In this essay, I explore the question of what freedom means in relation to birth, drawing on feminist conceptualizations, in particular: Einspahr’s (Reference Einspahr2010) notion of structural freedom, Krause’s (Reference Einspahr2010) plural freedoms, Beauvoir’s (Reference Beauvoir1948) ambiguous freedom, and Cornell’s (Reference Cornell1998) “imaginary domain”, in order to think about what feminist freedom might mean in relation to birth. Inspired by Young’s (Reference Young1988) iconic essay, “Five faces of oppression,” I outline five faces of feminist freedom in relation to birth, namely: (1) freedom from oppression, (2) freedom to labor, (3) freedom to be-in-relation, (4) freedom from violence, and (5) freedom to imagine. These faces should not be seen as mutually exclusive or as separate and distinctive aspects of freedom. Instead, each face is a necessary condition, and integral to the broader project of making, struggling for, and imagining what birth would be like as an experience of freedom.
1. Feminist birthing freedom
All is not well with birth across transnational contexts. While the problems differ in specific settings, some claim that a global sense of crisis surrounds birth (Reiger and Dempsey Reference Reiger and Dempsey2006). There is widespread dissatisfaction with rampant mistreatment, violation, and “obstetric violence” across very diverse contexts, for example: Australia, France, Kenya, South Africa, Spain, the USA, Mexico, and Argentina (Williams et al. Reference Williams, Jerez, Klein, Correa, Belizan and Gormick2018), as well as discontent with racist maternity care and stratified maternal mortality and morbidity rates in countries such as the Netherlands, South Africa, the USA, and Australia (Davis Reference Davis2019; van der Waal et al. Reference Van der Waal, Mitchell, van Nistelrooji and Bozalek2021; Keedle et al. Reference Keedle, Keedle and Dahlenforthcoming). There is anxiety about rising rates of caesarean sections across a range of geopolitical boundaries, with some declaring that caesarean sections have become an “epidemic” (Josi Reference Josi2019). Statistics show that global inequalities in maternal death rates, pregnancy and birth complications, and infant mortality, continue to persist along racialized and colonial lines. While many birthers are left dissatisfied or traumatized after birth, “natural” or physiological modes of birth continue to be idealized (Vissing Reference Vissing2017).
How have feminists made sense of these anxieties and discontents? Much feminist writing on birth has been insular and focused on the concerns of middle-class, white women in contexts of the Global North. There is a long tradition of feminist writing from the 1980s from a Northern vantage point that has written about what is wrong with birth using the framework of oppression, in particular medical and patriarchal oppression (Oakley Reference Oakley1980; Rothman Reference Rothman1982; Martin Reference Martin1987). As a result of the dominant oppression lens, the primary mode of feminist response to the problems of birth in the 1980s was critique against androcentric medical systems and interpretive frameworks in which birth was portrayed as pathological and in need of medical intervention. Feminist work on birth politics in this era has been retrospectively labelled as the “second wave” of birth activism (Beckett Reference Beckett2005). For the most part, this body of work understood oppression as a top-down phenomenon, with the solution to the problems of birth seen as lying in the turn to a midwifery or humanist birth model (often cast as the antithesis of medicalized birth). The oppression framework lost favor in the 1990s with the increased fashionability of Foucauldian concepts of power and poststructuralist theory (e.g. Martin Reference Martin2003; Simonds Reference Simonds2002). White feminist birth politics became largely depoliticized in contexts of the Global North during this time. In contrast, Black feminists in the United States placed racial oppression and intersectional dynamics at the centre of their birth politics (Oparah and Bonaparte Reference Oparah and Bonaparte2015; Gumbs Reference Gumbs, Gumbs, Martens and Williams2016; Davis Reference Davis2019). Meanwhile, in other parts of the world, birth activism retained a sharp political slant and became infused with the wider energy of gender violence activism and feminist social mobilization. Out of this volatile mix, the movement against “obstetric violence” was born in Latin America (Brazil, Argentina, and Venezuela) in the 2000s (Williams et al. Reference Williams, Jerez, Klein, Correa, Belizan and Gormick2018). Over the last two decades, the obstetric violence lens has become a powerful activist, conceptual, and legal tool for making sense of what is wrong with birth across diverse contexts (Chadwick Reference Chadwick2021). This approach has much in common with the earlier feminist framing of birth as a site of oppression but goes further in terms of widening the critique beyond medicalization, and naming birthing harms as a form of gender and intersectional violence (Dixon Reference Dixon2015; Shabot Reference Shabot2015). At the same time, the focus remains largely on critique and the struggle against the normalization and perpetuation of violence in the birthing sphere. For the most part, there has been little attention to what a feminist vision of birth freedom would look like.
In both past and present feminisms, there has thus been little imaginative inquiry focused on the question of what birth would look like, and feel like, in a feminist world. The term “freedom” is not often associated with birth, other than in relation to the phenomenon of “free birth” which is a descriptor used to refer to deliberate acts of unassisted birth-giving with no healthcare provider (e.g. Feeley and Thomson Reference Feeley and Thomson2016). The speculative question of what freedom might mean in this sphere has thus not been widely articulated. Of course, the question has been engaged from more indirect angles, particularly in relation to more expansive imaginings of reproductive freedom. For writers such as Shulamith Firestone (Reference Firestone1970), freedom for women meant liberation from the constraining clutches of biological reproduction—in particular, pregnancy and childbirth. Feminist freedom thus meant freedom from birth and the separation of procreative processes from women’s bodies so that gestation itself was no longer rooted in feminized bodies and wombs. For writers such as Firestone, women’s oppression was fundamentally rooted in their reproductive shackles; patriarchal dominance was built on the exploitation, distortion, and appropriation of gestation. Birth was thus cast as an obstacle to freedom, rather than a site where freedom might be made or created. Such views contrasted sharply with the trend towards the romanticization of gestation that was prevalent in some strands of feminist thinking (Hartsock Reference Hartsock1985; O’Brien Reference O’Brien1983). For many feminists, women’s reproductive experiences had been distorted and alienated by patriarchal systems but nonetheless were seen as a source of authentic power (e.g. Rich Reference Rich1976). Freedom in relation to birth (and for women in general) thus meant the eradication of patriarchal shackles and the turn towards the essential bodily power of the gestating and birthing body.
While the question of freedom was not always directly engaged in relation to birth and natality, it was nonetheless always implied. For feminist writers and activists, birth freedom meant either the transcendence of the physiological body and reproductive processes (e.g. via technology) and/or the eradication of structural oppressions (e.g. racial oppression, patriarchal oppression, medical oppression). Freedom was thus predominantly imagined as freedom from—freedom from the body/nature and/or freedom from systemic oppression. As a result, most feminist work has taken the form of critique—i.e. challenging sociocultural conditions and injustices, and criticizing social, epistemic, and political arrangements, norms, and infrastructures. Feminists have thus taken up positions against more often than actively working to imagine new arrangements, relations, practices, and forms of life (Grosz Reference Grosz and Gunew1990). This has been necessary and crucial work and it is not the aim of this paper to diminish or reduce the importance of feminist critique. At the same time, it is necessary to acknowledge that the work of feminist theory involves more than critique (in the sense of exposing and struggling against injustice). For Grosz (Reference Grosz and Gunew1990), feminist theory-making is a matter of both critique and creative construction.Footnote 1 Creative construction is the work of imaginative inquiry that is concerned with the making of new concepts, theories, possible worlds, practices, norms, principles, and imaginings. Feminist theory requires that we work and move in two directions simultaneously—i.e. in a movement against (critique) and a movement for (imaginative inquiry).
