Ep 1 - Nebraska
Season one of Fifty Feminist States is here! In this episode, the feminist road trip begins in Nebraska, where Amelia talks to Coop, Amber and Alex about doulas, birth work, and home births in the state ranked 49th for reproductive rights.
In this episode, we talk about Nebraska’s problematic history with reproductive rights, different conceptions of doulas and birthwork, and the many influences that impact hospital and home births.We also learn about Amelia’s family’s history in Nebraska and what it’s like to be in the nascent stages of organizing.
What is a doula? [5:55 - 7:30]
What is birthwork? [7:30 - 9:15]
Hospital and home births in Nebraska [10:10 - 14:45]
[music plays in background]
Amelia: This is Fifty Feminist States a roadtripping, storytelling podcast visiting all fifty US states to interview feminist activists and artists about their work for gender justice.I’m Amelia Hruby, and this week we’re in Nebraska.
Alex: It is illegal to have an assisted home birth in Nebraska. I know that birth happens and there's no criminalization of people that are birthing children should it happen at home. But if a certified midwife is to attend that, it is considered illegal. And there are ... there's a history of prosecution and persecution of said people that are attending these birds.
Amelia: When you’re going about a project involving all fifty US states, Nebraska isn’t an obvious starting point by any measure. But for me and my family, the United States really begins in Nebraska. As far as we know, my great-grandparents on both sides of the family came to Nebraska from Europe when they immigrated to the US in the late 19th century. At that point, the land they settled on in what is now central Nebraska was still being treatied and stolen from the Pawnee nation. I don’t know the exact timeline of events, but my family likely started their farms on land taken from the Pawnee people in 1857, perhaps only a few decades after the Pawnee reservation was dissolved for the sake of white settlers. I start this podcast about the state of feminism in the fifty US states with an acknowledgement of this colonial history, because it cannot be avoided that the history and the present of the United States is a colonial one. Each of the fifty states that now make up the United States were populated by diverse peoples with their own languages, cultures, and technologies that were often eradicated by the US government to form the states we’re now familiar with. The US is also still in the business of colonial occupation, maintaining the territories of Puerto Rico, Guam, American Samoa, Northern Mariana Islands and the U.S. Virgin Islands. All of this is to say that any project that attempts to explore the United States by state has to acknowledge that state boundaries were formed contentiously and most often violently.To get back to Nebraska -- in Nebraska today, there are still five reservations that serve as homes to the Santee Sioux, Omaha, Ponca, Sac and Fox, and Winnebago tribes. According the the US Census Bureau, their peoples make up an estimated 1.5% of the Nebraska population, which is otherwise 79% white.When you ask people what they think of when they think about Nebraska -- regardless of whether or not their from this state -- you probably get one of two answers: corn or cornhuskers. Nebraska is the third-highest corn producing state in the US after Iowa and Illinois, but I’ve always thought it’s the Cornhuskers, the state football team, that gets people to connect Nebraska and corn. Football is a big deal in Nebraska -- and that may be vast understatement. The Nebraska Cornhuskers have the fourth-most victories in NCAA Division one football, and on game-days, Memorial Stadium, where the Huskers play, has the third-highest population of any city in Nebraska. Holding 90,000 people, it beats out the normal third-place city Bellevue by 40,000 folks. This is what Nebraska tends to be known for on a national scale. But I’m not here to talk about football. In terms of feminism, Nebraska, like many of the states in this season, isn’t making headlines for its feminist politics, at least not in any positive way.In fact, in 2015 the Institute for Women’s Policy Research ranked Nebraska second-to-last among US states for reproductive rights which they define as “having the ability to decide whether and when to have children.”I think this ranking goes back to the fact that in 2010 Nebraska was the first state to implement a 20-week abortion ban, a move that was then replicated by 21 states a few of which have put in place an 18-week abortion ban. More recently in Nebraska, this year the governor of Nebraska, Pete Ricketts, added a proposal to the Nebraska budget to take Title X federal funding for family planning from clinics in the state that offer or refer abortion services. The budget that was eventually signed into law ended up eliminating federal funding for Planned Parenthood in Nebraska and required extensive negotiation in the Legislature in order not to cut funding for all clinics providing Title X reproductive health care. In the end, Ricketts argued, and this quote was splashed all over articles I found about these events, "Nebraska is a pro-life state, and the state's budget should reflect those values." To understand more about the state of reproductive rights and justice in Nebraska, I spoke to three feminists who are working on birthing rights and doula programming in the state: Coop, Amber, and Alex.Coop is a community organizer from Minneapolis with a background in youth work and sexual and reproductive health. They’re now living in Lincoln studying to be a medical assistant. Amber is a birthworker who’s spent most of their life in Nebraska and is building a career as a doula, attending births, doing placenta encapsulation and developing childbirth resources. And Alex is an herbalist who grew up in Lincoln, went away for a number of years, and has returned to continue her work in herbalism and raise her young child.I connected with this group because Coop had put up a flyer about doula services at a local coffee shop. So I thought we’d begin by talking about what a doula is. This is Coop.
