By Kristin J. Travis, C.D., M.A.
A cartoon condom. Last week, at its Annual Meeting, the American College of Obstetricians and Gynecologists (ACOG) chose to make light of the life-and-death situations many birthing individuals face by addressing this matter with contraceptive caricature. ACOG suggested that the primary way to fight America’s deplorable maternal death rates is to prevent pregnancy. ACOG marketed this asinine ideology in its flagship post to promote its new Instagram page. Instead of an apology, the ACOG proceeded to double down via Twitter and Facebook.
To place onus for preventing maternal death solely upon the pregnant individual is racist, sexist, and beyond insensitive. What adds insult to injury is that this is coming from ACOG - a research institution that is well aware that America has the highest maternal death rate of the developed world and that BLACK WOMEN are leading in that number being 243% more likely to die of childbirth and pregnancy related causes than their white counterparts. The implications here result in a clear and present danger for pregnant people: the ACOG makes recommendations that often medical institutions choose to incorporate into their processes and training, thus, we may very well see the healthcare industry respond accordingly. Because birthing individuals of color, immigrants, those who have less access to income as well as other marginalized groups often fall into higher risk categories for maternal death, it can reasonably be assumed that the medical response will be to target pregnancy prevention to these groups – which is modern day eugenics (read ethnic and social cleansing).
Beyond this, ACOG fails to properly address what pregnancy prevention does to maintain the health and well being of the already pregnant individual. Instead, what it offers is simply a lazy response to a complex, nuanced, and long-standing problem – ACOG could have suggested ways to tackle institutional racism and sexism, or it could have introduced ways to incorporate doulas into comprehensive care (doulas are proven to reduce birth related complications and maternal death rates), it could have discussed increasing postpartum care and making it more holistic, or it could have explored decreasing medical interventions such as Cesarean… this list could go on. ACOG most certainly was in the position to affect positive and impactful change, instead, it chose to fault pregnant people for their birth complications and deaths – whilst washing its hands of the responsibility to address any outside factors that are causing American birthing individuals to die at the highest rate of the developed world.
These statements are made with respect to the medical world. There are hard working obstetricians, gynecologists, and other medical care providers that seek solutions for pregnant and birthing individuals every day. Medical and technological advancements have made a great impact on the birth world and - when the situation necessitates it - these advancements can be life-saving. The medical and healthcare industry has been slighted by ACOG's recommendations in this instance, by not being given the opportunity to fully explore medical and technological solutions to the maternal death rate.
A cartoon condom. The birthing community is not here for the jokes or the games. Our clients and their communities deserve the very best. We are here to ask the tough questions, face the tough answers, and do the tough work. We are here for the safety and well being of our clients and all birthing individuals – ACOG, if you are not about THIS WORK, then step aside to make way for those who are.