2. Questions of freedom
Feminist writers and philosophers have had much to say about the question of freedom (e.g. Beauvoir Reference Beauvoir1948; Coole Reference Coole1993; Cornell Reference Cornell1998; Hirschmann, Reference Hirschmann2003; Davis, Reference Davis2010; Williams Reference Williams2019). Many of these writers have been critical of masculinist and normative conceptions of freedom rooted in the individual subject. They have called attention to the question of location or “situation” (Beauvoir Reference Beauvoir1989), asking us to reflect on our starting point—i.e. from what point of view do we ask questions about freedom? In everyday parlance, assertions of “freedom” have become synonymous with the claiming of individual rights (e.g. doing it “my way”) and/or the consolidation of projects of violence (e.g. gun ownership, hate speech couched as “free speech”). As a result, freedom has become a dirty concept that is often weaponized by conservative and right-wing agendas. As Maggie Nelson (Reference Nelson2021, 3) asks: “Can you think of a more depleted, imprecise, or weaponized word?”
As with most “big concepts” (e.g. justice, power, oppression, care), the notion of freedom is slippery and refuses singular definition. There are many meanings, and many different kinds of freedom (Nelson Reference Nelson2021). While freedom can become a weaponized concept used to justify harm to others, it remains an important site for the recognition and articulation of the limitations and incompleteness of structures of oppression—i.e. these structures and modes of domination inevitably fail to fully contain creative human struggle and meaning-making (Hartman Reference Hartman2016). Freedom is also a space to claim the irreducibility of the oppressed subject, who cannot be contained by practices of subjection and always retains the potential and possibility of resistance, freedom, and revolt (Spillers Reference Spillers1987; Hartman Reference Hartman2016). As such, we cannot throw away the concept of freedom, however stained or dirtied it becomes in right-wing efforts to appropriate it for hostile or conservative ends. Asking from what point of view the notion of freedom is being mobilized or enacted assists us in judging these claims or articulations.
In relation to questions of freedom, it is generally agreed (Coole Reference Coole1993; Hirschmann Reference Hirschmann2003; Fahs Reference Fahs2014) that there are two dominant approaches or ways of thinking about this matter—i.e. freedom from (negative liberty) and freedom to (positive liberty). According to Berlin (Reference Berlin1969), negative and positive liberty are two senses of freedom (he notes that there are potentially many others). Negative liberty is a matter of freedom from outside interference; it involves freedom to act without obstacles or constraints from others, external authorities, or institutions. It means that doors are open to us; we have the ability to take action as we please. Being “free” is thus conceptualized as being without outside constraints, impediments, or obstructions. We can make choices, do things in the world, and exercise agency. Positive liberty, on the other hand, is not about freedom from outside interference or obstacles but refers to whether or not a person is free to self-define, govern, craft a sense of subjectivity, and weave their own sense of meaning from their situation. At the heart of this sense of freedom is the idea that the self is potentially divided and that positive liberty involves a struggle with self in the ongoing and rational process of self-actualization. As Coole (Reference Coole1993) notes, both of these approaches are problematic and grounded in limiting assumptions.
For example, both regard the individual self as the starting point for questions of freedom and are rooted in assumptions that the free self is ideally rational, bounded, autonomous, and in control of itself. Such conceptions of freedom and the free self are inscribed by masculinist and white supremacist logics in which rationality must “win out” over emotions, passions, and animal-like appetites, and in which aspirations of being unencumbered by social, moral, political, and relational responsibilities reign as ideals. The “free self” thus looks very much like a white, middle-class, able-bodied, cisgendered, heterosexual, male from the Western metropole. It is thus not terribly surprising that the notion of “freedom” continues to be weaponized to hide bigoted ideas and undermine collective well-being (Nelson Reference Nelson2021). In these conceptions of freedom, the self is unmoored from responsibilities to others and “freedom” becomes an individualizing project.
Turning to the sphere of birth, we can see invocations of this white-centric, masculinist ideal of the “free self” in white feminist birth politics which champions emancipatory birthing as a matter of individual agency, choice, and the freedom to do birth “my way.” For example, this kind of thinking underpins the approach to birth politics in the popular book, Give birth like a feminist (Hill Reference Hill2019). Of course, individual choices are important; it is not the point of this essay to claim otherwise. However, as a feminist politics, it is not enough. It is also not sufficient to capture the intermingling layers of power, history, violence, and racial/cultural and geopolitical inequality that coalesce in the sphere of birthing. An overemphasis on choice risks the forgetting of the mangled, thick power domains that operate in relation to birth, in efforts to champion the self-mastery of the birthing subject: “take charge, take control, and make conscious choices” (8). At certain points, Hill (Reference Hill2019) is careful to note that the focus of her book is not individuals but systems—in particular: patriarchy. While racism is mentioned in passing, it is clear that gender oppression is regarded as primary and foundational. However, despite the disclaimer that systems are the focus, throughout the book it is clear that the individual self is the key target of instruction: “This is your body, and your birth” (29). Changing the system appears here as a matter of making up individual minds not to be uninformed and passive and getting on with the business of making choices. Hill supports all choices, as long as they are actively made. In this iteration, birthing freedom becomes defined as the ability to make choices, free from impediments and obstructions as an active subject: a free self is a choosing self.
Freedom to make choices is important but it cannot be the grounds for a feminist politics of birth. As research has shown (Lazarus Reference Lazarus, Davis-Floyd and Sargent1997; Chadwick Reference Chadwick2018), the centrality given to the matter of “individual choice” in relation to birth/maternity care is rooted in a very specific vantage point—that of the middle-class, privileged, usually white, and geopolitically Northern subject. Emphasizing choice as the primary ingredient of a “good birth” risks making invisible other values that are equally (or more) important to women across differences—e.g. safety, care, community, cultural integrity, and respect. As discussed earlier, we need to be reflexive about the vantage point from which we ask questions of freedom. Furthermore, it is also important to think about how we pose questions. For example, Hill (Reference Hill2019) poses the question as one geared towards thinking about how the individual feminist subject would give birth—this is illustrated in the title of the book: Give birth like a feminist. In this formulation, feminist politics is framed as a matter of identity (a subject position) and circumscribed within the field of individual choices, actions, and desires. I suggest that this is not the best way to pose the question of what feminist freedom means in relation to birth. We should not limit ourselves to questions which foreclose our thinking in/around the individual self. For example, if we change the question and ask what birth would be like in a feminist world, we invite a different set of responses and open the way for a more uncertain imaginative inquiry. With this question, a new slant on the matter is generated; feminist politics is no longer primarily about what the individual does, desires, or chooses, but becomes a matter of making a common world (Arendt Reference Arendt1958) organized in relation to a set of structural, political, relational, epistemic, imaginative, technological, and social arrangements, infrastructures, and materialities. We are invited to think more expansively about what this world would be like, rather than confining feminist politics to an individualizing project of self-making.
