We talk to Kathi Valeii

By Home Birth Aotearoa
Feb 2015

Tell us a little about yourself, what brought you to birth activism?

I hate answering the “tell us about yourself” question. It brings up all sorts of identity conflicts for me. Like, should I tell you about my kids? If I do, does that make me mother-centric? Do I talk about my partner? Does that mean my identity is tied up in relationship to him? How do men answer this question? Why do I care? Okay, let me try.

I’m the founder and content creator at Birth Anarchy. I started the blog after my youngest was born several years ago. I’ve always been an outspoken radical. I can remember my dad telling me at ten years old that he was worried about the rebellious streak in me. I recall a high school English teacher saying, “the biggest conformists are the non-conformists” and my face burned with anger as she tried to steer the sheeple to be better conformists. I’d call myself an introverted extrovert. I articulate best typing on a keyboard, rather than in verbal conversation. I do best in intimate, small circles, and want to crawl into the nearest manhole at large social gatherings.

I’m a parent to 3 boys – ages 3, 9, and 12. They are all super cool. My youngest never stops talking, singing, or making other guttural noises. Like ever. My middle son is funny as hell and is into skateboarding. He’s a really great writer and can make up poems on the fly. My oldest is the sweetest thing you’ll ever meet. He loves to run and read and cook and hates to clean. My partner and I both work from home and enjoy writing together, and outdoor activities, like camping and hiking and gardening. We fantasize about moving to New Zealand sometimes. Like now, when it’s February and 8 degrees.

My journey to birth activism began with the hospital birth of my oldest, almost 13 years ago. The whole experience was very confusing for me…. I prepared for an unmedicated, intervention-free birth, and that mostly happened. But I had never experienced such disrespect and emotional violence in my life. So, I wasn’t sure what to do with the complexities of emotions. I felt like I was *supposed* to feel all blissed out and thrilled that I had attained some sort of goal, but, really, I felt completely defeated and deflated and impotent and humiliated. I went on to become a childbirth educator and birth doula. The work was harder than I could have imagined. I don’t know if you can really fully prepare someone for witnessing systemic abuse over and over. I did this work for about 10 years before leaving that work to put all of my efforts into advocacy.

What were your own births like?

My hospital birth and postpartum stay was traumatic. From the nurse looking at my vomit that landed on the floor and then at me like I was a disgusting beast; to my mistrust of my doctor’s insistence that I needed an episiotomy, and her telling me I “was going to feel it” when I told her I didn’t want a local (something we had talked about prenatally, and that she assured me she could do); to the nurse making fun of me when I couldn’t walk because of the amazing amount of stitches between my legs; to the pressure to pee or be catheterized; to another nurse in my room a day later who literally ripped my newborn out of my arms and snarled into my face, “Babies die from Group B all the time!” before exiting the room with him for a blood draw we were still questioning the need for. I filled out an evaluation form and complained about that last nurse. A PR rep called me after I returned home, breasts full and leaking, still waddling with a diaper and gaping incision in my crotch, and always groggy from a constant state of in-and-out sleep with my new baby. I remember shaking and trying to hold back tears as I recounted the story with the person on the other end of the line. We hadn’t thought to get the nurse’s name – she was a superior, not our normal nurse (the one who couldn’t make us comply). She relayed her condolences and said there wasn’t much she could do without a name, and I asked why they couldn’t find it out from my chart – surely her name would have appeared next to the blood draw procedure. I never heard from them again. That was that.

My next two were born at home, both very different experiences, both healing and reclaiming in their own way. My middle son’s birth was only two hours long, and so the speed and intensity were a bit scary. But, oh my, there is nothing like a homebirth. Walking across the hall to my own bed, having my favourite foods brought and orange served and chatting with my midwife, cross-legged next to me on the bed, snuggling with my family and new baby. My last labour was my longest at 5 hours (ha!). I did a lot of emotional work during his pregnancy. His birth felt like full restoration for me. It was in the months after his birth that I launched the blog and really owned my activist voice.

Kathi Valeii, the woman behind Birth Anarchy

Do you think birth rights for women are improving, or are they getting worse?

This is a pretty complicated question because we can point to lots of ways that it’s certainly improved from, say, the years when our grandmothers gave birth, right? Like, most women aren’t knocked out and strapped down on their backs while their babies are fetched with forceps. We no longer use Twilight sleep or shave and enema women. But what we have instead is a new form of barbarism – one that masquerades as normal routines for the woman’s and the baby’s “safety.” I don’t need to waste a lot of time telling you that these guises of safety aren’t really about safety at all – but, rather motivated by fear of lawsuits, cost, and convenience. In the U.S., where I am, we spend the most money on maternity care in the world, and we have some of the worst outcomes. Women are dying at alarming rates, when compared to other countries. In fact, the U.S. is one of only 8 countries in which the maternal mortality rate is increasing. And we’re the only developed country, at that. And that’s not even to mention how racism and classism plays into this scenario. Black women die at upwards of 2-4 times the rate of white women. In some communities it’s even higher.

