our own self-worth, but also foundationally, what is it to be human, which for many of us, we have understandings of that that have been imbued with like hyper-capitalist colonial narratives around like individualism and competition and domination and scarcity. And, you know, because we're birthing and parenting in contexts that are so hostile and so often traumatic for us, we lose. Really, we don't lose. It's stolen from us, like the capacity for us to relearn all these things. And that is a real heartbreak for me. Absolutely. I really hear the heartbreak and then also the potential, the liberatory potential and both sides of that. And, you know, the show is called upstream, because it's about going upstream

to the root causes. So that's such a powerful statement. You said, obstetric violence is sexual violence. I never thought about it like that. And you mentioned the racial disparities, the isolation, and the history of the obstetrics and the individualization, like putting the traumatic birth experience as I did something wrong, right? So go upstream for us. What has caused this heartbreak around birth and the birthing experience? Well, I'll just say it very broadly, because the root causes are that birth and our knowledge around birth. So both our experiences around birth and our knowledge of birth are deeply embedded in larger, racialized, economic, gendered relations of power, right? So what that means is that the root causes of why birth

is the way it is in our culture, or white supremacy, capitalism, patriarchy, and misogyny, all, you know, colluding to create a context that is deeply oppressive and harmful to a lot of us. Absolutely. And let's focus on capitalism here for a moment. And so how would you say that capitalism impacts the birthing experience? What are some concrete examples or ways that that really creates that impact? Yeah. So capitalism inflex birth from almost every angle and in most places in the world at this point. And there's a few reasons we can get into there. You know, one of the most obvious is that there is like a health apartheid that's created by colonial capitalism and systemic like unresourcing of what we call the global south. But also because medicine itself is a

colonial tool. So we also have the way in which, like, Western frameworks, which are capitalistic, are introduced to less industrialized countries as a means of, like, how to manage birth and how to care for people in birth. There's this article in the Lancet from 2016 that's called Beyond Too Little Too Late and Too Much Too Soon that I think does like a really good job of explaining some of these capitalist forces on birth globally. And what they're referring to when they talk about like too little, too late, and too much too soon is that there are fundamental inequities in the way birth is managed around the world. You know, for some communities and namely in the global south, people do not have access to care, right? And so the maternal

mortality and infant mortality rates are higher than they should be because they have too little intervention and too late to save people. But in industrialized countries, people are subjected to too many interventions and too soon, you know, their births are pathologized too early. And those interventions are not neutral or risk-free. So they can create outcomes that are equally devastating. So that whole dynamic where there's inequity and how people are cared for is the result of colonial capitalism. And in the United States, we can even see that. It's not just a global south, global north problem because we know there are racial disparities in our country, there are maternal care deserts in our country. And, you know, in the city where I'm practicing, black birthgivers

are 12 times more likely to die as the result of pregnancy and birth than white birthgivers are. Nationally, it's three times, three to four times as many. And we can return to the roots of that. But I guess as a shorthand, I'll say, like, that is partially or primarily impacted by the particular brand of capitalism that has evolved in the United States, which has its foundations in slavery. And so a second way that capitalism, like, inflex birth, particularly in the United States, is this idea of, like, the fetishization of technology. and part of the way of statrics gain dominance over midwifery there are a lot of reasons but part of that was because

they offered like new tools that was like a result of sort of an internal industrial capitalist fetishization of technology and mechanizing the body it's kind of like a Marxist commodity fetishization in that it's ultimately magical thinking

because we know that overuse of those technologies is a large driver of morbidity and mortality. So industrialized countries like the UK or many other places in Europe, Canada, Australia, New Zealand, they have much better outcomes than the United States, partially because their healthcare systems are socialized. So there's some incentive to keep as many people safe and healthy without the cost exploding, right, because the society is taking on the cost. Whereas in the United States, there's like a for-profit capitalist model of care. And so intervention is highly overused here relative to other industrialized countries.

So that's another way in which capitalism inflex birth in this country. And we can talk about, and I think we will talk about how, like, judicious use of intervention is really important and does help in birth. but overuse we know is linked to poorer outcomes. And the United States, we rank 55th in maternal mortality worldwide and 33rd in infant mortality in the world, which means we're not only way lower than most industrialized countries. We're also below countries like Cuba, you know, like de-resourced and under-resourced communities. So, yeah, technology is not ultimate.

doing what we believe it will do in these instances. A couple of other ways that capitalism inflects birth is the whole model that we're birthing in, or that 98% of people in the United States are birthing in, which is the hospital, is designed to be optimized for efficiency and for, like, worker productivity more so than for care. And so there are a few help services today, even in other industrialized countries, you know, whether they're commercial, whether they're public, whether they're for profit, whatever, they're all are subjected to a certain capitalist pressure to like maximize productivity. And so what that means is that, and we're seeing this really a lot in the NHS in the UK as well, where people are really overworked, maternity care units are really understaffed. And that has impact on the care people are getting. You know, lastly, I'll say, like, we know that two-thirds of maternal and infant deaths worldwide would be prevented if there were more midwives. Like, that is indubitably true that's been studied. And yet, midwives are not invested in at all. Why? It's not just capitalism, but it's not not capitalism either, you know. And we can go into that when we talk about the history of obstetrics. Yes. And I just want to uplift a really important point you made.

