Natural Birth, Old Timey Death

Turns out, some birthing centers are anti-vax friendly.

What's the most dramatic "oh shit, these are not my people and I have to get out of here" moment you've ever experienced?

For me, it's a three-way tie between the time 1: when I was working at a financial institution in Chicago whose name rhymes with "Barrell Pinch" and one of the old-ass stockbrokers asked me to help open his window a crack so he could yell 'Get a job!' at the Occupy Wall Street protesters marching 22 stories below, 2: the time an American tourist with white lady dreadlocks I'd just met at a bunkhouse in Kathmandu asked me to hold onto a fist-sized brick of extremely illegal hashish for her, like, as a favor, and 3: the time I realized-- less than two months out from my due date-- that the birthing center where I planned to have my baby was anti-vax friendly.

Before I was actually making decisions about giving birth, I never thought of myself as the "natural birth" type. You would never find me in a field, twirling in a gauzy dress and a flower crown, just me and nature and the person I'd hired to follow me around all day taking photographs of me being carefree. (You wouldn't find me twirling in a field of any kind; I grew up surrounded by actual fields and fields are full of snakes and bugs and sometimes mud so sticky that it sucks your shoes right off.) I look weird in wide-brimmed hats. I've been paying somebody to shoot botulism into my forehead since my early 30's. I'm too impatient to wash fruit for long enough to get all of the pesticides off before I eat it.

But then I actually thought about it. I thought about how I don't like spending time in a hospital unless I absolutely have to (nobody does), and how the for-profit American medical system has given me plenty of reasons not to fully trust it as the best place to have a baby in every circumstance. I thought about how uncomplicated low-intervention births tend to lead to easier postpartum recovery than medicated births. I'm not trying to heal myself with blood moon-charged crystals by any means, but I don't believe that western corporatized medicine has all of the answers, either. If it did, America wouldn't have such shitty overall health outcomes, and it especially wouldn't have such shitty maternal health outcomes. A "natural" birth center in a major city felt like the right place to avoid both a hospital birth and --if, god forbid, something went wrong-- a prairie death.

I researched "natural" birthing centers in my area (I put "natural" in quotes when I talk about unmedicated birth because I find the implication that giving birth with medical intervention is somehow not "natural" to be weird. All birth is natural, even the kind when an alien baby explodes from a space explorer's chest). I liked the way that the "natural" childbirth community talks about pregnancy with reverence for the process of birth that made me feel powerful rather than scared. Pregnancy and childbirth are one of the most metal things a human can do, and I never connected with its cutesy pastelification.

I found a birthing center that was well-reviewed not too far away from where I live, near Downtown Los Angeles. I spoke with people at the center, Josh and I took a tour, and we decided that we liked the vibe-- it was more like homey, comfortable bedrooms that contained birth swings and whirlpools than stale hospital suites bathed in institutional fluorescent light.

We put down a deposit for a spot at the center back in June. I wasn't a field-twirler yet, but I could learn.

On the advice of a birthing center employee, I didn't tell my regular OB-GYN that I was planning on an out-of-hospital birth because I was warned that some OB-GYN's will drop patients once they know they're planning to give birth in a birthing center or at home. So my plan was to sneak around like a gynecological philanderer, getting duplicate care at both the doctor and birthing center until on or around Halloween, my due date, when I would have the unmedicated hippy-dippy birth I'd decided I wanted.

Fast forward to about two weeks ago. I was signing some paperwork with the center when I came across their COVID policy form. I asked if they required the COVID vaccine for staff.

A staffer replied:

Hi Erin, No, we do not. As healthcare providers, we care for all individuals including those with immune compromise where vaccination effectiveness remains inconclusive. If you have more questions, please let us know!Best,

That didn't even make sense. Because they care for people with compromised immune systems, nobody should be required to be vaccinated? What?

And then, just to make sure I got the picture, another employee emailed.

Hi Erin,To add to [Employee]'s response, [Center] continues to follow both HIPAA and midwifery principles of informed choice and we will NOT be asking anyone if they are vaccinated or asking people to present vaccination cards. Therefore, as a company, we do not mandate vaccinations for our employees. It is an informed choice for each body. If you would like to know the vaccination status of a midwife, you may ask her directly. She will have the right to choose to share her medical information with you.Please feel free to reach out to me directly if you have more questions.

A medical professional misrepresenting what HIPAA does either because they don't know what it does or they assume that I don't and they can just lie to me about it...red flag.

I did have more questions, namely, was it possible for me to request working only with vaccinated employees, as I wasn't comfortable having my newborn cared for by people who choose not to be vaccinated? No answer there. But I did get another email (emphasis mine):

Hi Erin,As the owner of [Center], I wanted to chime in and reiterate what both [other employees] have stated is true. [Redacted for identifying information], we offer every employee the same considerations regarding their bodies that we do to the families we serve: full informed consent when it comes to not only the covid vaccine but also all the other vaccines that we offer. We also continue to implement the same pre-covid safety measures for you and your baby, which center around symptoms and not vaccinations.I also make it a point to tell everyone at the interviews that if someone is looking for a birthing center that insists on all of the employees get vaccinated, then we are not their birthing center.

You know that moment from The Simpsons where Homer backs slowly into a hedge? That is what my brain did.