Coop: I've been trying to come up with like a new elevator speech to talk about what a Doula is because often people are just like well like the Greek term translates to like woman's servant and for me it's just like a historically, doulas have been namely assists women supporting other cis women through pregnancy and labor. And now more recently as Doulas have really caught on, that's meant like white cis women of privilege supporting other white cis women of privilege through pregnancy and labor, and full spectrum came to be a recognition that this other phrase that's been bounced around of like womb continuum, that pregnancy is something that can happen to an individual, but things happen before and things happen after. And that's, you need support before and after. And so then it became, how do we talk about contraception, how do we talk about family planning, and how do we talk about like postpartum, and then it became miscarriage. And it wasn't until lately that abortion got thrown into that as if someone chooses to become pregnant or they don't, like here's another option presented just as it would be presented to talk about adoption or IVF or surrogacy or any number of things. And now what I really appreciate is that the full spectrum doula continuum is now including death and dying and it's including in should be, um, it's being led by POC and indigenous folks of bringing back what is and always has been, um, the fact that, what a Doula is conceptually is just how communities should be caring for one another and how communities have cared for each other for centuries.Amelia: Here’s Amber chiming in about her sense of birthwork.
Amber: This is something that I have been a recently like unlearning myself and really expanding on in. I guess, at one point when I started doing this work, I would describe birth work as like supporting women through the birth process. And I think now that it is, uh, it's, it's so much more expansive than that. It really just comes down to people getting the experiences that they want and having access and choice.
Coop: Yeah, and so when I decided that I wanted to do full spectrum doula work as someone who now identifies as gender fluid and has done a physical transition and works with gender and a number of ways, um, birth work for me is how are we supporting people whose bodies are able to become pregnant. But also how are we supporting our communities and providing care. Because birth for me is a newness. I keep thinking about it over and over, and I think that birth work can be more than how are we just supporting pregnant people or how are we just supporting people who want to become pregnant or who don't want to become pregnant. For me, that means so many people's abilities and perspectives and options and choices and so it's more of like, how can I support my community? For me, that's what birth work is. It's how do we create intergenerational communities that see people where they're at.
Amelia: When Amber and Coop talk here about access, choice, and creating the communities they want to see, a lot of that has to do with the fact that those spaces are not available in Nebraska or accessible to all populations. Amber shared a bit more about this.
Amber: Working as a Doula in Nebraska, I was really noticing through working for this agency of birth workers is that there 100% was this demographic of like wealthy white woman. And I was told things like “Doula care is a luxury, you know, it's something that not everyone needs.” And that’s something that I don't believe at all. And I wanted to add religion too. And something that I noticed that I was, I was pretty surprised getting into this work in Nebraska is that my experience has been birth work and Doula work has been so ingrained in religion too. In like religion shaping almost who accesses like the Doula work in birth work and like also like the politics like surrounding it too. And even like the politics around working with midwives and birth centers. Um, I mean it is like, it's just, yeah, it's like really ingrained in religion, and that’s important too.