about how in a country that has universal health care, you know, the socialization of medicine, there is a benefit to having people well, right? And to preventative care and to having people be, you know, healthy and well. Whereas if GDP is the primary measurement of success, the indicator of success and GDP is just total exchange of goods and services and you're in more of a neoliberal capitalist country that has privatized health care, then more medicine and more intervention is actually better for the economy. And more health and more prevention is not. Exactly. You know, people often talk about the way in which, like, cesarean birth creates more profit for an obstetrician, even though the research shows that it costs less than a vaginal

birth, probably because the investment in a vaginal birth is often like longer or unpredictable and, you know, people need reassurance and care and all of these things. But, like, focusing on things like a cesarean birth, it's a very easy scapegoat to say, like, oh, people just do C-sections because they make them more money and they make the hospital more money. But actually, you know, C-section is the most common surgery in the United States. So it is like the bread and butter of a lot of hospitals, but actually so is birth. birth is the number one reason why people get admitted to a hospital. And so it almost reflects the way in which, like, parenting is the foundation of our economic system, but it's totally unvalued and totally invisible half the time. Like, the whole capitalist system is built on this, like, unpaid labor of caregiving. But we don't acknowledge that at all. We just, like, sort of naturalize it and, like, hide it and just exploit it. And I think birth is like that to a degree, too, where we don't. don't talk about it as like, it generates a lot of revenue in our economy. And it makes us treat it

in a very particular way. Like that profit and that revenue really distorts the kind of care that we give in oftentimes very invisible ways. Yeah. And, you know, it's called reproductive labor. Exactly. It's called labor. You know, like labor, you're in labor. But it's a, it's a labor. It's so funny because I've spent so much time in my life in leftist spaces, and it's a form of labor that is totally overlooked. And often people will be sort of inherently suspicious of me sort of demanding that it take up space, you know, and like that we need to talk about the ways in which medicine is not serving birthing people and babies. And it's interesting because these are people who are very interested in like disrupting other systems. But it's a very overlooked portion of that

dynamic for reasons we can get into later. Well, let's get into the history more. Thank you for introducing us to the history with telling us about doulas. I didn't know that. But it makes sense that more people were involved in birthing and birthing experiences, had more experience with birth. And then when birth became relegated and kind of confined to a hospital setting, that we need doulas to really support through birth. And so, you know, tell us more, zoom out a little bit more, maybe a little bit longer in time. You know, what is the colonial industrial history of midwifery and obstetrics? What do we need to know?

Okay. This is a big topic. I'm one of my favorites. So I'll try to keep it not too rambly. But I guess a place to start would be to say that in 1900, so, you know, not really that long ago, 95% of people in the United States gave birth at home with midwives. Okay. And so obviously prior to that, that's our ancestral anthropologic history is that people gave birth with, you know, midwives, whether they were always called midwives or not.

By 1935, so in that very short, 35-year span, 75% of urban births and 50% of births overall in the United States had shifted to hospitals. And the thing that's really, really important to disrupt here is that I think in 2025, we have this narrative that it's because birth was unsafe and moving it into the hospital made it safer. And that's why we had this rapid move into a hospital setting to give birth. But the history is really way more complicated than that and involves, again, some of these forces that we talked about. So paternalism, racism, and industrial capitalism and colonial capitalism. And one of the ways to really understand this is that prior to 1935, and between 1935 and 1945, when antibiotics were introduced into medicine

generally, the maternal and infant mortality rates went up. They did not go down. So with the advent of the hospital system, actually more birthgivers and more babies were being harmed and dying. And it was very clear, even at the time, if you read the research at the time, that it was because of overuse of interventions. And researchers at the time were very clear on this and say it completely baldly, you know, that it's doctors practicing their tools on people. And so it's important for us to disrupt that narrative a little bit, because I think that when we're trying to suss out, like what of medicine is really valuable to birthgivers and their babies versus what is like a superimposed, interventionive, technocratic kind of force that's harming them.

We need to look at like what actually are the drivers. Like what do we actually know brings maternal and infant mortality rates down? And not just like reproduce this narrative of like science and modern medicine saved birth givers and their babies from certain death, you know, which is not really the actual narrative there. So why does this happen, right? Like, why do all of these people move from home birth into hospital birth in like 35 years, even though they were much more likely to die in that situation? And so the first answer to that is white supremacy. Okay. So during the antebellum time, who are the midwives who are taking care of people? In the South, it was black.

enslaved midwives, right, who are bringing a lot of their knowledge from Africa and from ancestral lineages. In the north, it was a lot of like working class, immigrant labor, and so forth. In the wake of the civil war, obstetricians who at that time were very small and very, very poorly respected branch of medicine, because at that time it was thought that like, why would men ever want to be, like, associated with this female condition, you know, they basically preyed upon fears of white people with, you know, emancipation that, like, the supremacy of the Anglo-Saxons was in danger. And so they did a couple of different things. One thing they did was they stigmatized abortion, which midwives had been providing without stigma for, you know, thousands of years,

as something that could be used to stop white people from having babies, you know. And the other thing they did was they spread disinformation about their competitors who were black midwives, primarily. So they talked about them as barbaric and dirty and uncivilized. And so there was this like a really, really systematic propaganda campaign against midwives in that second half of the 19th century. So that's working. And the other thing I should say here is that obstetrics developed, in the United States, you cannot separate obstetrics from the history of slavery because much of the knowledge that we still use today was gained from forced experimentation on enslaved black women. The founder, as we call him, of American obstetrics, J. Marion Sims, was a

enslaver who tortured the people he enslaved in order to create knowledge about obstetrics. And so birthgiving in the United States is intimately affected by the fact that, like, we have not, to this day, meaningfully healed our own traumatic birth as a country, you know, because we're resting on this legacy of white supremacy and slavery. Alongside that, we have this rise of industrial capitalism, which is starting to talk about the body as a machine and starting to be really interested in efficiency, right? So that's where some of the move into hospitals comes from. The third thing that sort of accelerates this is the desire for pain relief in labor.

