A CONSUMER VIEWPOINT Humanizing Birth: A Global Grassroots Movement

A survey of a convenience sample of 24 grassroots birth activist groups based in several countries revealed remarkable similarities despite differences in culture and maternity care systems. With few exceptions, they began with a few individuals, generally women, who were dissatisfied or angry with an obstetric management system that failed to provide safe, effective, humane maternity care, that suppressed alternative models of care and nonconforming practitioners, or both. Responses indicated that organizational structures tend to fall into a limited number of categories, and strategies intended to accomplish reform overlap considerably. All groups have experienced difficulties resulting from the hegemony of conventional obstetric management and active opposition of practitioners within that model. Most groups are volunteer based, and all struggle under the handicap of limited resources compared with the forces arrayed against them and the scope of what they hope to accomplish. (BIRTH 31:4 December 2004) Don’t wait for the light to appear at the end of the tunnel.... Stride down there and light the bloody thing yourself. Sara Henderson, Australia This commentary arose from a casual conversation with Diony Young, Editor of Birth, at the media debut on April 14, 2004, of the booklet, What Every Pregnant Woman Needs to Know About Cesarean Section, published by the Maternity Center Association in New York. Through my association with the Coalition for Improving Maternity Services (CIMS) and other activities, I had become aware that all over the world there were grassroots birth-activist groups similar to each other. Also, despite the large differences in culture and maternity care systems and delivery among groups, their purposes, participants, strategies, and activities, and the obstacles to their progress were remarkably similar. This commonality pointed to both the importance of the grassroots birth-activist movement and the pervasiveness of the serious problems they sought to redress. An invitation to write about grassroots organizations ensued, and two others who were present agreed to help: Debra Pascali-Bonaro, who works with DONA International (formerly Doulas of North America), CIMS, and Lamaze International, and Tonya Jamois, president of the International Cesarean Awareness Network (ICAN), a venerable United States organization with global outreach. I devised a brief questionnaire, which we e-mailed to various individuals and groups, some of whom passed it on to other organizations. In addition to requesting contact information, we asked the questions that form the subheadings of this article. We used a purely convenience sample and did not perform a systematic or comprehensive survey. We received responses from 24 organizations in North America, South America, Europe, Africa, and Australia. We know of many additional organizations that fitted the description of birth activist groups Henci Goer is a birth activist, author, and independent scholar specializing in evidence-based maternity care. Address correspondence to Henci Goer, 970 Buckeye Court, Sunnyvale, CA 94086, United States, or [email protected]. 2004 Blackwell Publishing, Inc. 308 BIRTH 31:4 December 2004