While Berlin (Reference Berlin1969) regards negative and positive freedom as incompatible and sharply divergent, others regard these two senses of freedom as fundamentally entangled. According to Fahs (Reference Fahs2014), “freedom from” and “freedom to” are two sides of the struggle for social justice. They function not as mutually exclusive but as a dialectic; there can be no true freedom without both. Coole (Reference Coole1993) argues that we should abandon the distinction between these two forms of freedom given that they are “indissolubly intertwined” (94). We should instead talk about freedom as process; this process necessarily involves struggling against constraints and in this way we recreate ourselves. The problem however with both of these conceptions of freedom is that they are largely predicated on the individual (as with Hill’s feminist birthing subject). To be sure, we need to have space to include the particular and unique specificity of individual persons—their desires, modes of meaning-making, and projects—in our visions of freedom. But we also need to have room for questions that extend beyond the confines of the individual and enable us to explore how freedom intersects with structures of power, contingent bodies and relations, and material conditions. In the next section, I develop an imaginative inquiry around the question of what birth would be like in a feminist world. Inspired by Young’s (Reference Young1988) classic essay, “Five faces of oppression,” I explore five faces of feminist birthing freedom. I build my inquiry on the following strands of feminist work: Jennifer Einspahr’s (Reference Einspahr2010) idea of structural freedom, Simone de Beauvoir’s (Reference Beauvoir1948) ambiguous freedom, Mai’a Williams’ (Reference Williams2019) inter-relational “freedom-with,” Susan Krause’s (Reference Krause2010) plural freedoms, and Drucilla Cornell’s (Reference Cornell1998) “imaginary domain.”
3. An imaginative inquiry
I offer the following imaginative inquiry in the interests of exploring the multifaceted dimensions of what we are fighting for in relation to birth. Of course, this inquiry is necessarily rooted in the rich and diverse body of feminist work that has critiqued the multiple injustices, systemic and colonial violences, and toxic mistreatment of those racialized, gendered, and socially marked as marginalized (in diverse ways) in relation to gestation and birth. Freedom in relation to birth necessarily means freedom from these thick and entangled injustices. But I suggest that freedom also means more than this. It is this “more than” that I attempt to explore in the following inquiry. I emphasize that there are many faces of freedom and use Young’s metaphor of “the faces” (Reference Young1988) in order to signal that there cannot be a uniform or singular account of what feminist freedom in relation to birth means. There are, instead, several distinctive threads or strands that together might weave the conditions for the making of a common world (Arendt Reference Arendt1958) in which birth could unfold as an experience of freedom. I see the five faces outlined here all as necessary conditions for the realization of birthing freedom. They are not separate; each face is equally necessary to the broader struggle. I do not claim that these faces are exhaustive or final. There are, inevitably, faces or threads that are missing from this account. I think and imagine from a limited location: I am white, middle-class, and have never given birth. I offer this inquiry as a tentative beginning, with the hope that others will continue this imaginative experiment with fresh lenses. As such, this offering is not a definitive mapping of what freedom means in relation to birth—there can (and should be) no such coherent and homogeneous feminist map. Part of the open hopefulness of an imaginative inquiry is that there is no map—there is only an open door into an unknowable future. To retain this openness, we must in fact resist the very activity of map-making itself: of trying to fix solid routes, chart clear lines and destinations, and mark and render knowable (finalize) pathways and futures that are necessarily excessive and uncontainable. Like the women in Miriam Toews’ (Reference Toews2018) novel, Women talking, “We don’t have a map” (62) but like them, we (as feminist dreamers of whatever shape or ilk) must nonetheless venture into the uncertainty of the future with hope, and armed with some idea of what we value and stand for, carrying with us imaginative threads, manifestos, and gatherings of dreams, that weave possibilities for the kind/s of worlds we want to make.
3.1 Notes on plurality
This imaginative inquiry is rooted in respect for what Arendt (Reference Arendt1958) defines as the human condition of plurality. For Arendt (Reference Arendt1958), the plurality of human persons refers to the paradoxical fact that we are simultaneously equal and distinct. We understand each other because we are equal beings (there is sameness) but we need language and speech because we are wholly distinctive and unique. Human persons are a “paradoxical plurality” (176)—“we are all the same, that is human, in such a way that nobody is ever the same as anyone who has ever lived, lives, or will live” (8). Respecting plurality in relation to questions of (feminist) freedom means that we must protect space for the expression of this human distinctiveness. This does not mean reducing freedom to the matter of individual choice. It means collectively imagining and creating feminist principles and/or values and, at the same time, insisting on holding imaginative space for the specificity of individual meaning-making. Drucilla Cornell’s (Reference Cornell1998) idea of the “imaginary domain” is extremely useful in this regard.
Cornell’s imaginary domain is simultaneously an ideal, a right, a psychic and subjective space, and a heuristic. It is the realm in which we make meaning, orient ourselves in relation to the world/others, and claim the right to name and interpret our sensory, embodied, sexual and reproductive experiences, and creatively construct ourselves as distinctive beings. The imaginary domain is particularly important for persons who have historically been constrained by forces of oppression, given that the forcible shrinking of this realm is central to destructive projects, authoritarian regimes, and oppressive relations. Cornell invokes the work of bell hooks to give substance to this idea and draws on hooks’ writings on claiming a space for selfhood in the context of “imposed personas” (8). This descriptor recalls Collins’ notion of “controlling images” (Reference Collins1990), the representational arm of the “matrix of domination” which reduces Black women to a series of disempowering and marginalizing tropes. For hooks, recovery from these constrictive symbolic cages is described as a process of inhabiting a location of remembrance, reinvention, and performance, in which the self claims the right to reinvent personas, and claim interpretive control of their own experiences and personhood. This is Cornell’s imaginative domain. Cornell (Reference Cornell1998) positions the right to this domain as a central aspect of feminist freedom. This right means that while we can and should develop laws and protections to address and combat gendered modes of discrimination, inequality, and social injustice, it is imperative that there be a prior recognition that women and other marginalized persons are free persons who have the right to define themselves, and imaginatively craft particular and distinctive ways of being, relating, living, and enacting their sexual, gendered, reproductive, and embodied selves. As such, respect for plurality, and the distinctiveness of the imaginary domain, is central to any effort to think through the contours of feminist freedoms. Respecting plurality also means that we refuse to privilege any singular definition or approach to freedom. As argued by Krause (Reference Krause2010), a feminist approach to freedom must be plural and embrace the idea that there are competing and multiple freedoms that are all worthy of struggle.