And the really interesting thing about the history of pain relief in childbirth is that It was developed by racists and eugenicists as a means of making birth easier for white women. So when you read the writing of these people who developed pain relief, they talk about how, you know, brown and black communities like hide behind a bush and just give birth easily. And their fragile white wives and mothers could not do that. And so they wanted to develop pain relief. again, for eugenic purposes, right? So that more white women would have more babies. Like that is explicitly said in all of these treatises.

But of course, people were found the allure of not experiencing pain in childbirth to be very intriguing, particularly higher class women. And so that kind of shifts us into hospitals as well, although it's important to understand that these early forms of pain relief were not really pain relief. So what they were, we call it twilight sleep. and it's deep, deep sedation so that you have no memory of pain. But actually, these people were in so much pain that they were harming themselves, crawling the walls, just completely out of their mind, had to be, like, tied down. The process also slowed labor. So that creates this need for more intervention to speed up labor.

It creates a need for a newborn nursery because people were so drugs that they could not hold their babies afterwards. And so actually so much of modern. obstetrics is because of this intervention of twilight sleep, which we all agree now is completely barbaric, completely inhumane. But it fundamentally changed the way we care for birthgivers because we still routinely like separate the dyad. We still routinely speed up labor even when we don't need to. It normalized so many of these things and we've never really let them go, even though we've stopped sedating people so much. Wow. So much you said there. And one thing I'll pull out just that a lot of people don't know about the birth of obstetrics. And we haven't reconciled that and that trauma. Like you're saying how connected it was to slavery and eugenics and white supremacy. But also you hinted at that like we haven't never reconciled the birth of our country. Like just to go, you know, a settler colony on stolen land. So just so many. so many layers there. So thank you for bringing that out. And so then, you know, going from that

time when so many of the people birthed at home with midwives, what is it today? Do you know the numbers of how many people do home birth today or midwife assisted birth? Just so we have that like, you said the, you know, 1900s, the 1935. What is it? Where are we now? So home birth, I mean, it really varies according to state in the United States. And actually, you know, I didn't pull up the numbers for because in socialized in countries with socialized medicine there is more of a midwifery presence the u.s has developed where you know high risk specialist surgeons are seeing the average person in birth but in many countries that's not true but in the united states i do know that it is less than two percent of people who give birth at home nationally in new york where i practice it's

one percent i think it's like 1.3 percent and actually that represents a huge increase after 2020 because many people sort of, I think, saw some of the limitation of giving birth in a place that is founded upon or revolving around illness, right? And treating birth as pathology, we saw some of the cracks that come up in that, in that paradigm during COVID lockdown. And so that moved a lot of people into home birth at that time. But yeah, it's still a very, very small minority. Although in New York City, 1% of people is still a lot of people. So, It's still a lot of birds. You're listening to an upstream conversation with Robina Collett.

We'll be right back. that I really care that I'll never be a millionaire but I get that feeling something's going on it's a labor of love I guess because it sure doesn't pay to work this job

and raise these kids and feel this way dinner's on the table and I put the roof above God damn is never alone When I don't mind working hard But I get home at the dark

And I feel my spirit sinking into the floor And I'm pretty sure I used to be Sounds to know with an employee But I hardly can remember anymore It's a labor of love, I guess, because it sure doesn't pay To work this job and raise these kids To feel this way

this way Dinner's on the table and I put a roof above God damn this neighbor love It's a rich man's game and they play to win But there's more of us than they're out of them And I think sometimes they should change the locks We're a powder cake, they're a tender box and I don't know if you might.

Brother, can you give me a light? It's a label of love like this, because he sure doesn't pay. To work this job and raise these kids I feel his way. Dinner's on the table and napole. and I put a roof above. God damn it's a labor of love.

Well, they ought to be afraid of us because the whole world is made of us. That was Labor of Love by Carcy Blanton. Now, back to our conversation with Robina College. it. And so today you are not just a midwife, you also write. I love that you've carried on that curiosity and that sharing out through writing. And in one of your pieces, and we will link to your pieces in our show notes, but in one of your pieces, you connect the history of midwifery in the United States with the ongoing genocide of Palestine. So this is that kind of like big picture

systemic thinking. So connect that for us. What does, what do the two have to do with each other? Yeah, so there's a few intersections there. And I think, like, it can be simplified by saying that the way white supremacy and capitalism and colonial settler societies have created a context for obstetric violence and for also, like, an apartheid state, you know, at root, the systems that destroyed indigenous black and ethnic white midwifery in order to make room for obstetric control over birth, and for are related to the systems that uphold and allow, like, Israel to operate as a violently genocidal state. And some of this goes back to the idea of, like, risk and safety, which are highly weaponized in birth. You know, we've been really groomed in our society to believe that, like, dehumanization and violence and being treated like a machine is normal and the price we have to pay to be, like, delivered safely from birth, even though the evidence doesn't actually bear that out, but that's the culture that most of us have internalized. And even though that doesn't keep us safer, we're told

it keeps us safer. And I think in the same way, narratives of like that normalize, like policing are very similar, right? We know that policing does not keep us safe, but we've been groomed to believe that we must have a police force, that we must use narratives of terrorists, but we must use narratives of illegal. Those are not really the things that are endangering us. just like it's not really birth in it of itself that's endangering us. It's just a lot of these narratives are existing to consolidate power and wealth among the very few. And so it seems like a big, you know, wide connection, but I do really believe that they are connected. And some of it, you know, it can even be linked back to the history of the forced birth movement that I alluded to that was part of how obstetrics gained control.