But we can’t just parcel out birth from the entire feminist struggle and pretend that it stands alone; separate. Injustice in birth fits into the entire narrative of the way that women find themselves oppressed, the world over. It’s not just that women aren’t receiving evidence-based care in birth – it’s that their autonomy is being trampled on, routinely. Women are pleading to be “allowed” to be deciders in choices about their own bodies and their own pregnancies, as though there is some sort of authority figure that is better equipped to manage these choices for women. We see this on all ends of the reproductive health conversation – from access to contraception to abortion to birth. These are all the same conversations, the exact same struggles.

There is a growing body of evidence showing that physiological birth is not only safer but more beneficial to women, yet the medical birth model seems to disregard this in favour of routine procedures to enhance birth, why do you think this is?

Well, for one thing, most hospital care providers have never even observed a physiological birth. Since the inception of the obstetric profession, birth was established as a pathological condition. Dr. DeLee compared the normalcy of birth to the normalcy of “falling on a pitchfork.” And we’ve been operating under that impalement model for more than a century. So, it’s a pretty big undertaking – huge, actually – to think that the medical profession is going to just get on board with evidence that supports physiology. It requires a completely new understanding of birth, in general. It also requires patience and flexibility – not traits most OBs are renowned for. Obstetrics is about managing labour, being efficient, and being precise. If anything, the new science only affirms how wrong obstetrics is for low-risk women.

If you could change three things about birth at a global level, what would they be?

  1. Women’s rights to bodily autonomy would be respected and legally upheld.
  2. Women would be offered routine care that is based on evidence as a baseline.
  3. Informed consent and right to refuse would be a real, actual thing that was offered and honoured every time.

If those three things came to fruition, our maternity care crisis would end.

Birth rights activists can deal with some pretty nasty attacks both online and face to face. Some people suggest that we should ignore the voices of dissent and others suggest that we combat them. How do we challenge concerted aggressors whilst protecting our emotional and personal safety?

This is a really great question. I actually just tackled this issue with the Birth Anarchy members. This is not unique to birth activism, it is a side-effect of Patriarchy that women’s movements have faced for millennia. Women challenge their subservient position in society, and they’re deemed anything from hysterical to man-haters to sluts and bitches. I think how we respond to this depends. It depends on who the aggressor is (is it a troll or someone you have a relationship with?), it depends on what kind of space we feel like we have or are willing to give, and it depends on if we feel triggered.

Sometimes, in this (and any justice movement) we can feel like it’s up to us to address all of the concerns and all of the push back and all of the criticism. But it’s not all our responsibility. We do what we can. We do what our voice calls us to do. And sometimes it means we walk away. It’s never okay to sacrifice your own emotional space for someone who is not reciprocating that space for you. That doesn’t mean everyone always agrees in a conversation, but it does mean that there is an element of respect in the disagreement; an openness, a willingness to hear the other person. But, you know, it’s also okay to acknowledge that it’s not up to women to hold the entire burden of educating all of the men and all of the medical staff on how they’re behaving badly. In 2015, its time to step up and be able to own one’s place in oppression and to be able to take initiative in listening to women and deferring to women on issues that affect women.

One of the challenges we have is dealing with the media and their need to make topics more controversial than they are. In your mind. how do we hold the media accountable for their hand in muddying the waters when it comes to birth and particularly, birth safety?

We need to call them out when we see it. But it’s exhausting and it can’t be only one person’s or a handful of people’s responsibility. I’ve participated (and seen it done) as open letters, as editorial pieces, as comments on the article, itself, and as counter-articles that reference another (or several articles) on the same topic. Another tactic is to contact a writer and ask if they might be interested in another angle to the story they just wrote. There are countless examples of this, and it’s how we widen and deepen the conversation around this subject. The media absolutely frames cultural opinions around all subjects, including birth, and we shouldn’t ignore their power to do so. We can actually use it to our advantage.

I remember clearly the first time I came across a man who told me that there are instances where women should not be trusted to make good decisions during birth. Through the flush of rage and the shaking of incredulity I barely cobbled together a coherent sentence. If only I had that moment back again! What words would you offer up in that situation?

You mean, “what words do I offer up, routinely, in that situation,” right? Because the retort regularly goes, “Well, who’s going to speak up for the babies?!” As if all of the pregnant and birthing people are thinking about anything and everything but the fetus inside of their own bodies as they make complex decisions that affect their lives.

My response to that kind of insinuation is usually to offer up a question in return – “Who do you believe is the most invested person their own health and in their pregnancy and in their fetus? Do you believe strangers are more invested in those outcomes?” These questions all come back to illustrating how illogical it is to suggest that another person or entity control the health choices of another person. How twisted our beliefs must be about women if we can’t trust them to make competent decisions for themselves.

What words of wisdom would you share with a new mother to be?

