A Letter to the Editor of the New York Times regarding the Op-Ed
“Don’t Be Afraid of Giving Birth in a New York Hospital.”
By the NYC Homebirth Collective
May 6, 2020
“Don’t Be Afraid of Giving Birth in a New York Hospital.”
By the NYC Homebirth Collective
May 6, 2020
To the editor:
Dr. W. Spencer McClelland’s 4/28 Op-Ed "Don't Be Afraid of Giving Birth in a New York Hospital” opens with the assertion that birthing people should unquestioningly trust the authority of their obstetrician with a self-congratulatory quote from a former patient: “Two of us enter the hospital, three of us leave, and you tell us how to do it safely.” We, the midwives of the NYC Homebirth Collective, would like to inform Dr. McClelland of something we know to be true from our many years working inside and outside the hospital system: pregnant people are capable of critically thinking through the decisions that affect their health and do not need to be "told" anything. This includes making educated decisions about where, and with whom, they give birth. As we ourselves wrote in a statement dated March 18th, the hospital is likely the safest place for people who actively desire and trust giving birth in the hospital. For others, however, homebirth is an essential and safe option.
McClelland’s assertion that we owe implicit trust to a system singular among every industrialized nation and most of the developing world for its rising maternal mortality rate defies logic. Can we reasonably expect black people to “not be afraid” of a maternity care system in which they are dying at 8 times the rate of their white counterparts? Did listening to what her providers told her, despite their dismissal of her own concerns, serve Amber Isaac? There are constructive conversations to be had about improving birth outcomes in this country, conversations that won't happen if we paternalistically dismiss birthing people's concerns about the alarming issues they now face -- and have always faced -- in hospital settings. Countries with better outcomes than the United States integrate midwifery services into their hospital system as well as provide out of hospital options that allow for seamless transfers to hospital labor and delivery units. This is something the United States currently lacks largely due to a hostile refusal to engage with this option by obstetricians in this country.
We agree that Dr. McClelland’s knowledge is limited to the universe that is his hospital – a universe that boasts a cesarean birth rate of 38.9%. As experts in vaginal and out of hospital birth, we are happy to enlighten him about both, including how we facilitate a relationship of partnership and trust with our clients, how we make judicious use of the medications and tools available to us to mitigate risk and manage complications, and how we are experienced in facilitating hospital transfer in a timely way that generally does not require emergency transport. Of particular interest might be that the homebirth midwives of NYC do indeed currently don PPE at births. In fact, two of our collective, Kimm Sun and Kateryn Nuñez of Heartscience Midwifery, have distributed 3000 masks and 500 face shields not only amongst our own homebirth cohort but also to midwives in the hospital setting whose own “safer” systems have failed to protect them.
Robina Khalid, on behalf of the NYC Homebirth Collective
Dr. W. Spencer McClelland’s 4/28 Op-Ed "Don't Be Afraid of Giving Birth in a New York Hospital” opens with the assertion that birthing people should unquestioningly trust the authority of their obstetrician with a self-congratulatory quote from a former patient: “Two of us enter the hospital, three of us leave, and you tell us how to do it safely.” We, the midwives of the NYC Homebirth Collective, would like to inform Dr. McClelland of something we know to be true from our many years working inside and outside the hospital system: pregnant people are capable of critically thinking through the decisions that affect their health and do not need to be "told" anything. This includes making educated decisions about where, and with whom, they give birth. As we ourselves wrote in a statement dated March 18th, the hospital is likely the safest place for people who actively desire and trust giving birth in the hospital. For others, however, homebirth is an essential and safe option.
McClelland’s assertion that we owe implicit trust to a system singular among every industrialized nation and most of the developing world for its rising maternal mortality rate defies logic. Can we reasonably expect black people to “not be afraid” of a maternity care system in which they are dying at 8 times the rate of their white counterparts? Did listening to what her providers told her, despite their dismissal of her own concerns, serve Amber Isaac? There are constructive conversations to be had about improving birth outcomes in this country, conversations that won't happen if we paternalistically dismiss birthing people's concerns about the alarming issues they now face -- and have always faced -- in hospital settings. Countries with better outcomes than the United States integrate midwifery services into their hospital system as well as provide out of hospital options that allow for seamless transfers to hospital labor and delivery units. This is something the United States currently lacks largely due to a hostile refusal to engage with this option by obstetricians in this country.
We agree that Dr. McClelland’s knowledge is limited to the universe that is his hospital – a universe that boasts a cesarean birth rate of 38.9%. As experts in vaginal and out of hospital birth, we are happy to enlighten him about both, including how we facilitate a relationship of partnership and trust with our clients, how we make judicious use of the medications and tools available to us to mitigate risk and manage complications, and how we are experienced in facilitating hospital transfer in a timely way that generally does not require emergency transport. Of particular interest might be that the homebirth midwives of NYC do indeed currently don PPE at births. In fact, two of our collective, Kimm Sun and Kateryn Nuñez of Heartscience Midwifery, have distributed 3000 masks and 500 face shields not only amongst our own homebirth cohort but also to midwives in the hospital setting whose own “safer” systems have failed to protect them.
Robina Khalid, on behalf of the NYC Homebirth Collective