you know, that's often framed, like, forced birthers frame that they are anti-abortion because of moral or ethical or religious considerations. But really, when you look at the history of like the anti-abortion movement, it is 100% about consolidating power and wealth. And I think that anti-abortion movements basically are designed to reproduce inequity, right? Because we know that they're a form of class warfare, that they disproportionately affect black and brown folks, that they negatively impact people's economic trajectory, and they feed into a lucrative carceral system. And I think, like, I go into this, it sounds kind of tangential, but I go into it because I feel like it shows how, like, our narratives of reproduction and reproductive labor and our bodies

are manipulated in order to keep the people who are in power, in power, right? And to, like, reproduce capitalist and white supremacist systems that are profiting off of genocide right now. Yeah. And, you know, so much of this show is about unlearning, like what we need to unlearn. And we've done so much of that already in this conversation with you. So thank you for that. But just to make them clear, you know, what are the myths about midwifery and homebirth, home birth experience that you just want to dispel or that we need to unlearn? Yeah, I think like, and this is kind of related to some of what I was just saying in the prior question, I think one of the myths that we need to dispel is that there's a binary or that there are certain ideas about birth that are in opposition, right? So we very frequently understand in our culture that there's like this pinnacle of safety on one end, which is the rational, scientific, technocrine,

version of birth that is promoted by obstetrics. And then on the other end of the spectrum, there is this, like, irrational, like maybe spiritually based or aesthetic or, you know, low-tech, suspicious of modern medicine kind of version of midwifery. And I think it's really important to disrupt that binary because that binary rests on the idea of risk management in birth, right, as the most important thing. And it's really interesting because that binary relies in this idea that, like, the hospital, the technocratic version of birth is the safest version of birth. And the low-tech, community-based or home birth-based midwifery is the opposite of that, right?

is the less safe way to give birth. But actually, we're not actually comparing more risky and less risky. We're comparing different risks. And that's something that I think we really need to talk about because there are no guarantees in birth no matter where you give birth. And so what you're really comparing is you're comparing a relatively high risk of intervention that may have long or short-term health consequences to a person and a person's baby in one setting versus very low risk of those things in the other setting and a very low risk actually because part of what midwifery care is doing in a home birth setting is following somebody very carefully throughout their pregnancy and birth to

maintain some confidence right that this is still an appropriate setting for that person so midwives are doing their own risk management and their own risk assessment along the way, there's a very low possibility, you know, we're talking like less than 1% of the time, that you would need, emergently, access to an operating room or access to a pediatric team, and that delay in that care could change the outcome for the worst. But that's like a less than 1% risk most of the time and the risk of like many other interventions in the hospital are very high. So I think need to add more nuance to that conversation about what safety is, you know, because safety means different things to different people. And I think we have a very paternalistic way of thinking about

safety as well because not all birthing people are women, but because it's largely imagined in our cultural imaginary is like the realm of women. And we live in a patriarchal, misogynistic society. So we have a very paternalistic way of thinking about, like, if people are allowed to manage their own risk or if we have to manage it for them, you know? And obstetrics often dominates people into and coerces people into complying or conforming to what the obstetrician has decided as safest and not giving any autonomy to that person. And I think, you know, that's sort of a travesty, right? Especially because neither option is risk-free most of the time. You know, none of the options on the table are ever risk-free. So why are we not allowed to

make decisions about our own bodies. But I think the other part of this that's really important to disrupt is, you know, it's often leveled against midwifery, especially traditional midwifery or like indigenous midwifery or midwifery that's not just like complying with a larger obstetric imaginary, that it's like anti-science, you know, to like divest from some of the conceits and the norms of obstetrics is anti-science. But actually, when you look at the way obstetrics is practiced in the 21st century, I mean, kind of all along, but we'll talk about now. There are many things that you could point to to argue that obstetrics itself is anti-science. If you understand science to be like robust, controlled experimentation and then using the

evidence that comes from that robust experimentation to optimize protocol, right? So this sounds very, like, abstract. So let me give maybe one example if that's helpful. So one of the things that pretty much everyone in an industrialized system, whether it's in the U.S. or in places that have socialized medicine, like the U.K. or Canada or Australia, is continuous electronic fetal monitoring. So continuous electronic fetal monitoring is the process of basically strapping a monitor onto a birthgiver's abdomen and listening transabdominally. to the fetal heart rate throughout labor uninterrupted. And this was a technology that was developed in 1968. By 1979, it was basically subjected on everyone,

birthing in a hospital. And what's really interesting about the history of continuous electronic fetal monitoring, I'll say C-E-FM from now on, is that it was adopted despite having no evidence behind it and behind having no validation no standardized protocols, nothing. It was believed that it would detect babies who were compromised

and therefore at risk of developing cerebral palsy. And they bypassed the whole, like, scientific method of studying it because they decided that to keep this technology from birthgivers was ethically suspect because it had the potential to save so many lives. Okay, so fast forward to 2025, and there has been study after study after study that has shown that CEFM has never decreased cerebral palsy, has never improved fetal or neonatal outcomes, but has done one thing, which has changed the C-section rate from 5% to 32%.

