What if I told you that the fight for midwifery models of care and the push for trans-inclusive birth care are not just parallel struggles, but two sides of the same revolutionary coin? At first glance, they might seem like distant cousins—one rooted in centuries-old traditions of female-centric birthing, the other a modern reckoning with gender diversity in medicine. But dig deeper, and you’ll find a shared ethos: a rejection of patriarchal control over bodies, a celebration of autonomy, and an insistence that care must be as unique as the people it serves. This isn’t just about birth. It’s about dismantling the systems that have long dictated who gets to decide what’s “natural,” what’s “normal,” and—most insidiously—what’s “legitimate.”
From Witch Hunts to Birth Strikes: The Historical Roots of Midwifery’s Erasure
Picture this: it’s the 16th century, and midwives are the backbone of birthing knowledge. They’re the ones who’ve passed down remedies, techniques, and wisdom through generations of women. Then, the witch hunts begin. Suddenly, these healers—often older, often poor, often uneducated by the standards of the elite—are branded as heretics. Their knowledge is demonized. Their autonomy is stripped. The Church and later the medical establishment conspire to replace them with male physicians, who bring with them a new gospel: that birth is a medical event, not a natural one, and that only they hold the keys to safety. Sound familiar? It’s the same pattern we see today, where trans birth care is either sidelined or pathologized under the guise of “medical necessity.” The message is clear: if you don’t fit the mold, your body—and your right to care—is up for debate.
The midwifery model, with its emphasis on continuity of care, informed consent, and physiological birth, is a direct rebellion against this legacy. It’s a return to the idea that birth is not a crisis to be managed, but a rite of passage to be honored. And yet, even now, midwives face relentless pushback—restrictive licensing laws, insurance barriers, and the ever-present shadow of malpractice lawsuits that disproportionately target those who dare to practice outside the hospital-industrial complex. It’s a system designed to keep birth—and those who facilitate it—under lock and key.
Trans Birth Care: The New Frontier in the War on Bodily Autonomy
Now, fast-forward to the 21st century, where the fight for trans birth care is the latest battleground in this centuries-old war. Trans men and nonbinary people who give birth are met with a medical system that treats their existence as an afterthought at best, a pathology at worst. Hospitals misgender them. Providers refuse to acknowledge their pregnancies. Insurance companies deny coverage for basic care, let alone affirming treatments. The message? Your body is a mistake, and your right to parenthood is conditional. Sound extreme? Ask a trans man who’s been told his pregnancy is “unnatural” by a doctor who’s never once questioned the “naturalness” of a cis woman’s birth. Ask a nonbinary person who’s had to fight just to be called by their correct name during labor. The parallels to midwifery’s erasure are not coincidental—they’re systemic.
But here’s the twist: the midwifery model, with its focus on holistic, person-centered care, is the very framework that could transform trans birth experiences. Imagine a world where trans men and nonbinary people aren’t just tolerated in birth spaces, but actively centered. Where midwives—trained in gender-affirming care—provide continuity from preconception to postpartum, where pronouns are as routine as checking blood pressure, where the language of birth isn’t coded in cisnormative assumptions. This isn’t a fantasy. It’s a demand. And it’s one that midwives, with their history of challenging medical dogma, are uniquely positioned to lead.
The Provocative Question: Can Midwifery Models Survive Without Trans Inclusion?
Here’s where things get uncomfortable. What if the midwifery movement’s insistence on “natural” birth—often framed in opposition to medical intervention—actually reinforces the same exclusionary logic that keeps trans people out of birth spaces? What if the romanticization of “traditional” midwifery, with its roots in white, heteronormative ideals, inadvertently sidelines the very people who need its care the most? The challenge isn’t just about adding trans folks to the existing model. It’s about interrogating what “tradition” even means in a world where birth has never been a monolith.
Consider the language we use. “Natural birth” is a loaded term, one that often implies a purity test—no epidurals, no inductions, no deviations from the “ideal.” But for many trans people, the “natural” path to parenthood might involve testosterone, hysterectomies, or other medical interventions that defy cisnormative expectations. Does that make their births any less valid? Of course not. But it does expose a tension: if midwifery’s goal is to reclaim birth from medical control, does it risk replicating that control by dictating what “natural” should look like? The answer isn’t to abandon the midwifery model. It’s to radicalize it—to center the most marginalized voices and ask: whose birth is considered “natural,” and whose is deemed a deviation?
Solidarity in Practice: Building a Birth Revolution
So how do we bridge these struggles? The answer lies in solidarity—uneasy, imperfect, but necessary. Midwives must confront the ways their own movements have excluded trans and queer people, whether through language, policy, or unconscious bias. Trans birth advocates, meanwhile, must recognize that the midwifery model offers tools to dismantle the very systems that oppress them. It’s not about merging the two movements into one. It’s about recognizing that they’re already intertwined.
Picture a birth center where trans men and nonbinary people are not just welcomed but celebrated. Where midwives are trained in gender-affirming care, where intake forms ask for pronouns before they ask about due dates, where the language of birth isn’t coded in assumptions about who gets to be a parent. This isn’t a pipedream. It’s happening in pockets—queer doula collectives, trans-led birth groups, midwives who’ve made it their mission to decolonize their practice. The question isn’t whether this can work. It’s whether the broader movements will have the courage to demand it.
The fight for midwifery models and the fight for trans birth care are not separate. They’re two strands of the same thread, woven together by a shared enemy: a medical-industrial complex that profits from control, that pathologizes difference, that treats bodies as commodities rather than sacred sites of creation. The revolution won’t be televised. It will be midwifed.