4. The many faces of birthing freedom
4.1 Freedom from oppression
The first face of feminist freedom in relation to birth is freedom from oppression. This raises the inevitable question: what exactly is oppression? Feminist theorists have used a range of images to think about the phenomenon of oppression — for example: the birdcage (Frye Reference Frye1983), the double-bind (Hirji Reference Hirji2021), the matrix (Collins Reference Collins1990), the five faces (Young Reference Young1988) and the ironing press (Frye Reference Frye1983), among others. These metaphors speak to the constricting effects of oppression—the ways it shrinks subjects, reduces options and possibilities, and restricts movement. Frye (Reference Frye1983) explains that the roots of the word “oppression” lie in the notion of “press”—to be pressed or subject to the action of pressing is to be flattened, forced to assume a particular shape, smoothed over, regulated, and constrained. To be oppressed is to be caught between forces that act upon you. However, the image of the double-bind signals that we can have room for choices and agency and still be oppressed; when we are in a double-bind our choices are narrowly prescribed and we are caught/limited, regardless of the choices we make. Collins (Reference Collins1990) uses the image of the matrix to call attention to the fact that oppression is not a singular or one-dimensional structure, but a complex ensemble in which multiple oppressive forces compound, combine, and coalesce.
One of the most evocative images used to theorize oppression is Marilyn Frye’s (Reference Frye1983) birdcage. The image of the cage calls attention to one of the most insidious aspects of oppression—namely, that it functions as a totality that is often invisible from certain angles or viewpoints. Oppression (like the cage) can only be seen or understood from a holistic or macroscopic perspective. If one looks at only one wire or section of the cage, then the cage as a whole becomes invisible. Furthermore, there is nothing about any one wire that explains why the occupant (the bird) is trapped. It is only in its totality that the cage (and oppression) can be grasped. According to Frye (Reference Frye1983, 3): “the bird is surrounded by a network of systematically related barriers, no one of which would be the least hindrance to its flight, but which, by their relations to each other, are as confining as the solid walls of a dungeon.” The birdcage imagery helps us to make sense of the difficulty we often have in recognizing oppression. It is easy to become distracted by particular injustices, or inequalities, or types of violence, and miss the larger phenomenon of oppression itself. For Frye (Reference Frye1983), oppression is a structure. While made up of microscopic wires or bars that weave, connect, and assemble into particular patterns and arrangements, oppression is a larger totality that cannot be reduced to any specific component or point of contact. The totality works to constrict, narrow, shrink, undermine, and prevent the full freedom of the oppressed subject. The question of freedom is thus intimately related to the phenomenon of oppression. While this might seem obvious, as we have already seen, questions of freedom have more typically been posed from the perspective of the individual self, rather than the group or collective. As such, freedom has typically been presented as centrally concerned with the individual’s right to freedom from outside interference (negative freedom) or as the right to a project of self-making (positive freedom). Neither of these approaches have anything to say about oppression. While the concept of oppression is contested and has also arguably gone out of fashion in some strands of theory (it can be seen as “totalizing”), scholars are largely agreed that oppression is a group-based phenomena (Young Reference Young1988; Frye Reference Frye1983; Cudd Reference Cudd2006). It is not individuals who are oppressed as individuals but as members of specific socially marginalized groups. Thinking freedom in relation to oppression therefore means recognizing that the individual is not always the best starting-point for questions of freedom.
Jennifer Einspahr (Reference Einspahr2010) makes this argument in her paper, “Structural freedom and structural domination: A feminist perspective.” While not using the language of “oppression” per se (preferring the term “domination”), Einspahr advances the idea of “structural freedom” as an important intervention against narrow renderings of freedom as negative liberty, rooted in the perspective of the individual self. The starting point for the question of freedom thus moves, in this rendering, from the individual to structures. Einspahr changes the question, and argues that freedom does not involve being free of all constraints (some are necessary, after all), but is an effect of positioning within structures. We can think of this in relation to Beauvoir’s (Reference Beauvoir1989) notion of the situation, which emphasizes that there is no decontextualized self but that as persons we are always situated and as such, are radically shaped, even interpenetrated, by historical, material, social, environmental, geopolitical, and ideological relations. At the same time, we are embodied subjects who can act, imagine, resist, think again, and refuse. It is our situation that shapes, enables, and/or constrains our possible freedoms. For Einspahr, unfreedom (or we might say oppression) is the product of being positioned in relations of domination characterized by unequal power relations, the undermining of epistemic agency and interpretive control, and narrowed, constricted, and reduced opportunities to pursue projects and move/act in the world.
What does this mean for birthing freedom? Furthermore, can we say that birth is the site of oppression? As mentioned earlier, the lexicon of oppression was a galvanizing concept for feminist scholars and sociologists of childbirth in the 1980s. The use of the concept was however relatively atheoretical and generally used to refer to the repressive, top-down, medical and patriarchal control of birth. Some writers of the time did explore interwoven systems and ideologies of domination, e.g. patriarchy, capitalism, obstetric medicine, and technocracy (Rothman Reference Rothman1982; Martin Reference Martin1987). Structures of racism and imperialism were largely ignored. Feminist philosophical work on oppression (e.g. Frye and Young) were not engaged or used to think about the specific dimensions of birthing oppression at this time. As such, there was little attempt to analyse birth oppression as a distinctive phenomenon; instead the concept was used to describe a taken-for-granted reality. As a result of a lack of theoretical grounding, conceptual nuance, and intersectional savvy, the concept of oppression fell out of favor in white feminist childbirth scholarship and Westernized birth politics in the 1990s. Studies showing that many women actively desired medicalized births and felt empowered by technology (e.g. Davis-Floyd Reference Davis-Floyd1992; Fox and Worts Reference Fox and Worts1999) also seemed to nullify any claim that women were “oppressed” by medicalized models of birth. Mired in frameworks which continued to be individual-centred, white feminists foregrounded questions of agency, choice, and control (Zadoroznyj Reference Zadoroznyj1999; Root and Browner Reference Root and Browner2001; Westfall and Benoit Reference Westfall and Benoit2004). Later, these explorations became more sophisticated, using Foucauldian theory to study “internalized technologies” of power and “modes of discipline” in relation to birth (e.g. Martin Reference Martin2003; Simonds Reference Simonds2002). The concept of oppression nonetheless continued to be out of favor and there was little attempt to conceptually engage with structures of birthing domination, or explore the specificity of birthing oppression. As such, in the context of some women’s empowerment, agency, and choice, the cage itself—the totality of birth oppression—became largely unthinkable and invisible in white feminist birth inquiries.