And we know, you know, by the way, that the World Health Organization recommends that the Goldilocks rate for a C-section, right? So the rate at which people are not getting too much too soon or too little too late is five to 15%. So in the United States, we're doing well over double that. And it's largely because of liability. We have a very defensive medicine-based paradigm here. But I would argue that holding on to CEFM, when we know that there are alternatives that actually keep the outcomes the same, like do not create poorer outcomes, but keep the C-section rate less, which is, intermittent monitoring, which is what we do at homebirth, like clinging to doing continuous electronic fetal monitoring instead is anti-science. Do you know what I mean? Because science has shown to us that it's creating harm and it's not decreasing harm. So why are we still doing

it? And there's been study after study after study that shows like obstetricians practice is influenced by their own trauma, by their own personal experience, by all of these things rather than evidence. And so I'm not saying that, therefore, obstetrics should be abolished. I'm just saying we need to disrupt the idea that it is so objective or that it is a neutral body of knowledge that is practiced scientifically, whereas midwifery is this old throwback, you know, that like doesn't know anything. I think when we privilege one way of knowing about anything, but particularly in this case about birth, then we're losing so much valuable other ways of knowing. And, you know, I belabor at a lot of, you know, evidence-based medicine just now, but I think it's also important

to know that, like, the evidence itself sometimes is designed to reproduce certain beliefs about birth. So I would say the biggest example of that is our understanding of, like, how long birth should take, which in the United States is largely defined. find by two studies. One was in the 1950s by Emmanuel Friedman, and one was in the 2000 teens by, I think his name is Daniel, but I'm not sure, Dr. Zhang and his associates. And the Friedman curve was based on 500 white women between the ages of like 20 and 30 and one New York Hospital. And that dictated practice for everyone for many decades. And then Zhang's study, you know, increased it to 62,000 people and it's, you know, multiracial,

and way more diversity in age and location. It's U.S. wide. So it did improve the data. However, the thing that's really important to know about both of those studies on which we base our understanding of what labor is is that the vast majority of people in those studies had intervened with laborers. So we're basing our understanding of how long labor takes

on studies where people's labors were sped up by potocin. What that means is that we're in this loop, right, where we're just reproducing a belief system about birth. We're not meaningfully studying physiologic birth and taking any of the evidence from that. We're studying, we're studying obstetric management of birth, really, and then using it to justify obstetric management of birth. Wow. And what you're saying about obstetrics being kind of value-free, that just really reminds me of what we've learned here on the show about economics, you know, and about economics being value-free when actually it is a moral philosophy, and we must interrogate and challenge the assumptions and values and worldviews that underpin it. So I'm really hearing you

do that, do that challenging and kind of going through them. And also this thing that you're saying about being anti-science or anti-technology is so fascinating, because one thing I've really felt in the birthing experience personally and also post-birth is just how incredible the technology of the body is. Just like, for example, producing colostrum, which is, you know, what you produce right after birth. It's like kind of the baby's first food. And then comes the milk. Like just, just that one process, which I know people have differing experiences of, but just to just to feel that was like incredible technology of the body. Like, and there were just so many moments of that throughout the whole pregnancy birth and post birth where you're just like, wow. And I really do feel

that what I've learned from midwifery, from midwives and do those actually is trusting the body, you know, and trusting the body's experience and that the body will know when to, you know, break the water and start contractions and all that kind of stuff. So just interesting play on what does it mean to be anti-technology or anti-science? Yeah. I mean, one of the biggest things I've learned in my midwifery journey, which is now like, you know, over a decade of practice is that birth's goal, if we can like anthropomorphize birth as a force, is to keep birth safe. You know, like, that is the goal, right? That is the goal of the body. The goal of the body is to get through this process with a safe parent and a safe baby, like to keep everybody alive. And it really

employs, as you use the word, like beautiful technology and a beautiful language to communicate what is happening. And often, you know, part of the reason why the technologies we have developed come with short and long-term risk is because our ideas about what birth should look like often bypasses or throws off the technologies of the body itself. Right? So one example of this is like our focus on efficiency and speed, which by the way, a short labor has never been proven to be more safe than a long labor. There's not actually any inherent risks to a long labor when you look at like what are the risks of a long labor in the United States. I'll leave it at that. The risks are the things we do to a labor to speed it up. So the risks of a long labor are C-section, apotheomy, foreseps, things like this, right? And so it's interesting because we've decided that a long labor is inherently unsafe. And so we try to speed it up. But oftentimes what's happening in a long labor is that there is a baby who is trying to navigate the pelvis.

And the body is often slowing down contractions to give the baby some spaciousness to move, right? To also preserve the reserves of the baby. If you are forcing a uterus to contract upon a baby who is not in the right position to be, born, let's say, or who cannot descend any further, then you are risking deoxygenating the baby. You are risking the baby's heart rate dropping, right? And then we're like rushing into an emergency C-section, but it's partially because we have overrided the body's inherent knowledge of how slow that labor needed to be in order for the baby to do their part of it. And that is one of the things that like was never taught to me in midwifery school, right? I just had to memorize

