feminist clinic to home birth — a natural progression (part I)

In my mid-20s, when I decided to consider a future in nursing, birth wasn’t on my radar at all. In my queer community in the San Francisco Bay Area, I didn’t know anyone having babies or talking about birth. But I had long been involved in reproductive rights advocacy and had worked in coalition with the folks that ran the feminist abortion clinic in Oakland — so that is where I looked to get my first clinical experiences — to see if I really wanted to be a nurse.

Mostly volunteer-run with just a couple of paid staff, the Women’s Choice Clinic (WCC) (back before fake clinics had popped up with deceiving names like this; and before intersectional feminists adopted more inclusive language when supporting abortion rights) was a small outfit in downtown Oakland. On the second floor of what I remember as a somewhat dingy building, it was the homiest clinic setting I’ve ever encountered. Clearly run on a shoestring budget, WCC relied heavily on state Medicaid funding for most client care — but WCC also oozed an ethic of feminist care that was too committed to decolonizing “gynecology” (I hate that word) to try to be “clinical.”

I wish I had pictures to share. The best way I could describe it is that when I eventually watched the 1996 documentary about the legendary underground abortion service Jane, I understood in my body how WCC was situated exactly in the same history — borne of the women’s health movement. This is, of course, why I first learned about Jane from my time at WCC.

The footage from that film showed rooms that reminded me exactly of the recovery room at WCC — horizontal lighting and colorful blankets on the very non-medical-feeling recovery beds — blankets that looked like they came out of a quilting grandmother’s guest room.

The first job you would do as a volunteer was to observe procedures; then you would move on to provide doula support (though I don’t think we actually called it that) during abortions. This being the mid-2000s, the now-commonly used quiet MVA was not yet in use. The vacuum was loud, and I nearly passed out seeing blood and products of conception in the machine the first time. The gravity of witnessing and supporting someone through the transformation of an unwanted pregnancy in one moment to a blessedly empty uterus the next felt huge, sacred. The palpable relief, sometimes mixed with grief, was hard for my highly sensitive spirit to not catch.

Other than provide support during procedures, volunteers such as myself had to learn every aspect of running the clinic, though some specialized in certain roles like scheduling, staffing the phones, and billing. On clinic nights, we would take turns doing health history screenings, pre-procedure education and consenting, in-room support, processing labs (I loved the centrifuge!), recovery room nursing, and counseling about family planning options.

Similar to how I think Jane operated, all education about procedures happened in a group setting. We volunteers would learn the spiel about the abortion procedure, and review it with the incoming clients in the prep and recovery room, using as props some of the equipment that would be used during the procedures to demystify what would happen and ensure true informed consent. More senior volunteers were in charge of studying the products of conception to confirm the abortions had been complete, and ruling out problems like ectopic pregnancy or molar pregnancies.

A seasoned traditional midwife came in on “gyne days” to do “well woman” (using the language of the times) visits. I once saw her for an annual exam and received one of the most memorable, holistic checkups I have ever experienced. Long before I understood anything about midwifery or its historic ties to abortion, I knew that her approach to health was something I wanted to learn.

Other professionals that provided services included a family practice nurse practitioner who came several times a month to run a reproductive health clinic. Several kindly (and some grumpy) physicians came through to provide the procedural abortion services.

But what struck me over and over was that we were “just regular people” (mostly young women-shaped and genderqueer folks) making it all happen. Aside from the legendary elder queer who oversaw the place, the vast majority of volunteers were younger queers and feminists whose only clinical training had been under this roof.

There was no pretension, no hierarchy, no gatekeeping of knowledge. The idea that people who can get pregnant are the best experts on our bodies, rather than (white, male) physicians was revolutionary because of the women’s liberation movement and the women’s health movement that came out of it, and clinics like WCC. And though I had read about these movements prior to volunteering at WCC, that couldn’t compare to the empowerment of actually participating in that model of care as a volunteer that year.

The next time I felt that kind of revolutionary buzz happened when I attended my first home birth as a midwife over 10 years later and thousands of miles away, in Chicago. It was so familiar — that feeling of “Wait!? I get to just do this, and there’s no doctor watching over me? It’s just us, the midwifery team, with our client at the center?!” It was unsettling in a way, as I had become sadly accustomed to working in the patriarchal birth world by then with OBs overseeing me.

But the flash of embodied memory of intimate health care being something that (now, much more trained, but still—) “just regular people” (not under the watchful eye of the medical industrial system) could do has stayed with me and kept me tied to home birth and other decolonized models of reproductive care all these years.

If you had asked me 20 years ago if I would believe that I would end up a midwife — let alone a home birth midwife like that soft, grandmotherly woman who did my annual exam at WCC, I probably would have laughed! But when I look back now — it just looks like another full circle, and as natural of a transition as any midwife would embrace.