Palestinian Occupation & the Medicalization of Birth: Limbs of the Same Beast
by Ash D.
As a midwife and childbirth educator, it is my tricky quest to inspire clients to trust their birthing bodies while educating them about the reality of threats during birth within the Western medical industrial complex.
Resisting these threats to our well being, however, requires perceiving the beast behind them: the very same imperial oppression that harms people globally.
No industry under imperialist capitalism, not even the healing industry, prioritizes human well being over profit.
This is precisely why we cannot expect Western imperialist nations to let go of its colonial grip on Palestine without a fight to its last breath. Nor should we expect them to support childbirth with the interest of birthing people and newborns in mind.
The US will fall before it will withdraw support from the Zionist European colony in Palestine because when Palestine is liberated, it will be a profoundly nuclear punch in the face of Western imperialism across the globe.
It’s been well over 100 years since the secularist Herzl proposed the idea of creating this religio-exclusionist settler colony in a strategic location.
He convinced the British elite that the colony would be an opportunity for Western powers to leverage massive economic and political influence upon the Arab world (and the whole world).
Today, the US is the primary beneficiary of this unfathomable economic power with the illegitimate state of Israel serving as a puppet.
The Impact of Imperialism on Culture and Traditions
Imperialism works on populations in many ways, but its tools involve violence and threat.
These come in part through:
foreign aid which undermines native economic sovereignty,
economic sanctions as punishment for a nation’s withdrawal from participation in the imperialist powers’ economic system,
and complex campaigns of propaganda which lead civilians toward behaviors that serve the economic power of the occupier.
Many tools of imperialism directly impact reproduction and family building.
For example, religious moral bans on abortion work to ensure population growth with the goal of a larger white presence in colonies and/or larger labor force among colonized and enslaved groups.
I recently read about the colonial impact on native practices of birth spacing (time between births) and lactation among Congolese birthers in the early 1900s.
European settlers to Congo used charity, missionary women, and mass distribution of artificial infant milk to “reeducate” the Congolese birthers on resuming sex and procreating more quickly after birthing each child so they could boost the labor force in the mines.
Bodyfeeding tends to inhibit fertility, so the white colonists discouraged the long term nursing that was typical among the Congolese. The distribution of baby formula had both the intent to boost infant survival as well as increase Congolese fertility and birth rates (since formula supplementation decreases bodymilk production).
Consequently, the settlers could ensure a more rapidly growing population of people to colonize and indenture.
In this dehumanization, shrouded as altruistic public health improvements, there was no consideration of the impact these practices had on the well being of Congolese families or cultural traditions.
Even now, despite the fact that gestational mortality rates are rapidly increasing in the US, the medicalization of birth in the last century works hand in hand with encouraging the proliferation of working Americans—though of course it has ensured this survivability increase would occur among whites at significantly higher rates than BIPOC since Black birthers are more than twice as likely to experience the death of a newborn compared to their white counterparts.
The medicalization of birth focuses on narrow short term physical results, usually ignoring longer term and social emotional impacts.
Medical tools have become routine procedures rather than applied when indicated, which causes them to become indicated more often than they would be otherwise.
In this way, “care” becomes consumptive, generic and rushed, rather than sustainable, individualized, inclusive and holistic. These are extractive, imperialist settler colonial values.
Interventions and Capitalism
In the US, about 90% of labors in hospitals monitor fetuses with continuous electronic fetal monitoring (CEFM), but the evidence overwhelmingly contradicts the routine use of CEFM in low risk birthers!
CEFM has such a high false positivity rate for detecting problems that it has significantly increased the C-section rate without decreasing the amount of neonatal deaths or cerebral palsy at all.
The absurd frequency with which non-evidence based CEFM is used regardless, is a trickle down effect of capitalism: it saves money for hospitals.
They are able to assign multiple patients to one nurse who can stay at the nurse’s station and watch several monitors simultaneously. The research backed intermittent auscultation (IA) method, on the other hand, generally requires a 1:1 nurse patient ratio because it is more time and labor intensive. Therefore, IA ultimately requires paying more staff, resulting in less financial efficiency for the hospital.
Capitalist imperialism is why, despite the evidence showing IA to be safer in low risk births, I don’t see this changing anytime soon.
Additionally, surgical births most likely generate higher revenue for hospitals, despite the increase in risks to patients for undergoing a surgery compared to a vaginal birth when the surgery was technically unnecessary.
One study in 2021 (Sakai-Bizmark, 2021) found that hospitals who profit more from Cesareans also have higher Cesarean rates, displaying the direct link between the supposed medical recommendation of these procedures and, well, profit.
Both the non-evidence based use of CEFM and the profitability of medical procedures under medical capitalism are factors that contribute to the 32% Cesarean rate in the US, which is about double what it should be!
Imperialist Powers and the Fight for Human and Land-Centered Ways of Life
The more I learn about how the US maintains its control over the globe, the more I become aware of how the gestational health crisis and many other social ills are simply reflections of imperial corruption on the local level.