Amelia: What’s important to understand here is that home births are illegal in Nebraska. So the type of birth someone has is determined by the institutional spaces available for giving birth. And in Nebraska the hospital landscape has a strong Catholic influence. According to the ACLU, 40% of hospital beds in the state are in Catholic facilities. There’s been a lot of publicity in Nebraska about the new birth center that, while in a hospital, is run by certified nurse midwives and provides more natural options to people giving birth. However, that facility is still located in a Catholic Health Initiatives or CHI hospital. Amber explains more of this here, and then Alex shares her experience.
Amber: In Nebraska there's only, currently there's just one birth center. So the options are to birth at the birth center, which is in Lincoln, which is still under the insurance umbrella of CHI health or, um, Saint Elizabeth's hospital. And then hospital births. And then there's two: there's a methodist women's hospital in Omaha, which is their specialty is birth. And then St Elizabeth also in Lincoln. They have like a labor and delivery unit that is pretty close to a birth center, I would say. And they're Catholic, and that's the thing -- they're the most popular place to, to, to birth. And so yeah, it does, it comes back to that, you know, it's inundated with religion.
Alex: speaking back to the idea of home birth, specifically. It is illegal to have an assisted home birth in Nebraska. I know that birth happens and there's no criminalization of people that are birthing children should it happen at home. But if a certified midwife is to attend that, it is considered illegal. And there's a history of prosecution and persecution have said people that are attending these births. And so knowing that, in my choice, I've lived in a number of places outside of, um, outside of growing up and leaving Nebraska when I was a teenager, but most recently before coming back and putting roots down here was in Colorado. And the decision was just not a question to me in terms of should I add another level of stress and illegality to what seems like just a very clear choice in how I want to bring life into this world. And, I was able to access someone who was working as a midwife that had a sliding scale that was accessible to me, but just to see models in that were just so matter of fact in somewhere that has a legal border across the state from Nebraska. And then to cross that. There's this whole illegality and taboo that goes with it. And then, just the idea of being on stolen land where the larger ideas of what's legal and illegal has always served people in power who have been property owning white men. And there's definitely a lot of need. There's abortion protestors almost daily at the one Planned Parenthood that's in Lincoln. The access is abysmal and , even for folks that can access Planned Parenthood in services, there are still many barriers. And it's it's not just Nebraska, but there's definitely, there's definitely a lot, a lot of barriers here.
Amelia: Alex’s candid story of choosing to travel across state lines to give birth here highlights the lack of choice that people giving birth have in Nebraska. And while Alex doesn’t get into it here, there are many reasons why people may choose to have home births. One of the most prominent ones may be the positive health outcomes for parent and child. A 2009 study of births in Canada found that the rate of perinatal death per 1000 births was 0.35 among people having planned home births while it was 0.64 among those attended by a physician. Additionally, the study found people having planned home-birth group were significantly less likely than those who planned a hospital birth to have obstetric interventions such as electronic fetal monitoring or adverse maternal outcomes such as a third- or fourth-degree perineal tear, or postpartum hemorrhage. Lastly the study also found that newborns in the home-birth group were less likely than those in the midwife-attended hospital-birth group to require resuscitation at birth or oxygen therapy beyond 24 hours. Findings like these are still pretty contested in the medical landscape of the US where 99% of births occur in hospitals. But I bring in statistics like these to say that people have very good medical reasons for choosing to have a home birth in addition to desires like those Alex expressed to have choice and body sovereignty in the birthing process. Now we’ll hear from Coop about their experience of gender and sexuality in Nebraska.