Friedman and Zhang. And then it was only by practicing. And I think this is where like my academia and my midwifery, you know, really informed each other was like, I'm just so curious. And I'm, I think also like my own spiritual experiences of birth, like allowed me to constantly be critically engaging with what I was seeing and not just immediately be like, this is slow, so it must be bad, you know, but like really trying to give some space to hear what birth is actually communicating to me and like where my own biases or my own indoctrination was like impeding someone. And so that became, you know, kind of like a process where I unlearned a lot of what I had been taught. And that's knowledge that like you would never have if you just keep

doing the same thing and getting the same results, you know? Absolutely. And yeah, this unlearning through experience, I mean, this has really been why I wanted to have this whole series on post-cabulous parenting. And I do feel like I ought to share about the birth that I just had just because it's so relevant. Yeah. And also because listeners have been kind of following along that I have been pregnant. So what I will say is that I was working with a doula and a midwife and planned for a home birth and a water birth and had the tub and everything. And 15 days before went into my OBGYN and they said you have gestational hypertension. we need to induce you today. And, you know, it's like severe risk to your health and safety. We need to do this today. And so I actually was like, well, I want to go home and kind of get behind this new reality. And they said, absolutely not. You cannot leave this hospital. Liability issues. We do not recommend that. And I said, like, I totally get that. I just want to get behind this new reality. I'd like to leave the hospital. Had to fill out some forms, had to talk to multiple people. I mean, this was really.

against, you know, medical practice. Medical advice. That's what they said. Went home, got behind the new reality, you know, really was like, okay, I'm doing this, letting go of what I thought was going to be happening. And then turn myself in the next day for this different birth plan and was induced. So the potocin and the induction and all of that and to speed it up and all that kind of stuff. And then due to the fetal heart monitoring once I did start pushing oxygen level decreasing, you know, the baby's head not in the right position. They said the heart rate's dropping,

your baby could die. We need to do an emergency C-section. So again, I said, wait, pause for a second. Again, let me get behind this new reality. Again, they said, no, no, no pause. This is a crisis situation. And did end up getting the C-section and have delivered. And, you know, the baby and myself are healthy and well, which we're very, very happy about. But I'll just say, just so fascinating hearing all of the things that are related to this conversation, whether it's C-sections or trusting the body or the emergencies of it. Also, one thing in one of your pieces, you know, you recounted a meal with a fellow midwife who told you, I can never go back to labor and delivery because what I realize now is everyone leaves thinking they almost died

or their babies almost died. Yeah. This is in one of your pieces. And that struck me so hard because in the birth experience that I had, there was a time when I thought I was almost going to die if I didn't do this induction and give birth immediately. And then there was a time when the baby almost died if we didn't do this emergency C-section. So I was like, whoa, that's wild. And I will say I was supported by the midwife long distance, still talk to them on the phone as well as the Dula grateful for both of them. And they did affirm that both the turning myself in for the induction and the C-section were wise choices. So they weren't saying this is being forced for, like you said, profit motive reasons, but just so fascinating the difference in what happens and how much this relates to, you know,

everything you've been talking about. So I don't, you don't have to analyze that at all. And I'm sure you've had, I mean, I know you have so many stories, both your own and others. But just if there's anything you want to say in reflection to that. No, I mean, I think, you know, I alluded to the way in which like antibiotics really helped with maternal and infant mortality rates. And the other, you know, real advance in medicine that has changed our outcomes was, in fact, better understanding of hypertension, right? So I do think, like, part of the technology is that we need our ability to intervene in situations like that, you know, where somebody's blood pressure is dangerously high, you know, managing that through pregnancy sometimes when it's chronic.

and then inducing if it's, you know, showing that, you know, maybe somebody is developing preclampsia or pregnancy-induced hypertension. You know, there are dangerous outcomes that we are avoiding when we intervene in those situations. I think, you know, sometimes the problem is that we don't limit our use of interventions to those emergency circumstances. And, you know, that quote that I wrote about with my, with my former colleague who I worked with in the hospital, who left, went and became a therapist and started her own therapy practice. And that's when she said to me, like, oh, I'm realizing that everybody leaves their birth, thinking that they were about to die or that their babies were about to die. Like, this is what we're doing to people in labor

and delivery. And I could never go back to that. I mean, I think that that is related to some of these narratives that we talked about, about this, like, technologized thinking and this, like, role of, like, the obstetrician as the authority and the person who's saving people from birth, like we just keep reproducing these narratives. And many times, like, well-meaning providers are reproducing those narratives and not questioning them, you know, because, again, we're treating birth in a very specific way. So we're seeing birth in a very specific way. And then there's this confirmation bias of like, wow, birth is so scary and birth is so dangerous because we have created the context for us to see these really dangerous, scary things all the time. And people just end up

believing, like, oh, we really are saving people from death all the time when it's not actually based in a scientific or evidence-based understanding of what birth is. And I found that it continues on, like, since the birth, there's been, whether it's a conversation with a pediatrician who said, you know, you absolutely cannot go sleep with a baby or you will kill them, you know, or even in the car seat, there's something on the side that says, like, if you strap the baby in the wrong way, you will strangle the baby to death. Like the intensity around death and risk is so strong for parents even beyond the birth experience. No, it's true. And I actually think like some of the ways in which we care for people who are birthing does create, I think part of what happens when you take birth out of the community, right? And you silo it into this like specialized medicine, the specialized knowledge is akin to what happens when we take people out of,

like extended kin networks, which capitalism wants to do, right? It wants to silo you in like a nuclear family because then we have more individual units of consumption. We have isolated people who are like more defined by their workplace than by each other. Like all of those things are related. And that's part of why I think the approach to birth is the way it is, is because the approach to parenting is like that too, where we want people to be, you know, dependent on official advice, right? like advice and narratives and paradigms that ultimately serve these larger structures that we're all operating within and make us more compliant. I mean, that sounds like a conspiracy theory, but it's not. It's just the way in which those structures like are the foundation of so much