As a result of a radically different vantage point in which racism and the struggle for survival (rather than choice) has often dominated birth politics, Black women have a more complex relationship to questions of birth oppression, freedom, and justice. Indeed, rather than emphasizing “choice” and “control” in childbirth, Black feminist writers have drawn on “reproductive justice” (Ross Reference Ross2018) frameworks inspired by intersectional lenses and matrix thinking (Collins Reference Collins1990), and continued to center questions of justice as the central axis of birth politics (Oparah and Bonaparte Reference Oparah and Bonaparte2015). The racist roots of obstetric and gynaecological medicine (Schwartz Reference Schwartz2006; Verges Reference Verges2020; Owens Reference Owens2018) have also been exposed and critiqued. Positioned differently in relation to obstetric medicine and healthcare, and more likely to experience poorer outcomes, discrimination, and inadequate care, Black feminists have maintained a stronger focus on structures of birthing oppression, including racism, socioeconomic disparities, and the destructive effect of capitalist profit-motives on birth (Oparah and Bonaparte Reference Oparah and Bonaparte2015). Questions of reproductive freedom are also foundational to the reproductive justice approach which frames such freedom as underpinned by practices of equality, access, safety, non-discrimination, and socioeconomic justice (Ross Reference Ross2017). In her writing on reproductive justice, Loretta Ross (Reference Ross2018) does not shy away from using the lexicon of “reproductive repression” (287) and “reproductive oppression” (288).
So what then is birthing and reproductive oppression and who is the target of such oppression? Is it women? And if it is “women”, how do we make sense of racialized and other differences that undermine any semblance of gendered homogeneity? My argument is that the group that is constrained, reduced, and impacted by reproductive and birthing oppression is not “women” in any coherent biological or social sense, but reproductive subjects more broadly (of course these two groups overlap but they are not necessarily the same). I suggest also that reproductive oppression is distinctive but also inextricably enmeshed with other modes of marginalization and exploitation. It is also historically foundational to patriarchal, racist, and colonial-capitalist relations of power. It is beyond the scope of this paper to outline these historical and threaded connections in detail (see Federici Reference Federici2004; Chadwick Reference Chadwick2021). Reproductive subjects (all those who have the capacity to gestate or who are positioned as such by sociomaterial relations) are a group on the basis of their potential relationship to procreative labor (pregnancy, birth, gestation). Their relationship to this work is not the same but is shaped, facilitated, and undone by/through other modes of oppression and privilege. Reproduction and birthing are not just biological or bodily processes but modes of labor that are essential to nationalist, capitalist, imperialist, and patriarchal projects of domination (Chadwick Reference Chadwick2022).
An understanding of birth oppression as a group-based phenomenon means that birthing persons are not oppressed as individuals but as reproductive subjects who are positioned (differentially) in relation to the totality (cage) of structural oppression. Some have more space to move, to act, to imagine, and exert control and epistemic agency. Others are multiply constrained by crisscrossing wires and compounding layers of injustice. This means that not all who give birth will have a negative experience or a “bad birth.” Many birthing subjects will not experience themselves as oppressed and can experience birth as a time of empowerment, satisfaction, and pleasure. The fact that some have good experiences does not cancel out the matter of wider group-based oppression. Feminist freedom in relation to birth means freedom from oppression. As feminist scholars, activists, and practitioners, the first step in moving forward is to acknowledge the existence of this multifaceted, and yet also strangely distinctive, oppression. I suggest that reproductive subjects need to be recognized as a group on the basis of their relationship (real, imagined, or constructed) to the capacity for gestational and birthing labor. There are those that have/have had/or will have the capacity (or the socially perceived capacity) to gestate and those who have/will not. This distinction has had profound consequences for the organization of human sociality, politics, and material life, but has been under-theorized and often rendered invisible. It is not hard to see why this distinction has been so heavily denied—one can only imagine the upheaval possible if a class of reproductive subjects recognized themselves as such and took collective action against a shared (if differentially experienced) oppression.
4.2 Freedom to labor
The second face of freedom in relation to birthing is freedom to labor. While the word “labor” has long been associated with childbirth (Williams Reference Williams1976), it is usually used in a narrow and medicalized sense to describe the physiological and supposedly involuntary actions of the uterus and/or the general suffering and travails of childbirth. Birthers are often described as “in labor”—meaning they are in the throes of a physiological laboring process rather than involved in an activity. When I write of the “freedom to labor” in relation to birth, I am departing from a different understanding of what labor means in this sphere. Drawing on the important work of Marxist feminist writers such as Mies (Reference Mies1986), Federici (Reference Federici2004), and Hartsock (Reference Hartsock1985), and more recent writing on gestational labor (Lewis Reference Lewis2019), I argue that birthing is a form of labor in the Marxist sense—that is: “practical human activity” (Marx Reference Marx1975, 327) that involves an interaction of consciousness with nature. Birth is not simply a biological or physiological event that happens to birthers, but a mode of genuine labor that involves negotiated thinking, reflection, plans, interaction, imagination, and struggle. Reflecting on her birth experience, diarist and writer Anaȉs Nin (Reference Nin1948, 99) writes:
I look at the doctor pacing up and down, or bending at the head which is barely showing. He looks baffled, as before a savage mystery, baffled by this struggle. He wants to interfere with his instruments, while I struggle with nature, with myself, with my child and with the meaning I put into it all, with my desire to give and to hold, to keep and to lose, to live and to die.
Like all labor, birthing labor involves wrestling with nature, the body, technology, and unpredictable more-than-human forces. Like all labor, birthing labor involves a conscious human person who makes meaning, who reflects, who thinks and imagines, and struggles to make sense of their situation. Like all labor, birthing labor is shaped by material conditions, technologies, and socioeconomic and political forms of life. According to Marx (Reference Marx1975), labor can be creative, affirming, satisfying (in terms of needs), and/or estranged, forced, degrading, and a source of repetitive and imprisoning drudgery. And so it is too with birthing labor. As underlined by feminist philosopher Virginia Held (Reference Held1993), birth is not “animal-like” (as suggested by the father of the “natural childbirth” movement, the obstetrician Grantly Dick-Read) but distinctively human—that is, a paradoxical interplay between consciousness and nature, mind and matter, activity and contingency, reflection and physiological forces. While the work of writers such as Mies (Reference Mies1986) and Hartsock (Reference Hartsock1985) is critically important for their efforts to foreground the idea that gestational labor is valuable, we must not fall into the trap of romanticizing such labors. Furthermore, while we must recognize that birth is a distinctive human activity and a form of genuine and valuable human labor, we must not prescribe what this labor should look like or how individuals negotiate, refuse, and/or give form to its meaning. I will expand on this theme in the section on the “freedom to imagine.” Nonetheless, I suggest that recognizing birthing as labor is a critical step in the movement towards birth freedom. The genuine social, legal, political, and medical recognition of birth as labor (in the Marxist sense) would have wide-ranging and profound implications for the organization of birthing care and the protection of birthers’ rights as genuine worker rights. A core ingredient of systematic birthing oppression has been the denial, erasure, and disappearance of birthing as genuine human labor. Mies (Reference Mies1986) describes this denial as foundational to patriarchy. I suggest that it is foundational to the oppression of an entire class of workers—i.e. reproductive subjects.