All of these layers function in service of the same goal: that global powers maintain and increase their domination.
We can see these abysmally corrupt values of imperialism displayed in birth as well as within the occupation of Palestinian land and people, because these systems are limbs of the same corrupt beast.
We, the humans of the globe, are fighting for an ideology that centers human and land well being in Palestine (rather than abusive power-driven ideology).
The resistance in Gaza has so deeply threatened US imperialism that the US has now spent actual billions of US tax dollars trying to quash it!
The US would not do this for a mere “ally” as the US is not a moral entity who values friendship. The US only has allies that benefit its own political motives, and the moment that’s no longer true, the US will drop them immediately, e.g. Iraq.
The US is abjectly against the liberation of Palestine no matter how genocidal the “Israeli” state acts.
The maintenance of control over this land by a force that will cooperate with capitalist, imperialist goals is critical for the US to remain in global economic dominance.
This is why Joe Biden is famously quoted for saying in 1986, “were there not an Israel, the United States of America would have to invent an Israel, to protect her interests in the region.”
The US requires a strong military foothold in the Arab world for oil, economic monopoly, and leverage against any entities that threaten its control.
But, as Palestinian journalist Bisan Owda in Gaza postulated on her Instagram on 24 April 2024:
“I still do not know why my people are paying the price for the world’s greed for land, wealth, and gas… And why do world leaders strip humanity away from my people and treat human beings who love, dream, work, build, and rejoice as less valuable than Israeli settlers and citizens of any other country?”
Palestinians are simply an indigenous people who love the land from which we’ve been exiled.
It is our roots, the restful home from where familial stories come alive and our ancestral histories cycle countlessly through birth, life, death.
Whether physically present or dispersed, we are in a relationship to the land that our parents and grandparents have intimately known very recently, and subsequently shared with us by simply raising us and being with us.
That relationship does not strip the land of resources in order to engage in a global financial rat race that ultimately benefits the few who have power and disempowers the rest.
The US, however, is incentivized to support the Zionist settler colonial project who has been pillaging the land since its inception in the 1920s, killing thousands of elderly olive trees across occupied Palestine, all the way up to the recent destruction of massive amounts of agricultural land in Gaza during this current massacre in which they claim to simply be “eliminating Hamas.”
The occupying military has wreaked toxic ecological havoc on the land that will last for many years to come.
Their true goal is to decimate a population’s ability to sustain itself, because that will enable deeper imperial control… and if they get their cake and eat it too, it might accomplish a thorough ethnic cleansing of the land entirely.
We all know about the Ben Gurion Canal plans, the fertility of Gazan land, the rich resources present for extraction.
You can identify natives from colonizers by the way they treat the land. One strips and uses it like a greedy child at a candy basket to seek quick profits. The other is in relationship to the land, honoring sustenance and mutual reciprocity over capital with deep care for the long-haul embedded into practice.
A Deeper Look at the Occupation in 2024
The land occupation enables the occupying state to usurp significant control over the people of the land.
The apartheid regime of “Israel” dictates a limit on the amount of fresh water going in and out of Gaza and the West Bank to about 1 gallon/person/day prior to October 7, which is well under the WHO bare minimum requirements of 4 gallons/person/day. In order to prevent Palestinian autonomy, “Israel” even claims ownership of rainfall, making it illegal per Military Order 158 for Palestinians in occupied territories to collect rainwater or dig wells without permits, which “continue to be nearly impossible to obtain.”
There are dozens of videos of settler machinery filling in Palestinians’ wells with concrete in the West Bank.
Not only do they occupy water, but “Israel” also controls every single item going in and out, including the amount and types of food, medicine, building materials, agricultural materials.
Items prohibited from entry since October 7 include maternity kits, ultrasound equipment, wheelchairs, crutches, anesthetics, water quality testing kits, and chocolate croissants, requiring aid trucks to turn back if even a single banned item is present.
Birthers in Gaza have been undergoing Cesarean births without anesthetics for months now.
But “Israel” has forced a crippling land, air and sea blockade on Gaza since 2007.
In both the West Bank and Gaza, Palestinians are required to get permits for all infrastructure improvements, which are rarely issued, blocking essential infrastructure like repairing sewage systems or building homes, schools, or hospitals for years or, often, indefinitely.
Everyone knows what “pending” means in occupied Palestine: it’s the continued indefinite response you get from the “Israeli” government after submitting building permit applications.
At the time of this writing in May 2024 in Gaza, residents are exhuming mass graves at Nasser Hospital and Al Shifa Hospital which the Israeli military held under siege for weeks, and they are discovering people buried in scrubs wearing zip tie handcuffs and others buried with catheters still in place.
Children and adults are executed without reason, cause, or discretion.
Thousands of Palestinians are held in Israeli prisons without any charges, of which there are countless documented accounts of rape, starvation, torture, medical negligence, and more, over the years. The Zionist army and supporting imperial powers have shown no war crime or crime against humanity is off limits to guarantee “Israel” maintains control over Palestinian land, lives, bodies, and narratives.
