the Voice of
The Communist League of Revolutionary Workers–Internationalist
“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx
the Voice of
The Communist League of Revolutionary Workers–Internationalist
“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx
February 16, 2026
Pregnant women in working class communities in the U.S. are at risk of dying in pregnancy and childbirth. The U.S. has the highest maternal death rate of all developed countries. And levels of maternal death are three times higher for black women. Eighty percent of maternal deaths in recent years were preventable. And the real numbers are even higher because the data does not correctly capture statistics for after-birth deaths of moms. According to the U.S. Centers for Disease Control, 50% and more of maternal deaths occur seven days to one year after delivery.
What does this say about the wealthiest, most technologically advanced country in the world?
The delivery of a healthy baby depends on many factors. First and foremost, it depends on the health of the mother. In the U.S., the lack of health care generally and the lack of maternal care, specifically, contribute to difficult deliveries. The continuing economic crisis with its high prices and lack of good food result in obesity, high blood pressure and diabetes, to name a few risk factors. Many pregnant women never see doctors until they are in crisis. Work and/or caregiving for others comes first, so they don’t have time.
In the most recent period, as capitalism cannibalizes infrastructure for profit, hospitals and clinics have been increasingly unavailable to pregnant women. Many women have no medical monitoring during pregnancy. Health care of any kind is unavailable and unaffordable.
But the history of birthing in the U.S. has not always been so, and in its history lie important lessons to be learned to take us to a safer place.
In the U.S., like every other place in the world, women play a major role in assisting childbirth. Communities built systems of support by selecting out women who were trusted to guide safe and healthy deliveries. Doctors were eventually included in this important profession, but they were not primary. These women, called midwives or doulas, provided services up until around 1910 when they were displaced by hospital systems.
As the hospitals took over birthing, laws were passed which placed childbirth under a doctor’s care. Midwives were banned from the delivery rooms.
While this transition to hospital care greatly reduced mortality, the birthing environment moved from being one of support both physical and emotional in the home with loved ones, to the sterile environment of a hospital. Twilight sleep was introduced, which removed a woman from any active role in birthing. And finally, increasingly, natural birthing was replaced by planned events called C-sections, where the baby is taken out of the mother through abdominal incision.
Many of these changes instituted were based on racism and misogyny, a disdain of women. Hospitalization treated pregnancy as illness, and subjected women to the increased negative attitudes of the population at large. One prominent obstetrician called pregnancy and childbirth dangerous and evil. He promoted the use of forceps, sedatives, ether, and argued that midwives be ejected from the process. Laws passed in 1921 finally barred midwives from practicing almost completely. For example 150 midwives were eliminated in Alabama alone, overnight.
Nurse-midwifery, a system instituted under Mary Breckenridge, while attempting to retain midwives, reflected racist values. It demanded education of midwives and then refused to allow black women to be educated. These combined attacks broke the tradition of midwifery, resulting in the numbers of Hispanic and black midwives dropping to 5%.
It is important to have emergency rooms and operating rooms available or close by birthing centers. Society should use the best of medicine and technology available to support childbirth. But birthing as it was transferred to hospitals fell under the effects of capitalism and its profit orientation. It was not primarily organized around supplying the best care for pregnant mothers. It was organized like capitalism’s other assembly lines: to cut corners and staffing to increase profits.
Giving birth is not a process that is designed to be digitalized and sped up. In fact, the hospital corporations found ways to change the birthing process to accord with their profit system.
The new process severed women from control of their own bodies and undercut assisted natural child delivery. It added killing stress at all levels. The system was less empathetic and less responsive to women’s pain and their wishes. Especially in the early 1900s, racist and chauvinist actions and remarks, supplemented by anti-female attitudes, resulted in harmful, dehumanized physical processes. These social attitudes are well documented in the experiences of black women being badly treated in hospitals.
Finally, it resulted in the practice of making C-Section, Caesarean Section, a major surgery, routine for well and high-risk mothers alike. This introduced risk and complications for mothers. Decisions to do so were often made during labor when patience, watchful waiting, positioning and movement comfort measures, rest and calm could have resulted in safer, more natural childbirth. The rate of Caesarean Section surgeries has reached around 33% of all live births. The system seems to be saying, “Heaven forbid a pregnancy delivery would be relaxed and natural. Where is the money in that?”
And so, women who bring the new generations into this world are put in harm’s way by capitalism, as are their babies.
During the 1960s and 1970s, the Women’s Movement and the Black Movement put maternal rights in the spotlight. They advanced slogans like “Our Bodies, Our Selves,” and protests against discrimination against women. Birth centers and midwifery programs followed in some more progressive hospital systems. And newly enacted Medicaid funding gave a financial support for birthing venues that provided for more natural delivery.
These more human approaches to birthing resulted in traditional midwifery being combined with hospital services in some large hospitals like those in New York City. Women were able to deliver babies in more comfortable home-like areas within the hospitals. Special areas called birthing centers were established. This approach allowed women not to be rushed and badgered and to experience a more comfortable delivery assisted by midwives and family and friends. If emergency services were needed, they were available immediately.
The combination of hospital care and midwifery is practiced today in France and other European nations, with up to 75% of births assisted by midwives.
Why not here in the U.S.?
Pregnant women are running out of places to give birth. Less than 42% of rural hospitals nationwide offer labor and delivery services. Over 120 rural hospitals have halted maternity delivery since 2020. But it isn’t limited to rural hospitals.
The number of closures, including urban hospitals, is estimated at 500 since the year 2000. From 2010 to 2022, 399 maternity care units across the U.S. closed. In Los Angeles County, 26,500 babies were born in emergency rooms between 2016 and 2023!
Beyond the closing of maternal birthing units comes the closing of hospitals altogether. And while some authorities cite the high cost of maintaining round-the-clock staffing and increasing expenses, this shearing off of maternal care units and centers is a deliberate choice being made by the medical industry and Wall Street profiteers to cut any and every service, vital or not, that is lower on the profit charts and to replace it with more profitable services.
While early application of hospital services greatly reduced maternal mortality, in the early 2000s, it was on the rise again.
Today, working-class people are seeing the struts of their world pulled out from under them. Inflation is causing us to lose buying power, high prices forcing us out of our homes and apartments. Jobs are disappearing, putting a lie to the politicians’ promises. Health care? Most cannot afford it. When it comes to maternal care, working women mostly don’t have it and don’t have the means to take care of themselves during pregnancy. Almost 40% of births require Medicaid funding (and no, not just for the jobless). Medicaid pays 8,732 dollars less than private insurance per delivery.
What can we do to protect ourselves and our babies? Of course, we have to fight for better services and to protect ourselves and each other best we can under the current system. But individual mothers have little defense against the attacks of the system.
It is unbelievable that authorities are telling women in rural settings to catch a ride to a facility in a faraway town or city because the local hospital just closed its doors to pregnancy. Emergency rooms are overflowing. How long can this go on?
The capitalists have billions for what the elite upper class wants. Trillions for war. One war machine could fund millions of hospital visits and new births. Money has to be reallocated to supporting life, not war. But …
Capitalism is not going to release its deadly grip on our bodies and our babies. Profit is their bottom line.
The capitalists will not give up their power or profit voluntarily. This system is so corrupt, so decrepit, so anti-life! We will have to knock their system out of the way, and build a new one that serves the interests of workers and the population.
Because, for as long as profit comes before human life, we are caught in a downhill slide all the way to the bottom.