of our thinking about these processes. Yeah. So to summer is one of the main kind of themes of this conversation. How can we hold an appreciation for modern medicine, right? For for like you said about, you know, hypertension and also things that really do, you know, really are risks or modern medicine has really served us well, while being critical of medicine under capitalism or the medical industrial complex. How do we hold this? Yeah. I mean, I think one of the things that I love about birth is that it has taught me to hold so many contradictory truths at the same time. It has taught me that contradiction is like just part of life, right? Like the process of birth is kind of like in the pain of it. Sometimes like the worst life has to offer, but it's also the

best life has to offer, you know? It is this like extremely individual, singular, specific, intimate experience that also almost 400,000 other people per day are doing, right? People in labor are both strong and extremely vulnerable, right? So it's like allowed me to rest in these moments that seem contradictory, but just are, are the same in some ways. And one of the things I think it's really important to be able to hold all the truths about medicine at once, too. And I think, you know, this is a really important conversation in the context we're working in right now in 2025 when, like, you know, we're in the United States, like public health is being so intensely defunded. And there's, you know, we have this whole like make America healthy again framework that is like, you know,

ultimately serving oppressive forces in our culture under the guise of like freedom, you know? And and I think like a lot of, a lot of people in leftist spaces will often just like uncritically defend public institutions like medicine and, you know, public education as a reaction to those forces, you know, because we want those public services. We want modern medicine to serve people. We want public education to be this like liberatory reality for people. But I think like we have to reckon with the ways that they are not because they are reflecting in a society that is deeply racist, that is deeply inequitable, that is deeply misogynistic and patriarchal, that is founded on discourses of colonialism and capitalism and domination and exploitation. Like these are reflections.

of our society, and the society we have right now is not serving us. So those institutions of our society are de facto not always serving us, but they can. And I think we can't reckon with the ways that they can if we cannot reckon with the ways that they aren't right now, right? Like if we're just like, modern medicine good and we cannot question it because like maybe then we won't have it anymore. You know, like it's like the scarcity thinking of like, We don't want to align ourselves with these conservative, regressive, you know, privatizing forces. But we can't do that and build the world we want either. You know, we really have to be able to see that it is possible to deconstruct the ways in which, like, medicine has been developed from within a colonial industrial paradigm that treats bodies as machines, that it's a knowledge that has been accrued, not just in obstetrics, but medicine overall on abuse and experimentation of marginalized communities.

that those knowledges that has created have been used over time to naturalize and justify inequity, you know, for any listeners who are really interested in this, Rupa, Maria, and Raj Patel do a beautiful job writing about this in their book inflamed. But I think, like, we have to be able to understand that it is 100% possible to keep people alive and not abuse them at the same time. Like, we can do that. And we're not doing that right now. You know, So how can we shift to holding both of those things? Yes. And to move towards the world that we want to see and also, you know, thinking about building that future,

what does post-capitalist birth mean to you? And I love this idea of post-capitalist both in terms of like after capitalism but also that it exists now. Like that there are seeds of what we want to see now. And of course, you and your work and lineage as a. midwife is part of that. So, you know, what is, what is the vision of post-capitalist birth? What would it feel like, what would it look like, both for an individual, but also collectively? Yeah, I think when I think of like a post-capitalist midwifery practice that is serving everyone, I think of a situation where care, like true deep care and reciprocity, exactly.

Right? So I think of like a midwife or an obstetrician or whoever is providing care during birth as being like deeply part of the community, right? And like they are somebody who comes to the community with experiences and knowledges and has things to offer the community but is part of the community as opposed to like a dominating force in the community or like a specialist or somebody who whose word is like sacrosanct. Do you know what I mean? So that, like, there is this deep integration that care is just, like, part of what we do for each other. And the person who is doing the caregiving is also cared by the community that they're caregiving for, you know? And, like, respected not because they can't be questioned, but respected because they're integrated as part of the community. And that relationship is relational rather than built on these structures where institutional needs are overdetermining, like, what the care. can or can't do for the person they're caring for. And related to that, I think, about it as something that is built in and founded in and rooted in trust, right? So that, you know, it's really funny. I think it was a couple of years ago that you all had an episode with

Alnur Lada about like, I think it was just like post-capitalism or something. And after I listen to that, I started writing a piece called post-capitalist birth. And it was, I never finished it. I had just had a baby, but it was about this birth that I had done, that I had attended with a client of mine who had had a baby with me before, who was a doula, so another birth worker and who I had developed a friendship with in between her two births. And the thing I'll say about that birth is that it was so profoundly liberatory to me in ways that, you know, as somebody who's like always trying to unpack and unlearn, like I didn't even realize that the way this birth went, could be so different from the way I've cared for other people. But basically,

you know, her birth was, was safe and was relatively uncomplicated, but it did throw some like, like, forks that we needed to navigate together. And what I realized was like, there was such safety in the relationship for us that, you know, I could bring to her my experiences and my knowledge as an offering that she could then grapple with and decide for herself what felt safest for her. And I knew that she would be able to take personal responsibility for that. And so there was no part of my brain that had other voices in it where I was like, oh, you know, obstetricians would really like look down on this or like, oh, if like the outcome isn't great, am I going to get sued? You know, like, I didn't have any of that, which unfortunately is so

baked into us from our like education at the outset. And, you know, that's offensiveness, especially as midwives who were like looked down upon by obstetricians. And so it was such an amazing experience because we could both just lean into the trust we had for each other to have this like amazing birth that was perfect for her, you know? And that's what I think about when I think about post-capitalist birth is a birth where like the loyalty of the care provider is the person doing the birthing, you know? And that's the only voice in their head is like hearing deep. the person doing the birthing and what they know and what they want.

