Meg Novak wants you to understand midwifery
"I've always seen birth work as a form of activism," Novak said.
ROCHESTER — Meg Novak is a certified professional midwife who runs a midwifery practice in Rochester. She’s been a midwife for nine years, and has done birth work for about 20 years.
Novak, in some ways, stumbled into midwifery. You could also say it’s the work she was made to do.
She approaches midwifery, and birth work generally, in a different, more personal way that stems from her upbringing in south Minneapolis. Novak laid out the nuances of her work as a midwife and what led her to see birth work as a form of activism in a conversation with the Post Bulletin.
Why did you ever decide to start doing birth work?
Actually, it's kind of an unusual story. I had an art and cultural center in Minneapolis, and it burnt to the ground. And my son, my oldest, was 6 months old at the time. And I had had a doula at his birth. His birth was not what I envisioned, but the presence of the doula there led me to still come out of it feeling empowered and good about it. So that was kind of what started me on wanting to become a birth worker. And also, just while I was pregnant, I really nerded out about pregnancy and enjoyed learning about it, and I didn't want to stop hanging out with pregnant people. So that's one thing I really like about being a midwife. And birth work is that the science is always changing. So it's like a lifelong learning thing, which I really like.
I've also been a political activist for my entire life. And, to me, midwifery is a form of activism, and helping to bring people into the world in a peaceful way and also helping families to become empowered to be in charge of their own lives and their own health care.
How would you describe midwifery to people who don’t know what it is?
I provide all the same prenatal care that you would get in a clinic or with a doctor or hospital, except it's much more personalized and thorough. Our prenatal appointments are usually about an hour long, and we talk about your mental, emotional, spiritual and physical health. There's a lot more of a focus on nutrition exercise, herbs – a really holistic approach to pregnancy. We don't view pregnancy as a pathology, we view it as a normal part of a birthing person's wellness cycle in their life.
The focus for me is being as low intervention as possible. We are well trained, so we know how to look out for complications and stuff like that. I think sometimes one of the myths that particularly doctors believe about midwives is that we don't have any training and we just come in and wave crystals around or something. But I do have a medical license from the state and then we provide postpartum care in the home as well.
Do all the clients that you take on give birth at home?
That's the goal, to have a home birth. Sometimes people have to transfer out if they develop a medical condition that makes them high risk, or if the baby has something that makes them high risk, then they might end up in the hospital.
How would you describe that experience of a home birth for people who haven't been through it?
Home birth is like a steak dinner and hospital birth is like McDonald's, but they're not even that comparable, in my opinion. They're just two totally different events. When you're in the hospital, there's tons of concerns about liability for the providers. You probably won't have the same person that you've been seeing prenatally, you're in a room full of strangers with bright lights, lots of noise, people coming in and out. You don't have choices like even what you wear, what position you're in, all different kinds of things. And home birth to me is just like part of a family's culture. It's a significant family event. But it's not a medical event, right? It's just, like I said before, part of somebody's wellness cycle.
One of the things I really love about home birth is the relationships that I build with the entire family, including the other children. I think about how they're going to think about that when they get older – that when their sibling was born, it was this really peaceful, joyful, sacred event in their family's lives. I get to be that little Mary Poppins that comes in and pops away, you know, and helps them with that. And it feels really good.
You just touched on it, but what does it mean to you to be involved in something as sacred as birth?
It really is an honor. It can be easy to just be like, “Oh, this is my job.” But when I sit and think about it, you're really sitting at a portal where life is coming into the world. And it's never not amazing how many times I see it. I had some clients last year, and they lived on a farm. And there were four older siblings, and they were playing with dolls, and they had a doll that looked like me. That’s just how impactful that relationship is.
It can be a lot of pressure. The care is so personalized, and you have to be very thoughtful in how you approach everything. But I love being a midwife. I wish it was more supported.
What is the Black Home Birth Initiative and how did you get involved?
The Black Home Birth Initiative raises money to fund families (so they can afford home births). Britt (Jackson, the founder) was my student for the tail end of her training. I got involved through her, I guess. I mean, she is just amazing. She's a mover and a shaker. She's really trying to change things.
I've been doing anti-racist activism for 30 years. I've also been involved in organizing anti-racist racism training for birth workers. I've always seen birth work as a form of activism. I feel like pregnancy can be a really transformative time where people can be empowered. To me, it's all about supporting the moms, supporting the families, helping people go into motherhood with a really strong, resilient core that will benefit their family for the rest of their lives.
But the way that women of color are treated in the hospital is disgusting, and it's deadly. Black women die at four times the rate of white women with everything else considered, and it doesn't matter if you're poor, well-educated, whatever. It's simply based on systematic racism. So I want to really support Britt as the only Black home birth midwife in the state of Minnesota, and support her initiatives.
What is the historical context of midwifery that most don’t know?
Midwifery was kept alive by Black midwives in the south, and Native midwives. When white people started going into the hospital, different states employed a group of midwives like thousands of them, many more than we have now, to do home births for poor communities of color. Then when Medicaid was invented, doctors made money off of that, and poor women started going into the hospital. So we owe our profession and our history and our knowledge to those women who were functioning during that time and kept the professional life and kept the knowledge, which is not the common view of the history of home birth midwifery in the U.S. People talk about Ina May Gaskin and, in the 60s, all of a sudden, all these white hippies were having home births and stuff like that, and we owe a great debt to those women who kept that alive. It's about justice. It's about racial equity and injustice in the world, which is something I've always been passionate about. I feel like our liberation is tied together. And I don't feel like I can really separate that from my life.
Will people come back around and rediscover home births as an option?
Well, there's a huge question of accessibility, and if you're in medical assistance, you don't have to pay for anything, if you give birth at the hospital. And my fee is $5,500. For some people, that's just not accessible at all. That's why I supported the Black Home Birth Initiative. But one of the goals of our collective in the Twin Cities (beginning this fall) is going to be that we can serve anybody regardless of their ability to pay. We're opening as a nonprofit, hoping to get funding from other places.
But I do feel like doctors are afraid of the competition, which I'm like, we do less than 1% of births in the United States as home births. There are countries where that's the thing, though, like you go to a midwife. These are all places that have nationalized health care because midwives save money. So as long as there's a profit motive in it, I don't know that it will ever change, as long as we still operate the way that we do. But that's gonna have to change. If that doesn't change soon, there's gonna be a revolution in this country. People are drowning in their medical bills.
Asked & Answered is a weekly question-and-answer column featuring people of southeastern Minnesota. Is there somebody you'd like to see featured? Send suggestions to email@example.com .