In order for birthing labor to be free, it must not be estranged. But what is estranged (or alienated) labor? According to Marx (Reference Marx1975), the alienation or estrangement of labor under capitalist relations refers to several things, namely: (1) the worker’s relationship to the products of labor are estranged, (2) the worker is estranged in the activity of laboring itself (i.e. the labor belongs to another), (3) labor is not voluntary but forced, and (4) in laboring, the worker is estranged from self (rather than affirmed or enlarged). We can see all of these facets of estrangement potentially at play in relation to birthing labor under (differential) conditions of patriarchal racial capitalism and obstetric medicine. For example, in relation to birth, labor is estranged when the relationship between the birthing person and the infant is framed as antagonistic, distinctly separate, and bound by masculinist and white imperialist boundaries of self versus other. Feminist writers have critiqued this kind of relational separation and have shown how such framings are weaponized in anti-abortion rhetoric and the criminalization of pregnancy and reproductive subjects more broadly (e.g. Markens et al. Reference Markens, Browner and Press1997; van der Waal and van Nistelrooji Reference Van der Waal and Inge Nistelrooji2022). Feminist scholars have also argued that pregnancy, birth, and gestation call for more complex understandings of human inter-subjectivity and emphasized that individualist conceptions of self are inadequate when trying to think about enmeshed gestational subjectivities (e.g. Young Reference Young1990; DiQuinzio Reference DiQuinzio1999; van der Waal and van Nistelrooji Reference Van der Waal and Inge Nistelrooji2022). Often these theorizations have centered on the significance of the embodied phenomenology of pregnancy/birth and have not posed questions about how the activity of laboring itself mediates the relation between birthing persons and the multiple others around and within them. The infant is not a self-made individual that arrives in the world as if by magic—the infant is also “labor embodied and made material in an object, it is the objectification of labor” (Marx Reference Marx1975, 324). At the same time, the infant is not just any kind of object—it is a living being. Furthermore, the gestating/birthing person also makes themselves in the act of laboring. Birthing labor thus involves a series of complex relations and negotiations. When these relations are denied and made to fit imposed imaginaries which posit antagonistic and fundamental separation, birthing becomes estranged. For a birthing person, being confronted with an image/construct of an infant that is an easily separable product or “outcome” is reductive and potentially at odds with the visceral and emotional complexities of birthing labor.
In birth, there is also often estrangement present in the act of laboring, given that it is framed by obstetric norms, and regarded—not as the activity of a sensual, feeling, experiencing, thinking human being—but as the mechanical operation of a uterus-machine that is managed by medical professionals. In the obstetric imaginary, labor is not a complex human activity but an involuntary process that has to be controlled, disciplined, and ordered according to outside timetables, parameters, and norms (Shabot Reference Shabot, Hengehold and Bauer2017; Chadwick Reference Chadwick2018). In this imaginary, birth labor is not seen as the activity of the birthing person but is redefined and appropriated as the work and creative achievement of the expert (Martin Reference Martin1987). In this process, birthing labor becomes radically objectified and is disaggregated from the embodied laboring person. At the same time, this person continues to labor. This labor is, however, in the Marxist sense, estranged because the labor belongs (in large part) to another (Marx Reference Marx1975). We know that the appropriation of reproductive and birthing labor by medical, patriarchal, and white supremacist capitalist-colonial machineries has been a historical process rooted in violence (Federici Reference Federici2004). The repercussions of this appropriation continues to play out every day in the birthing sphere, where the material conditions shaping birthing labor continue to be defined by relations of estrangement. Freedom in relation to birth is grounded in the freedom to labor authentically, as a means of affirming, negotiating, and realizing one’s ambiguous and embodied humanity, and distinctive aims, projects, and needs. For this to be possible, birthing labor needs to belong to the laboring person; the activity of labor needs to confirm and realize the self rather than be a tool of obliteration, reduction, and destruction (Marx Reference Marx1975).
Birth labor is also estranged when it is not voluntary but forced. For Marx (Reference Marx1975), forced labor is a “mortification” in which a human person becomes reduced to an animal-like status—that is, they are estranged from human species-being. For Marx, human species-being is characterized chiefly by “conscious life activity” (328); he writes: “free conscious activity constitutes the species-being of man” (328). In forced labor, persons are no longer engaged in conscious creative activity in dialogue with nature, but forced to submit and subscribe to outside demands, prescriptions, needs, targets, and definitions. The laboring person does not realize or affirm themselves in their labor or satisfy an intrinsic need, but nullifies self, and is reduced to their labor instead of being engaged in activity as a conscious, reflective, and imaginative being. I suggest that lying at the crux of reproductive and birthing unfreedom is the denial of reproductive and birthing activity as distinctively human labor—as “conscious life activity” (328) that is made meaningful, interpreted, and negotiated by an imaginative human person. Instead, the reproductive and birthing activities of women have been historically defined as animal-likeFootnote 2—that is: as supposedly unthinking and involuntary acts of nature. As a result, reproductive subjects are regarded as human and yet as also not quite human. Within this “not-quite-human” framework, reproductive rights do not fully make sense. If gestators are simply the sites of an unfolding natural process or animal-like function, why should they have rights of choice, control, or agency? Instead, it becomes possible to argue that they have a duty to submit to nature regardless of “choice” and that, in fact, this duty should not be distressing, troublesome, or alienating because (from this point of view) they are not engaged in human activity but simply fulfilling their animal-self. If we disrupt the framework, and insist that gestational and birthing labor are redefined and recognized as human labor, we are able to see that in all societies where women and reproductive persons do not have free and unobstructed access to both abortion-on-demand and safe, free, elective caesarean sections and other obstetric technologies, birthing labor is not free but is enacted within broader regimes of forced labor and is, as a result, fundamentally estranged.
As already argued, under present conditions birth is, across geopolitical contexts, predominantly organized, defined, and arranged according to social conditions of unfreedom (racial capitalism, white supremacy, medical misogyny, western imperialism, androcentrism). As a result, birthing labor is a site in which birthing subjects often do not feel their sense of self is affirmed, realized, or enlarged. Instead, many feel diminished, routinely estranged, confused, violated, and minimized (Crossley Reference Crossley2007). According to Marx, one of the hallmarks of estranged labor is a sense of estrangement from self. Instead of feeling confirmed in the activity of labor, the subject feels lesser, smaller, unsure, tremulous. According to Marx (Reference Marx1975, 326): “he (sic) therefore does not confirm himself in his work, but denies himself, feels miserable and not happy, does not develop free mental and physical energy, but mortifies himself, his flesh and ruins his mind.” It is not only a product, a thing, or an outcome that is created through the activity of labor; the laboring person also makes themselves (and relations with others/communities). Under oppressive conditions, birthing persons are not free to labor in ways which confirm their needs, desires, thoughts, histories, values, hopes, and relations. At this point, it could be protested that birth is a biological event and cannot ever be a guaranteed site of positive, affirming, and creative self-making; birth can involve death, complication, tragedy, pain, and injury. I have no disagreement with this. It is, in fact, the case that all forms of human activity are biological, unpredictable, and contingent—that is, dependent on outside forces of nature and the more-than-human world. This is part of the ambiguity of human labor—i.e. that it is both potentially free and yet always situated, also emplaced, and always undertaken under certain conditions (historical, biological, social) that are not freely chosen. Freedom in relation to birthing labor, as with all labor, will always be contingent on unpredictable forces. This does not minimize the importance of creating the conditions (as far as humanly possible) for birthing labor to be an activity that confirms, affirms, and satisfies the human need to create meaning and negotiate their place in the world.
