Sunday, June 10, 2007

Transmitting the subcultural identity of homebirth advocacy

I have long maintained that homebirth advocacy constitutes a particular subculture. I am not alone in this thinking. Amy Chasteen Miller explores the construction of the subcultural identity in the article Like A Natural Woman: Negotiating Collective Gender Identity In An Alternative World. Miller explores the transmission of the subcultural identity of homebirth advocacy in the midwifery courses at the Farm, now known as Vision:
In oppositional subcultures, the kinds of identities formed are often quite political as a result of their distinction from the dominant society’s constructions of normalcy. In subcultures that contain alternative visions of what it means to be a woman, members must negotiate a sense of self that takes into account the messages given not only by mainstream culture,.. but also within their more immediate and closely-held social network. In most cases, this creates a conflict that must be managed to develop a sustainable sense of gender identity. In some cases, the alternative subculture has sufficient power to displace the larger cultural standards. This power often comes from the resonance of a collective identity with the individual identities of group members. In social contexts geared towards political activism around gender, participants must feel a connection to the group’s shared gender identity in order for the message to be meaningful and a sense of solidarity to develop...

In this article, I examine how women in a series of intensive immersion courses in midwifery negotiate the constructions of gender presented by the politicized community context within which the courses occur... How do women, who come from across the country to study midwifery at Vision, process the world of gender they encounter? Is a collective gender identity communicated and shared by participants?
Miller describes key features of the subcultural identity:
Vision itself houses a particular shared understanding of what it means to be a woman, and this collective gender identity among women at Vision is strong and woven into all aspects of everyday life. At Vision, being a woman is constructed as a fundamental physical reality that is tied to both spiritual meaning and political obligation. The culture of Vision, in general, places strong emphasis on the value of naturalness. However, as scholars have pointed out, the meaning of "natural" must itself be socially constructed... Not interfering is defined to include particular scripts for labor and birth and a broader set of norms for everyday life...
Miller describes a number of methodologies used to transmit this particular subcultural identity to other women. One of the most important ways of forging this collective subcultural identity is through stories, particularly birth stories.
... [T]he ritual of repetitive storytelling ... marks the interaction among participants at Vision workshops. Importantly, when stories are told, they are often followed by a series of highly similar "me, too" tales. These stories are primarily of two types: affirmations and rejections...

For instance, at the start of one seminar, many women in the group shared stories of traumatic medical experiences with pregnancy and birth; in doing so, they rejected the nonmidwifery way of understanding birth. One of the midwives began the class by stating that the medicalization of birth has taken from women the sacrament of birth that is naturally accorded to them... [A student] described a physically and emotionally scarring experience giving birth to her first child via c-section; "I feel like I was robbed," she said. Others then told similar rejection stories of how they were disrespected by doctors or how they were denied a "real birth experience" as a result of a normative medical birth. Not everyone, clearly, has such a story to tell. But many know such stories, and they tell them ... Whether the stories are about them was less important than that the stories are about how the medical model of care is not something that the collective sees as healthy, good, or appropriate...

Affirmation stories serve the same purpose as rejection stories; they create a sense of a shared understanding of the world. As the midwives tell their own positive stories about birth, many women in the group open up and share similar stories...

... Some dimensions of the birth culture at Vision are less mainstream, however. Birth, for example, is described by Gaskin and other midwives as a sexual event as well as a spiritual one; the possibility of orgasmic birth is discussed, amid some laughter and exceptional interest from those who have not previously heard of it. When one woman in the group described her birth as "orgasmic," she was met with no doubt or shock, but rather with much affirmation about how wonderful that was...

Additional beliefs that would be met in other contexts with disbelief were affirmed in this group context. For example, one woman began describing her own experiences being born, which she stated that she remembers now after much therapy. Crying, she told of the experience of being born to a medicated and detached mother who was not even aware that she was giving birth. An assertion of such a memory would likely be met with much skepticism in mainstream culture, but she was met with none...

... In the case of collective gender identity formation in this group context, the shared identity is maintained not only by the modeling and affirming practices but also through ... tact. Members ignored violations of group norms and also practiced what I would term "tactful silence" in choosing not to discuss anything that might disrupt the sense of cohesion and solidarity. Tactful actions — whether blindness or silence — reveal internalized technologies of collective gender identity. The collective gender identity disciplined the women such that they did not choose to do or say things that might disrupt the sense of unity, cohesion, and belonging.
In other words, the formation of the subcultural identity of homebirth advocacy requires specific strategies for transmission and reinforcement of the desired cultural values. These strategies include the telling of stories whose main purpose is the denigration of the "medical model" of childbirth and the telling of stories about the benefits and wonders of "natural" birth. Being able to tell such a birth story (whether a rejection story or an affirmation story) is an important way of identifying yourself as a member of the group. Hence there is considerable pressure to tell such a story.

There is also a third category of story, one that would be met in mainstream culture with utter disbelief. Stories of "orgasmic" birth and stories of remembering one's own birth are regarded in mainstream culture as absurd or as fabrications. Within the subculture of homebirth advocacy, such stories are uniformly affirmed. Importantly, this occurs whether the listeners actually believe the stories or not. The subculture enforces of form of self-censorship that does not allow for the questioning of of birth stories, no matter how fantastical.

This is yet another confirmation that homebirth and "natural" childbirth advocacy have little or nothing to do with childbirth in nature. They are simply cultural subgroups of white, Western, well-educated and relatively well off women, groups that have come into existence only within the last 50-60 years. Homebirth and "natural" childbirth advocacy do not represent a return to nature. Indeed, most homebirth and "natural" childbirth advocates are woefully ill informed about what childbirth in nature is actually like. Homebirth and "natural" childbirth advocacy do not hark back to a pre-technological philosophy of birth. They are thoroughly modern creations with modern philosophical and political antecedents.

This is why stories of "empowering" and "orgasmic" birth only exist among women who have read and believe the homebirth and "natural" childbirth literature. "Empowering" and "orgasmic" birth did not even exist until "natural" childbirth founders (primarily men) made them up. Now, telling such stories are the price of admission to the cultural subgroups of homebirth and "natural" childbirth advocacy.

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