The center offered a refund on our deposit, we parted ways civilly, without as much as a single word in ALL CAPS, and I counted my lucky stars that I hadn't bailed on my gyno. California health care workers in most types of facilities are required to be vaccinated as of September 30. Birthing centers are not on the list of facilities that must adhere to those guidelines. The giant corporate hospital I feared stopped looking quite so bad.

As I thought about it, I got more annoyed. A policy of vaccine "choice" in a birthing facility makes about as much sense as a policy on cigarette "choice" in a delivery room. The people who share air with the human chimney or petri dish don't get any "choice" to not breathe in carcinogenic or contagious air, and a newly-born baby especially doesn't have a choice of how other people's "personal" decisions to pollute the air or open themselves up to be incubators of disease impact them. I'm sick of this bullshit "choice" language from those who tolerate unvaccinated people as though those choices don't directly impact others. Enough of this wishy-washiness. You're either pro-everybody-who-can-gets-the-vaccine, or you're anti-vaccine, period.

Maybe it's first-time mother ignorance or my relative California newcomer naivete, but it hadn't even occurred to me that a health care provider that works with newborn babies would tolerate anti-vaccine employees. And how, in a neighborhood like mine, with relatively high levels of income and education, does an anti-vaccine sentiment flourish?

"Natural" childbirth isn't new; people have been giving birth without the assistance of anesthesia and labor-expediting drugs since humans existed. But today's "natural" childbirth community rose with the second wave feminism of the 1970's as a response to a perceived over-medicalization of childbirth in the West, and the way medical professionals deprived birthing mothers of agency over their own bodies during the birthing process.

But in recent years, aspects of the movement have grown more extreme. The "Freebirth" movement has emerged as a more hard-core version of "homebirth," encouraging mothers to give birth outside of a hospital or medical facility without any assistance from anybody. So-called "pastel Qanon" has married extreme distrust of the medical establishment with extreme distrust of all establishment bordering on delusion, marrying dangerous medical advice with baseless conspiracy theories, all through the sun-kissed lens of lifestyle social media influencers. The twirling flower crown-wearer in the field now believes that the world is run by a secret cabal of child-molesting elites.

For more information, I reached out to an expert: Kolina Koltai, a postdoctoral fellow at the Center for an Informed Public at the University of Washington. She studies the way that the anti-vaccine movement builds and strengthens itself through social media. She noted that the anti-vaccine movement and "natural" childbirth community had some overlap before the internet, but that social media has given the movement new life.

"First of all, natural childbirth isn't bad," Koltai said. "A lot of [anti-vaccine sentiment] starts as a desire to protect their families, and do what's best for their kids."

Koltai noted, however, that there's a large overlap between some "natural" childbirth circles and an anti-vaccine sentiment. But people don't start out in the batshit insane "Dr. Fauci is injecting the children with devil semen" camp, nor does everybody end up there. Many people who end up in the anti-vaccine camp start out like I did-- wanting more information on low-intervention birth. They don't get the answers they're looking for from establishment doctors, and so they start doing their own research online.

"In the natural and holistic community, there's a big emphasis on natural immunity and a distrust of the medical system," Koltai added. "And sometimes that extends to belief that vaccines interfere with natural processes."

Information-seeking parents-to-be (like me) join groups on social media to exchange tips and information with other parents with similar philosophies. And while not every "natural" birth community devolves into an anti-vaccine hive, some of them do.

Pinterest cracked own on vaccine misinformation years back and has essentially rid itself of anti-vaccine content masquerading as natural birth community content, but other social media companies haven't been as successful. Facebook, for one, has been playing whack-a-mole with anti-vaccine/natural birth communities for years without much to show for it, as anti-vax groups able to get around flagged words and bans more quickly than the social media giant can take the pages down. And anti-vaccine TikTok has turned into, in Kotai's words, "a hot mess."

It is a deep, dark rabbit hole, and I don't recommend diving in unless you're able to decompress on the other side with a stiff drink or weed. (I can do neither at the moment and am thus waiting for the brain-bath of stress chemicals to subside on its own.) Compared to some of what's out there, my anti-vax former birthing center is the Mayo Clinic.

At my next visit with my OB-GYN, I relayed my concerns about being pushed into interventions I don't want in a hospital environment and was reassured by how supportive she was of what I wanted out of my birth experience. She assured me that I could have the "homebirth" experience I wanted from a birthing center-- except with emergency help just down the hall rather than a 10-minute ambulance ride away. I did some light google stalking of her birthing philosophy when I got home and found plenty of women like me singing her praises. Plus, all of the nurses and midwives she works with are vaccinated. They proudly wear stickers on their nametags advertising that fact. (Weird! I thought that was against HIPAA!)

I should have done my homework earlier rather than making blanket assumptions about hospital births being bad, or birthing center births being good. I'm glad that the right birth plan for me was right in my own backyard.

Besides, "birth plan" is a combination of words that projects confidence in an impossibility. Babies simply do not care about anybody else's convenience. Maybe one day we'll have the technology to grow babies in jars with timers attached that ding in time for us to properly install a rear-facing car seat, but until then, everybody who gives birth must face the maddening uncertainty of nature taking its course.

Screengrab from Midsommar/ A24