Beautiful. And thank you for sharing a story of what, you know, a paste of post-capitalist birth. And, you know, if you do ever finish that piece, please do share it. I will. So we're coming to the end where we look into invitations for those listening. And I have a few and then I want to ask what yours are. You know, first of all, we will certainly link to your Instagram and your website, your writings, all the article. that I mentioned and there's, and there's more, as well as we did a conversation with Rupa Maria and Rosh Patel on In Flame. So we'll link to that as well as the conversation on post-capitalism

with Al Nour. The other things that are coming up for me are, you know, and I had this as I went through a birth experience, is reflecting on your own birth, you know, like what you experienced, you know, and like I had to ask my parents because I actually didn't really know much about it, you know, and it's just interesting to think about that. And sometimes there is healing and processing needed, right? Is there an opportunity there if you are someone who wants to give birth, you know, like getting interested or curious about this alternative world? I mean, I hate to say that it's an alternative world, but there were just, as I had chosen home birth and working with a midwife, there were some people who didn't know what that meant and had never heard of it or

just really had some myths about it. Like, that is so unsafe. I would never do that. Right. So just continuing with that on learning. I will also say supporting folks who are midwives and, you know, birthing collectives, like I'm one that I'm connected with Mama Sana Vibrant Woman in Austin, Texas, a black and brown women's birthing collective. But just those folks who are doing that work particularly on the racial disparities and supporting low income and people of color as they go through the particularly difficult birthing experience. You know, I also, what comes to mind right now. For me, I'm just thinking about, you know, children in birth in Palestine. And that breaks my heart so much to think about, you know, my child growing and other children, you know,

starving. So I don't know what the invitation is there, really just, you know, feeling her heartbreak and continuing with our activism against the genocide. But, you know, what would you add? What would your invitations be for those listening as they go forth from this conversation? Well, those were some great invitations, Della. Let me see how I can follow them up. I think that, you know, one of the things that I would invite listeners in addition to what you just said about, like, learning and expanding, you know, and unlearning about birth, I would say that, you know, even, you know, Robin Wall Kimmerer and other indigenous authors, like, have written about this idea of, like, reciprocity as our foundation and how there's, like, an abundance and a reciprocity. in the natural world and that, you know, some of these indigenous writers have dubbed like the maternal gift economy. And so I would invite listeners to think about like what happens

when we organize society and human life from this basis of like that all of us were given to and cared for because someone else gave to us completely unconditionally when we were fully dependent and how that is the foundation for everyone, right? And I think it's like, it's so beautifully illustrated in pregnancy and in birth, because actually we have like capitalist thought around parenting has often made us think that like the needs of the parent and the needs of the baby are like in opposition. But actually when you really get into like the granular needs, it's not that. It's the needs of capitalism and the needs of the baby are in opposition. And parents actually benefit from the same things with the babies do, right?

like this like uninterrupted bonding time and like a not being set to like a particular schedule and not being separated and all of these things. And so if we can like reorient around what we know intuitively about like how the world can work and use pregnancy and parenting as a framework for that, you know, there is enough if we share, right? Like that is just true. And pregnancy and parenting show us that. And I think we didn't get to talk too much about parenting sadly, because it's one of my favorite things to talk about along with birth. But I love to invite people to think about pregnancy, birth, parenting as a creative force. You know, June Jordan talks about this a lot. It's like a practice in creating the world we want. You know, I think

June Jordan says something like, children begin the world anew and a new and a new and a new. And so I like to think about parenting as like almost like an act of abolition where we can divest from some of the things that have harmed us in our relationship with our children and in like listening to them as people and relearning what it is to be in relationship. And it's an act that we can like actually see our power in the world and not power as like a dominating force, just like standing in power with another. person, like you can create new realities when you are in relationship with children in a way that sometimes it feels completely impossible in your larger life. And so, like, that I think is one of the invitations I would give to people who are thinking about pregnancy and birth and having children. And, you know, related to what you were saying, sometimes when parenting during polycrisis is very hard, it's very emotionally grueling. And sometimes when I'm feeling the weight

of that, you know, because we didn't even get into how capitalism makes parenting so impossible. It's equally hostile to parenting as it is childbirth. You know, sometimes when I'm feeling the weight of that, I just think about how giving care and modeling care is such a privilege in a time when the world needs care. That is an act of creation and a profound opportunity to practice the world that we want to be in. And I think, you know, making the choice to be pregnant, it's inherently like an act of love towards the world because I think that if we didn't love the world, if we didn't find things worth loving in this beautiful gem of a planet and like in the people around us, we would not have children. We would not bring children into it. And so I love to think about it as like the love

letter we write to the world around us and an inherent act of hope. And so I would just invite listeners to, you know, start their parenting journey with their pregnancy and births from that framework or the decision to have kids, like, you know, really understanding what they already know in their bones from their own births in that way. You've been listening to an upstream conversation with Robina Collett, the mother of four, midwife, writer, former academic, and activist. Please check the show notes for links to any of the resources mentioned in this episode. Thank you to Carcy Blanton for the intermission music.

The cover art for today's episode is from the Palestine Poster Project. Upstream theme music was composed by me, Robbie. Upstream is entirely listener-funded. No ads, no promotions, no grants, just Patreon subscriptions and listener donations. We could not keep this project going without your support. Subscribe to our Patreon for bi-weekly. bonus episodes, access to our entire back catalog of Patreon episodes, and for stickers and bumper stickers at certain subscription tiers. Through your support, you'll be helping to keep

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I'm going to be able to be.