The apartheid state attempts to control all aspects of Palestinian life in order to suppress resistance and to reify their white supremacist rhetoric about the “impoverished, violent, incapable, animalistic, terrorist” Palestinian people.
Affirming this dehumanizing narrative helps maintain popular support for their slow, progressive genocide of the population native to the land they are grabbing.
The “Israeli” government reminds Palestinians living in Gaza of its power by carpet bombing the strip every few years, sometimes referred to as “mowing the lawn”. “Israel” does this habitually to keep a population majority of Israelis in all of occupied Palestine, to remind the Palestinian people again and again they have no control over their lives, safety, or their land.
They do it to flex their beefy muscles before the entire world. This flexing enables them to continue to terrorize without accountability, as other nations are scared to get on “Israel’s” hit list. This is the epitome of imperialist control.
Control and the Medicalization of Birth
Control over the masses is a core tenant to the continuation of imperialist regimes.
Likewise, the medicalization of birth is also focused on the control of bodies.
Birth is a mystery: unpredictable, physiological, unique, raw. Mysteries are not acceptable within capitalist imperialism because systems can only become quantitatively efficient if they are mechanized, predictable, controllable.
The interventions available in bundled birth care serve this end. Some speed up the rate of labor and apply a formula of interventions to all birthers regardless of individual differences and nuances.
We see violent control in the coercive nature of a lot of obstetric care. Procedures like breaking water are presented as only options or performed without discussion or consent during a cervical check.
When recommended interventions, birthers may be threatened with phrases like, ‘You don’t want your baby to die, do you?,’ which is essentially a death threat to manipulate a personal health decision, disguised as concern.
The majority of hospital births occur in supine and lithotomy positions because obstetricians have a greater sense of control standing over a laboring person whose legs are spread out in front of them, but evidence is extremely clear that supine/back-compressed positions carry the most risks to both babies and birthers. Risks include higher rates of instrumental/surgical deliveries and increased rates of fetal distress due to diminished placental flow. Birth position isn’t necessarily tied to profits, but it is about bodily control; particularly, control over marginalized and socially disempowered people, like that of birthing people under patriarchal social hierarchy.
Health and its maintenance, in general, is kept relatively secretive in Western culture where the capacity to understand clinical wellbeing is reserved for experts, and we see a significant extension of this ideology in the context of obstetric care.
Sometimes benefits to the population, also help the dominating power. For example, improving overall health outcomes, result in increasing populous and workforce, which ultimately benefit the state.
However, whenever the state vs. peoples’ interests diverge, the dominant power will steer toward its own benefit and do its best to disguise this as moral policy or public health, trying to prevent revolt (think of the recently proposed TikTok legislation).
Average Americans are trained to submit to medical professionals.
As such, birthing people are primed to progress through pregnancy, labor and postpartum to fully depend on medical experts. They may default to surrendering their self-knowledge and power to their providers.
This deference to authority to manage all aspects of one’s body (even within the intimacy of labor instinct) is a part of the maintenance of Western imperial systems.
It ensures these same individuals will trust larger systems around them, trusting themselves and their communities less and less. This control is maintained by appealing to people’s fears of death and dying; the messages we receive are shrouded in promises that they will grant health and longevity.
Medical imperialism contributes to imperialism at large by enforcing, at a deeply intimate level, that individuals within a society comply with governmental, industrial, and capitalistic authority.
Furthermore, it empowers the status quo, which maintains structures and systems that benefit the powerful, while quietly or overtly oppressing the powerless.
The Importance of Resistance
As we exist throughout various strata of imperialist systems, we must continue to be clear about resisting imperialism at all levels, from local to global.
It is important we help others draw the connections between the specific boots on their neck and the realities of oppression all over the world. So many individuals are narrowly focused on the oppression that affects them, but when they back up they fail to understand its context.
Birth workers know that the pathologization and patriarchal control of physiologic birth has brought widespread harm. Does the birth worker spend their energy fighting for Palestinian liberation such that we can all birth free from coercion, occupation, and separation? So, too, do the coal union worker, the underpaid restaurant server, the discriminated patient, and the traumatized postpartum birther all need to understand that the inequities within their life experiences are deeply tied to the occupation of Palestine, to the harrowing force of imperialism.
Fighting for Palestinian liberation is every human’s innately biological instinct toward survival against the bloody, treacherous imposition of capitalist imperialism, which always and forever exists enveloped within the curse of profit over humanity.
May our lives be catalysts for liberation.
Human nature on a large scale cannot sustain the half lives we are all living to various extents.
Palestine will be freed.
You will benefit from this liberation regardless, but hopefully you’ll be a part of it the whole way through.
Ash D. Is a Palestinian trans midwife (CPM), nurse, educator and parent. They teach a live virtual birth class for trans and queer folks called Embodied Birth, as well as deliver workshops on queer competency, trauma informed care, trans inclusive care, gestational health, obstetric violence, and more. Get in touch at www.embodiedbirthclass.com or on Instagram at @embodied.birth