Trust yourself. You’re way more intuitive and knowledgeable than anyone is going to give you credit for. Surround yourself with people who support that, who truly support you. Don’t compromise and fight like hell for what you want.

What are the biggest challenges in birth freedom we have facing us right now?

The use of force against women for procedures and surgeries and interventions they do not want. And also, the criminalization of pregnant people. These two things are super intertwined and it’s hard for me to piece them apart. We have created a universal sub-caste for pregnant folks, wherein all of their bodily autonomy rights and sometimes their physical liberty is completely removed based on their pregnancy status. And that’s a really scary road we’re heading down. When we can get court orders to slice women open against their will, when we can hold women hostage or threaten removal of their child until they consent ; when we can randomly or selectively screen women and their newborns for drugs without knowledge or consent – when we can base the screenings on what the woman looks like or what race she is or what socio-economic level she exists in – and then take her baby and then throw her in jail, women have no freedom around their reproductive health and lives. Women are reduced to reproductive slaves.

Your unique (and yet so incredibly important) approach to birth is that you tie birth rights to how we, as women, are treated universally and the basic rights of women through all stages of our fertile lives. Why do you think this is so important?

I think this is one of the most important things to recognize in this fight. I’m not sure, actually, why anyone would think that parcelling out all of these issues, as though they are separate makes any sense at all and we’ve got to stop behaving as though they are all isolated issues if we want to make any progress at all. One of the keys to moving birth into the foreground of the feminist movement is to begin using alliance language – language centred around choice and around autonomy and around beating the war on women – this is language that is recognizable and embraced by the larger women’s movement. And we need each other. We need to recognize the inter-connectedness of these issues and how we can pull them together in our advocacy efforts to be more powerful.

What reactions have you received from the #howwehatewomen hashtag?

That hashtag was born out of article I wrote by the same name about a year ago, and the reaction was pretty profoundand so there was a wide breadth of reaction from so many eyes. There was a lot of THANK YOU! And then, of course, there was a bunch of, “I don’t hate women… what the hell are you talking about?” But it was an amazing conversation starter. It’s really where the conversation started to really tip in the direction of gender-based oppression for me, and where I began to slam that into the forefront of the discussions around birth and other reproductive injustices.

Where did it all go wrong? At one point women were free to birth as they needed to and were supported in this (surely, they must have been!) but at some stage birth was completely removed from women, leaving them a passive or unwilling observer in many cases. Do you have any thoughts on this?

“Surely, they must have been!” This made me chuckle – not in a ha-ha-funny way, but in a *snort*-no-shit kind of way. There isn’t a woman alive in any industrialized country who can attest to this, that’s for sure. We are all left saying, “surely at some point in herstory, women MUST have been in control of this process….” Where it all went wrong depends on how far back you want to take it. We could take it a little way back – like one or two hundred years ago – and talk about how the male-led obstetric profession paved the way for ushering women into hospitals en masse and the amount of control that offered them; or we could go even further and talk about the beginning of Patriarchy – the mass genocide of women in an attempt to wipe out female knowledge and power. Regardless of how far back we go, where it went wrong, was with Patriarchy. Patriarchy is what has robbed women of their authority and of their power, and it still what this struggle, at its root, is against.

Tell us about the word “allowed”

It should stop being “Allowed” to be used in the context of what rights women have access to once pregnant. The end.

Really, though, the fact that we use this word with such consistent regularity – to describe how “supportive” or unsupportive our care providers were, reveals a lot about the social standing of women, doesn’t it? I was recently talking with a career PhD holding academic who was organizing a feminist talk series. Of course, I steered the conversation toward birth and how that issue needs a larger place at the table in the feminist discourse. She empathized, then went on to tell me about when she gave birth how her provider was so accommodating and how they “allowed” her to do this and do that and how that made her birth a positive thing. And I remember sitting there, thinking, “what the hell is going on here? This is such a profound problem when intellectual feminists have trouble discerning that submissive language in birth is no different than similar language used to control women elsewhere.”

If you could be paid a full wage to ‘do what you do’ how would you frame your role?

Well, I suppose it would look exactly the same, except I could do more. I could hire help. I would drop the ball less often. I would meet deadlines more quickly. I would still see my role as a writer and speaker and conversation facilitator.

Well-Behaved Women Seldom Make History – Laurel Thatcher Ulrich

Kathi Valeii authors and moderates the Birth Anarchy blog. Her decade-long years of bearing witness and listening to women’s stories offer a unique lens into the rampant abuse of women in today’s maternity care system.

Kathi has been called “a true artist,” and “one of the brightest minds in this movement.” Her essays have appeared in numerous publications including, Squat Birth JournalThe Birth Institute, Mutha Magazine and Midwifery Today. As a sought after speaker, Kathi has addressed both local and global audiences on the subject of gender-based oppression in reproductive health and childbirth.

In addition to her writing and speaking, Kathi collaborates with a number of consumer advocacy organizations in their efforts to improve the state of birth and end rights violations in pregnancy and