Coop: Since being here, for good and bad, it's really made me decide, how do I want to live on my politics? What are my boundaries around that? How far am I willing to push? I was met with almost immediate resistance, in part because I'm read as a masculine person, and what does it mean to be a masculine person in what is deemed like a feminine space? Especially when you're talking about birth, you're talking about abortion, a masculine presence is an uncomfortable one and that’s something I navigate personally and am very careful to walk around. And I also got a lot of pushback as someone who is trans. So like my body is able to become pregnant, and as someone who is a queer identified person and who wants to support that community. A lot of the feedback that I initially got was, “oh, you, you want to work with the gays,” um, and not, not understanding why language is important in this work. And I just got so angry and so frustrated so quickly, because it seemed no matter where I would go, people just, they weren't understanding what I was talking about and there was no willingness to continue that conversation. And a lot of feedback that I got was, “well maybe it's just not right here. Like maybe it just can't happen here. Like Nebraska is not ready. Maybe you need to go out to Seattle or Portland or the Bay Area and like get the work done that you want to get done. And then bring it back here.” And me being like, maybe then they’ll be ready and I think since meeting these two folks, I've been like, no, fuck that, you know, like I get really frustrated when people tell me like, “This is just Nebraska. Like this is Nebraska culture. You can't change Nebraska culture.” And for me, I'm like, what does that mean for people who choose to put down roots in Nebraska or, or who have or are here for any number of reasons. And to me that just doesn't seem right. So I decided, no, I want to push this despite the fact that it is constantly uncomfortable, and it's a lot of me expanding energy, uh, that I often don't feel that I have. Um, so that's both a negative and a positive, right? It's, it's me saying like, thank you Nebraska for a helping me, you know, get past my own comfort zone to be like, no, this work is really important. This has to happen. I want to have these conversations, these conversations are important here.
Amelia: One of the most exciting things for me about talking to Coop, Amber and Alex was their obvious passion for reproductive justice and the nascent stage of their organizing. In a state with a long and strong history of so-called “pro-life” advocacy, these folks are building the resources they see needs for and that they need themselves. Hear a bit more about their plans in their own words:
Alex:Where we're going seems really organic and timely in the sense that it's really necessary. And I think we're all in it for the long game. Meaning like we've found work that is necessary that resonates with all of us in our personal experiences and those in the immediate communities around us and that we're building it in the way that we want it to be. I'm personally also like wanting to do more listening to what people need in this community, but also trying to listen to the more marginalized voices because I think these are voices that had been surviving in situations and in the margins of the dominant way that things are, and that's, that's where, um, I think some of like the strongest skill set is, is that survival.
Coop: And so right now, uh, not having a clear direction feels great, because it's giving us so much time to learn from each other and to learn from other people and really decide and take time to figure out, okay, this is what this could look like here at, this is what needs to happen and how can we best serve our communities, plural.
Amelia: If you’re interested in learning more about the womb continuum and doulas, Coop, Amber and Alex highly suggested the work of Samantha Zipporah who offers courses and resources online that I’ll link to in the show notes. I’ve also found Miriam Zoila Perez’s blog and book The Radical Doula to be a wonderful, intersectional guide to birthwork. You can head to fiftyfeministstates.com to find links to those resources, as well as audio from this episode.As we wrap this first episode, I just want to say that the beginning of Fifty Feminist States is really about beginnings. The state of my family’s beginnings in the United States. The state of what it’s like to begin life in the state of Nebraska. And the state of what it means to begin organizing for reproductive justice. There’s a beginning there, too.Next episode we’ll travel one state west to Wyoming. Until then, I’ll see you on the road![music plays in background]Thanks for tuning in to this episode of Fifty Feminist States. You can follow Fifty Feminist States to stay updated on episodes and roadtrip happenings on Instagram at @fiftyfeministstates, that’s @f-i-f-t-y-feminist states.Our opening music is by Lobo Loco and this wonderfully sexist song that you’re listening to on our way out is a recording by Billy Murray from 1916.Special thanks go out to Coop, Alex, and Amber for meeting with me as well as to my family for providing more information on our history on Nebraska. I also have to thank the hundred or so Kickstarter backers who made funding this season possible.Until next time, wild ones! We’ll see you on the road.