Horseshoes and Maternalisms: Homebirth Midwifery and the Politics of Demedicalized Reproductive Expertise

• In Event: Reproductive Subversion Reconsidered: Contemporary Politics of Reproductive Knowledge

Abstract

In the field of contemporary United States homebirth or community midwifery, practitioners make and use a demedicalized form of reproductive healthcare expertise. Instead of defining truth, managing risk, and altruistically making decisions, they suggest, experts could be figures who do something else: support lay decision-making. Neither anti-expert nor classically professional, the field is politically united by a maternalist sensibility that what happens in the scene of birth can set in motion dynamics with powerful possible effects on the social world. While considering homebirth midwifery through popular so-called “horseshoe” theories of political convergence might suggest that conflict the midwives and parents who meet each other in the world of homebirth agree more than they disagree, I find the opposite. Because the cosmology at the heart of community midwifery is flexible enough to be compatible with very different ways of seeing the world, this shared sensibility holds together very disparate politics. Over what should parents have autonomy? About what should they be able to choose? And just which dynamics should ripple out from the familial to the social? I examine three conflicts that engage these points of sometimes “vicious” disagreement: about abortion and racism, about gender and sexuality, and about COVID-19. I find that navigating political divides at the occupational level—in community midwifery institutions and organizations—forces confrontation with these normative questions, and is thus more difficult than collaborating across them at the clinical level. Consolidating a novel form of reproductive expertise in an occupational group, in other words, is strained by the politicization of reproduction and of expertise itself.

Author

• Liora O Goldensher, Virginia Polytechnic Institute and State University