Wednesday, November 10, 2010


Well, I got into BUSPH. Hurrah! This won't really change anything - I'll still keep working and taking one course per semester. On the other hand, I'll have an advisor, and can hopefully start being more integrated into the various SPH communities - I'm especially hoping to meet lots of other MCH students and find some relevant volunteer opportunities now that I'm legit and whatnot.

I would like to post my statement of purpose, because I was pretty happy with it and it came out kind of like a credo. But I'm not sure if that's dumb (e.g. someone could steal it and use it? Is that a realistic worry?) I thought about putting in a bunch of fake typos or something, but that seems silly and annoying to read. You know what, to heck with it.

Here she be:
I hope to improve women's experiences of childbirth by reorienting it as a woman-centered, life course event. In the United States and many other countries, childbirth, infant feeding, and other perinatal events are conceived as medical occurrences. I believe that this approach, while not intrinsically detrimental, is more a reflection of medical risk culture than of objective physical fact. An institutionalized treatment of birth fails to acknowledge the breadth of women's experiences, subjecting individuals to standardized treatment that not only impinges on their reproductive choices, but may also result in suboptimal health outcomes, broadly defined. I am concerned in particular with such issues as high rates of surgical delivery and induction, indiscriminate use of epidural anesthesia and electronic fetal monitoring, restrictive hospital protocols during labor, and lack of access to midwifery care, doula support, and non-pharmaceutical forms of pain relief.

My motivation in addressing these issues is not a denial that birth can be dangerous or that medical advances have saved the lives of countless mothers and babies; nor is it a plea for women to embrace "natural childbirth," or a claim that they are unprepared before birth or dissatisfied afterward. Instead, I am concerned that unchecked progress along the current trajectory will not only fail to improve maternal and child health, but also result in widening racial disparities in birth outcomes, growing threats to women's reproductive rights in birth, and the exportation of questionable American birth practices to communities whose indigenous birth systems are perceived as inadequate.

Why I am interested in childbirth is not apparent from my professional or academic history. I majored in linguistics, focusing on the most theoretical subareas I could find. After realizing I did not want to spend my career in academia, I withdrew from a linguistics PhD program and changed directions, looking for something less abstract and more practical. When a friend sent me a woman's blog post about giving birth to her son in a tub in her NYC apartment, I was shocked to realize that I knew nothing about the choices women have and make about birth. I started collecting stories from my mother and grandmothers and exhausted the popular media on the topic. After writing a research paper for [redacted] on a related issue, I began reading full-length scholarly works on childbirth and participating in online communities of midwives, doulas, mothers, and childbirth activists. My interests have expanded to include infant feeding practices, overall perinatal health, and prenatal care.

I love the dialogue surrounding childbirth (and associated issues) for the range of interested parties it attracts: obstetricians, midwives, and other birth workers, social justice and reproductive health activists and practitioners, anthropologists, sociologists, historians, gender and policy scholars, and of course public health professionals. This interdisciplinary appeal reflects both the complex nature of birth and its status as a societal repository of many, sometimes contradictory, meanings.

Of all these approaches, I believe public health is uniquely positioned to shape birth practices and beliefs effectively and competently. First, public health can speak authoritatively to the medical communities that currently control birth practices and policies. Childbirth practices in a medical setting are often guided by risk-centered medico-legal concerns and entrenched protocols. Public health can provide both the epidemiological data to inform these policies from a population standpoint, as well as the social and behavioral tools to aid birth workers (and women) in better understanding the implications of standard practices, giving truer meaning to informed consent and informed rejection.

Second, public health as practiced at Boston University acknowledges the multiplicity of human concerns that interact with medical health. Many authors have documented that giving birth is more than a medical procedure: it is a life course event that has spiritual, relational, sexual, cultural, social, and emotional ramifications. Rather than setting these aspects aside as ancillary, good public health work exploits them to inform a more complete, realistic approach.

In applying to the Maternal and Child Heath concentration, I hope to gain multiple public health tools, from epidemiology to program management skills, with which to address the particular MCH issues that motivate me. The many faculty members working on childbirth outcomes, birth-related disparities, and feeding practices come from diverse disciplines; the School of Public Health's past involvement with midwifery education also distinguishes it. Moreover, the BUSPH commitment to effective research, imaginative practice, and integrated service aligns with the kind of multifaceted work I aim to do in childbirth. Finally, as a Boston resident, I value the connections SPH forges with local health and wellness organizations and the chance to coordinate with these communities at the practicum stage. My experiences with SPH courses and people over the past few semesters make me eager to join this community of scholar-practitioners and create positive change for childbearing women.
Dirty secret - the link from a friend story is slightly apocryphal. In the interest of full disclosure, however, a friend did link me to a woman's blog, for non-birth-related reasons, whose homebirths were among the earlier things piquing my interest in the topic. It's here (thanks Leigh!).

1 comment:

  1. Awesome! My grad statement of purpose was similar to this, as I too wish "to acknowledge the breadth of women's experiences" in birth, through my study of MCH and also applied anthropology, for exactly as you state, "it is a life course event that has spiritual, relational, sexual, cultural, social, and emotional ramifications."

    Best of luck! :)