4.3 Freedom to be-in-relation
The third face of feminist birth freedom is the freedom to be-in-relation. Here the starting point for the question of freedom shifts away from the structural and the individual and moves to the intersubjective realm. This dimension of birthing freedom recognizes that freedom is not a prize that can be gained via individual endeavor; instead, it is, as Williams (Reference Williams2019) writes, an inter-relational achievement. Williams (Reference Williams2019, 500) asks: “What if freedom is the development of interdependence, not independence?” and offers us what she describes as a third way that is distinctive from both negative and positive freedom. She names this third way: “freedom-with” or co-liberation. This approach to freedom recognizes that our experiences of freedom are, “co-created, co-affirmed, co-nourished and co-sustained by networks of interdependent care” (500). However, rather than being a “third way”, it might be more helpful for our purposes to think about “freedom-with” as intimately and paradoxically intertwined with positive freedom. Beauvoir’s (Reference Beauvoir1948) writing on freedom and ambiguity is instructive here.
While some claim that Beauvoir’s approach to freedom is limited by the dominant role it gives to activity (Shabot Reference Shabot2016), I regard her conceptualization of freedom as thick and nuanced, and dripping with productive contradictions. In The ethics of ambiguity (Beauvoir Reference Beauvoir1948, 3), she deftly traces an approach that recognizes the paradoxes of freedom for the “tragic ambiguity” that is the human subject. In Beauvoir’s (Reference Beauvoir1989) philosophy, the subject is a becoming that achieves transcendence in the active and creative pursuits of projects. Freedom is forged by movement, venturing forth, and putting oneself in the world: “freedom realizes itself only by engaging itself in the world” (Beauvoir Reference Beauvoir1948, 74). At the same time, Beauvoir’s approach is steeped in the recognition that the human person is both sovereign and unique and “an object for others” (3); human beings are imaginative and agentic, and at the same time, are always subject to outside forces and the constrictions of situation—this is our “fundamental ambiguity” (5). Freedom emerges in this ambiguous space; as such it is always contingent and in relation with others. Beauvoir underlines our absolute dependence upon one another—“each one depends on others” (78). As a result, our freedom is only ever possible if others are also free. She writes: “to be free is not to be able to have the power to do anything you like; it is to be able to surpass the given toward an open future; the existence of others as a freedom defines my situation and is even the condition of my own freedom” (86).
This complex, dense, and brilliantly paradoxical account of freedom enables us to grasp that freedom involves both creative activity, and an enmeshed and vulnerable dependence on others (and their freedoms). We are distinct, we each have particular aims, imaginings, values, needs, and desires, and yet we are inevitably intertwined with others. This ambiguous account of freedom enables us to grasp that freedom, in relation to birth, means both space to claim the right to labor and act (or refuse these activities) in ways that are affirming and meaningful, and is cognizant that birthing is always contingent, in relation, and collaborative. We cannot realize and affirm our projects, values, imaginative endeavors, or activities, without the support and recognition of others. And so too it is with birth. Birthing as an act of freedom cannot materialize without supportive others who facilitate and recognize us. As Shabot (Reference Shabot2021) writes: “We birth with others.” Freedom in relation to birth thus depends on relations with others, and on the freedom of the others who care for us (e.g. birth workers, midwives, significant others, healthcare professionals).
It is thus not surprising that women often emphasize affirming relations with others as key to their experiences of birth (Chadwick Reference Chadwick2019; Lyerly Reference Lyerly2006). In my conversations with birthing women (Chadwick 2019), “good births” were at times described, not as individual achievements or acts of lone heroism, but as an indistinguishable intermesh of grunting and groaning bodies-without-boundaries that collectively birthed together. Birth is always a singular act and yet it is also always relational. Even if one chooses to birth alone (i.e. freebirth) there is always an other involved (e.g. the unborn). Birth is one of the most fundamentally social of all human acts. For birth to become realized as an experience of freedom, the critical importance of relationality must be recognized and respected in obstetric care. It is only by being-in-relation to others that birthing persons can realize and affirm birthing freedom through the labor of birth. The isolation of birthing persons from significant others during birth (common in some contexts—e.g. South Africa) is a form of unfreedom that denies birthers the ability to affirm themselves in relation to others. The recognition that birth is always a distinctive act of human labor and a collaborative endeavor rooted in the freedom of caregivers and significant others, enables us to grasp the fact that the struggle for birthing freedom involves the freedom of all who take part in birth (whether they are birth workers, midwives, partners, or healthcare workers). Birth will never be an experience of freedom as long as those who care for birth are unfree, devalued, oppressed, and/or exploited in their own labors. Birth is also made unfree (it is degraded and mortified) by the unjust workplace conditions in which many birth workers toil.
4.4 Freedom from violence
The fourth face of freedom in relation to birth is freedom from violence. As noted above, birth is fundamentally a social and relational act. Sometimes these relations become violent, destroying the bodily emotional freedom of the birthing person, any possibility of the affirmation of their distinctive projects, and exploiting their vulnerability and dependence on others in/through destructive exchanges or a relational milieu that degrades, shames, threatens, and ruptures self/body. There is, by now, an extensive body of literature across disciplines that has documented the potent and persistent problem of birth and obstetric violence across transnational terrains (Shabot Reference Shabot2015; Pickles Reference Pickles2016; Chadwick Reference Chadwick2017; van der Waal and van Nistelrooji Reference Van der Waal and Inge Nistelrooji2022; Mayra et al. Reference Mayra, Sandall, Matthews and Padmadas2022). There is however little agreement regarding how to define obstetric violence. While birth violence has been widely recognized as gendered and/or intersectional in nature, an array of different theories of violence have been used to explain the phenomena, e.g. structural violence, symbolic violence, epistemic violence, obstetric racism, and metaphysical violence. Scholars and feminist researchers working on obstetric violence have consistently refused definitions which reduce violence to an interpersonal event between an individual perpetrator and victim (Chadwick Reference Chadwick2023) and, in line with feminist tendencies more broadly, have embraced so-called “elastic” conceptions of violence (Mardon and Richardson-Self Reference Mardon and Richardson-Self2022). While this has several advantages (e.g. in allowing long unrecognized forms of abuse to be named as violence), it also has limitations.
