In Conversation with a Midwife-to-be: More Babies and More Love and More Justice

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Kari Jonsson, sunshine distilled, finished up at NYU this spring and preparing to attend nursing school, pursuing her lifelong dream of midwifery, she sat down and let me pick her brain on female anatomy, birthing practices in the US, and what giving birth can mean—  if we’re willing to talk about it with candor and tenderness.

Anna

So, here's a funky one. What is your relationship with your uterus like?

Kari

Ooh, that's a good question. Yeah.

I remember school, my fifth-grade sex ed teacher being like, “you should use a pad.” Not even a tampon. And forget about masturbation. Bad Catholic school sex ed. I believed that if I had sex or did anything with anyone or put anything in there or did anything remotely touching it… that it would “be bad” or [my uterus] would “get sick”.

From an early age, I was introduced to my body parts in a very unique, religious way. And then, as I grew up, I realized the issue with that, and I now love my uterus so much. I just love it. I think it embodies my womanhood.

I recently got an IUD. And since not having my period and not having the cycle and the shedding of my lining, I just like miss the bleeding and the attention towards my vulva and all the different parts.

Anna

Can you explain the difference to me between being a midwife and a doula?

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Kari

So, a doula is a person that helps someone go from one state to another. You have been a doula at some point in your life. We all are doulas. We could argue that we're doulas every day for different people in different situations. But in this case, I trained as a birth doula, and I studied how to provide labor support to birthing people. Like nonmedicinal labor support.

And then a midwife is the person who actually is medically trained to catch the baby. They also provide a wide array of other health services. They can educate people; they can perform other reproductive health services.

Anna

And now you'll be focusing on midwifery?

Kari

Yeah. So, this semester I'll be volunteering on the L and D floor at New York Presbyterian and helping out there. So, I'll hopefully witness a birth.

Anna

Do you think people take midwifery seriously?

Kari

No. [laughs] Um, I was talking to a family member and, um, they were like, "oh, well, you're gonna wanna OB, right?" because even my family members don't trust really midwifery because, well, I think there are many reasons why people in the US don’t trust midwifery even though there are statistics saying that it only improves maternal health rates to have one in the delivery room. But a midwife isn't automatically assigned. Most people have an OB. So, from what I understand, the majority of births in the US are done by OBGYNs.

Anna

Wow.

Kari

About 10% of births are done by midwives.  And midwives are for people who are very, quote, "low risk," which, that term is kind of fraught with issues. Many factors go into that. Someone's age, someone's weight, someone's BMI. Historically, BMI is fraught with racism, and its patriarchal and just not an accurate representation of how bodies function.

And age. Everyone ages differently. So, if someone passes their birthday when they're 35 and they're deemed high risk, then it could mean that that person has to endure all these other interventions that are probably, or potentially, interventions that don't need to be had. Midwives can't perform C-sections. So, midwives are obviously less inclined to jump to “oh, we need surgical interference.”

And although those are extremely necessary, cesarean rates has really jumped up exponentially within the US in a way that is not reflective of any other reason except for the medicalization of birth.

Wait, can I make a little side note?

Anna

Please!

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Kari

So, an epidural is a pain-relieving treatment that essentially will cut off pain receptors, basically chest down. So, you won't have the same pain messages sent to your brain, and those pain receptors are important for dilation, for the labor to actually begin, and for you to actually deliver your baby. You need to dilate nine centimeters. And when you don’t dilate on your own, you’ll need to use Pitocin. So basically, once you begin treatment, you’ll likely have to do another one and then another one.

Anna

Oh my gosh.

Kari

I hope I'm making sense.

I feel like I'm, throwing tons of ideas at you. But this is an issue because birthing people are not given the education and the resources in terms of what their options are… that's an issue across all facets of reproductive health. From contraception to sex practices to birth practices.

Anna

How do you reconcile doing and believing in birth work with America's attitude toward reproductive health and the current reproductive justice landscape?

Kari

I firmly believe that a quote “good" birth can only happen if that person had the choice to have the child in the first place. I think that the anti-choice argument is riddled with contradictions. I mean, I think this gets into a larger conversation of the social determinants of health and how access to housing and food and education and clean air and climate change, how that all impacts health. Until those human rights are ensured, the conversation about limiting access to reproductive health can't even begin.

And even with that, I still believe that people should have the choice to be pregnant or not. I think that before even talking about birth, comprehensive abortion care services are essential to any conversation. The overturning of Roe V. Wade impacts all facets of women’s rights, trans rights, non-binary rights, human rights.

Anna

It all feels so heavy these days. Can birth be joyful?

Kari

Oh yes. I think I'm committed to becoming a midwife because it can be so joyful. I think it can be the most joyful thing life has to offer. But that's me bringing in my personal experience. And I have to acknowledge my privilege of having healthcare and the financial means to receive care and be taken seriously when I have a medical concern.

It's the most visible transition from one state to the next in life. We have so many transitions from one, like from graduating high school, from college to integrating into the workplace, falling in love with someone, or building a beautiful friendship. There is no way to put a timestamp on that. And I think birth is an explicit timestamp. You can just see… you changing into a new person and a new person entering the world, and that’s unlike any other experience that can happen to humans, you know?

Anna

I've heard it described in many different ways ranging from "selfish" to "a radical act of hope". What does bringing a child into this world today mean to you?

Kari

That's a good question. Should I take a second? I’m gonna take a second.

It's interesting because I, like, ever since I was little, little, little, I've always wanted to have children. Literally, that's it, loving my family and wanting to have kids. Those have been my two constants throughout my life. But I think the answers to that question are as unique as each person's lived experience.

Oh, it's just such a toughie.

Honestly, my want to have a family goes beyond reason. You know? It's a want that's like been in me forever. It's like my name.

It may take shape in many ways. I may adopt, I may carry kids.

Ugh. I don't even know how to answer this question.

I mean, I know I want more of what I have now, which is my strong love for my family. I just know that I want more of that. Because more is more. I just love love. And I love feeling loved and cared for by my sister and my cousins, and my friends. And I just think that… love can never be wrong, you know? You can never have too much of it.  For some people, expanding your love could be gardening or writing a play or working or running, or whatever, but making your life more love-filled. And for me, I feel like providing care to women and being a midwife, and also having children are like the two things that are gonna make me— Make me more love-filled.

Anna

Where do you think it, all this love, comes from? Is it biological, like the need to reproduce? Is it a higher power? Is it just its own force?

Kari

I have been rejected by a lot of like schools, and I went to four universities, so I don't know if that's a reflection of my not being able to settle. But I just have had this feeling of “everything's gonna pan out,” and the journey is gonna be windy, but then I'm gonna get to where I need to go.

I don't know. I grew up religious. I grew up Catholic. I wouldn't define myself as Catholic. I believe in love, and higher forces. Bigger forces pushing us to make decisions, to want certain things, or attract us to certain people, you know?

Anna

What a special thing to be able to unpack. This big giant force, birth, and birthing, which propels society and people and the world. Yet the actual event of birth kind of exists in the same taboo sphere as death. It's something we don't talk about, even though it's everything.

Kari

Like those are the things. Death, love, birth. Those are the things. And taxes. Yeah, taxes.

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