I suggest that it is important, if we want to fully understand what freedom means in relation to birth, to think with more specificity about the possible distinctions between violence and oppression. This is very difficult, not least because violence and oppression are closely entwined. According to Cudd (Reference Cudd2006), violence is a material force of oppression—it is through violence or the threat of violence that conditions of oppression are reproduced and maintained. Despite this close relationship, Cudd theorizes them as distinctive categories of harm that require different analyses, actions, and strategies of resistance. This has advantages, not least in reducing the risk that in our haste to name all birthing injustices as (some or other) variant of violence, we generate conceptual confusion (see Pickles Reference Pickles2023) and open the door for critics to dismiss the idea of obstetric violence wholesale (e.g. Lappeman and Swartz Reference Lappeman and Swartz2021). Providing a fine-tuned exploration of the distinctions between obstetric violence and oppression is unfortunately beyond the scope of this essay. In this effort to unravel the dimensions of what birthing freedom might mean, I operate with the assumption that the two phenomena are distinct and yet, at times, enmeshed and indistinguishable. Oppression works predominantly via constriction while violence destroys. At the same time, these modalities are not mutually exclusive, but are often co-extensive and/or compounding. The repetitive constriction of oppression can destroy and violence or the threat of violence most surely constricts agency and freedom. Obstetric violence (and the threat thereof) acts as a force that constrains, shapes, and restricts birthing freedom; it is a central element of the structural cage of birthing oppression. Violence however does not materialize in all birth and obstetric encounters; there are many “good births,” and affirming and supportive healthcare interactions. Oppression, on the other hand, is the cage itself—it affects the group (reproductive and birthing subjects) as a whole by structuring possibilities, agencies, available interpretive domains, intersubjective relations, and the material conditions of birthing. Systemic violence of any kind that targets a group (e.g. racist violence, gendered violence, homophobic violence, obstetric violence) is indicative of widespread oppression. Needless to say, freedom from the (often in-tandem forces) of both oppression and violence is a condition of birthing freedom.
4.5 Freedom to imagine
The fifth face of feminist freedom in relation to birth is freedom to imagine. As outlined earlier, this essay is an imaginative inquiry that is grounded in respect for plurality. This means that while birth freedom is framed as indisputably a matter of freedom from oppressive constraints, destructive violence, and the minimization, devaluing, and denial of birthing labor as human activity, it is also critical to recognize the right to claim birth (and gestation more broadly), as a distinct site of subjective meaning. To this end, I invoke Cornell’s (Reference Cornell1998) idea of the “imaginary domain” as a site of freedom. According to Cornell, the protection of each person’s right to a specific and unique imaginary domain lies at the very core of feminist projects of freedom. The imaginary domain is, according to Cornell, a psychic, interlocutory, and moral space in which we are able to orient, create, and claim ourselves as distinctive sexual and reproductive beings, craft meaning (about our situation, history, relationships, desires, needs, values), affirm our purpose and goals, and make plans and projects. The imaginative domain (a space of play, creation, imagination, and meaning) is not a luxury but an essential right of human personhood (Cornell Reference Cornell1998). Because each person’s imaginative domain is distinct, there can be no regulatory ideals that prescribe what sexuality, gender, familial, or reproductive life should look like. Each person must have the space and the right to construct their own conceptions of what a good life or a good birth might look like. At the same time, Cornell notes that we must refrain from imposing our idea of what is good onto others (the good must not become confused with the right). In relation to birthing freedom, this is crucial.
Birth has long been a site of intensive idealization, moral policing, and the ruthless imposition of regulatory norms in which notions of “natural childbirth,” “pleasure,” “selflessness,” “being a real woman,” “good mothers,” and the “maternal instinct” have all worked to set constraining parameters that limit the ways women/birthers can create, refuse, and/or give shape to the distinctiveness of their reproductive lives (Vissing Reference Vissing2017). These narrow prescriptions of what is right, acceptable, and natural, support and consolidate legal and political efforts to restrict and deny reproductive freedom (in particular the right to refuse pregnancy and birth). For feminist birthing freedom to be realized, it is crucial that reproductive and birthing subjects be recognized as persons with the right to claim the interpretive and imaginary space to define their own situation and to claim (and refuse) their bodies, sexuality, gender, and reproductive capacity, in specific and particular ways. As such, it is not only the freedom to labor that must be recognized and protected as a core condition of birthing freedom; the freedom to refuse gestational and birthing labor, either through abortion, the decision not to become pregnant, surrogacy, and/or an elective caesarean section, must also be recognized as core ingredients of birth freedom. Any effort to enforce pregnancy, gestation, and/or birthing labor on a person must be recognized for what it is: a form of forced labor and a serious infringement of human rights and personal freedom. Furthermore, depending on a person’s distinctive situation, projects, and sense of self, any kind of forced birthing modality—whether it be vaginal birth, caesarean section, and/or instrumental delivery—is a violation of their right to the realization and affirmation of the imaginary domain. Any refusal of birthing labor via demands for elective caesarean section should be affirmed, respected, and enabled, regardless of medical indicators, external opinions, or socioeconomic concerns. For birth to be truly free, obstetric and medical technology and expertise would be in the service of women and birthing person’s needs, values, and projects. There can be no feminist birthing freedom without free and unrestricted abortion on demand. Similarly, there can be no birthing freedom without free refusal of birthing labor and full access to all available obstetric technology. I suggest that for feminist birthing freedom to be fully realized, obstetric technology should be transferred into the control of reproductive subjects themselves.
5. Conclusion
This has been an imaginative inquiry centered around the question of what freedom in relation to birth would look like in a feminist world. While birth has been extensively explored, analyzed, and written about by feminist scholars and researchers, the question of freedom has not often been directly posed in relation to childbirth. In this essay, I engaged a diverse array of feminist theories of freedom to trace five faces of birthing freedom, namely: (1) freedom from oppression, (2) freedom to labor, (3) freedom to be-in-relation, (4) freedom from violence, and (5) freedom to imagine. The approach to birthing freedom that I have outlined here is grounded in respect for plurality and rejects the idea that there can ever be a singular vision of what freedom in relation to birthing means. Instead, inspired by the work of Hannah Arendt (Reference Arendt1958) and Susan Krause (Reference Krause2010), my approach insists on the recognition of human plurality, distinctiveness, and the importance of struggling against any singular conception of birth freedom. The five faces of birth freedom that I have outlined here are thus only provisional and are grounded in my specific standpoint—a white, middle-class, cisgendered, and feminized migrant from the South living in the North, who has never been pregnant or given birth. My approach is not meant to be exhaustive, firm, or final, but hopes instead to invite further developments, conversations, and interpretations. This has been an imaginative inquiry: the door is open.
Rachelle Chadwick is Senior Lecturer in Gender-based Violence at the University of Bristol. She has written widely on birth politics, obstetric violence, and the feminist politics of knowledge production. She is co-editor of the Journal of Gender-based Violence and an editorial board member of Feminist Theory, Feminism and Psychology, and Methods in Psychology. She has a PhD from the University of Cape Town.
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