The Gentrification of Home Birthing

By Jael Kamagate - June 2026

Home birth is not new.
It is not a trend.
It is not an “alternative lifestyle.”

For most of human history, birth happened at home. Not because people were trying to make a political statement. Not because someone had read a hypnobirthing book or ordered an expensive inflatable birth pool online. But because home was where birth belonged.

Across continents, cultures, and centuries, childbirth took place within homes and communities. Women were supported by experienced birth keepers — midwives, aunties, grandmothers, herbalists, and traditional birth attendants who carried generations of knowledge.

Birth was woven into everyday life.

Children saw pregnant women giving birth. Women supported other women. Knowledge moved from one generation to the next through observation, experience, storytelling, and care.

Birth was not separated from community. It was part of community.

Today, however, birth has become increasingly institutionalised, medicalised, commercialised, and in many cases disconnected from the communities that once sustained it.

This talk explores how home birth — once associated with survival, poverty, colonisation, and necessity — is increasingly presented as a luxury wellness experience available primarily to those with privilege, housing security, financial flexibility, and access to resources.

And in asking these questions, we must also ask:

Who gets to feel safe during birth?

Who gets listened to?
Who gets access to choice?
And whose birth knowledge has historically been erased?

BIRTH KNOWLEDGE IN AFRICAN SOCIETIES

Across many African societies, childbirth knowledge was deeply respected and community based.

Among Yoruba communities in present-day Nigeria, traditional birth attendants held highly respected social positions. Their role extended far beyond simply “delivering babies.”

They supported women physically, emotionally, spiritually, and socially.

They used:
• herbal remedies
• massage techniques
• abdominal support practices
• labour positioning
• nutritional guidance
• postpartum healing rituals

Birth was viewed not as an isolated medical emergency, but as a sacred transition.

In many communities, postpartum care was considered just as important as labour itself. Women were cared for intensively after birth through rest periods, hot baths, body wrapping, specialised foods, and communal support.

This matters because modern maternity systems often focus heavily on delivery while neglecting postpartum recovery entirely.

Traditional birth systems understood something powerful. Healthy mothers create healthy communities. Knowledge was usually passed down matrilineally. Young women learned by observing experienced women over years.

This knowledge was embodied.
Relational.
Practical.
Community-rooted.

And importantly — it existed long before colonial medical systems arrived.

THE AFRICAN DIASPORA & BLACK MIDWIVES

When millions of Africans were forcibly displaced through slavery, birth knowledge travelled with them.

Across the Caribbean, South America, and the United States, Black midwives became essential healthcare providers for entire communities.

These women were often called “granny midwives.” They delivered babies in homes, plantations, rural communities, and isolated towns where doctors were inaccessible or unaffordable.

One documented example is Mary Coley, a Black midwife from Georgia who practised for decades and delivered thousands of babies.Another was Onnie Lee Logan of Alabama, who delivered more than 3,000 babies throughout her lifetime.

For many Black families, these women were not alternatives to the healthcare system.
They were the healthcare system.

They offered:
• prenatal support
• labour care
• breastfeeding support
• herbal knowledge
• postpartum healing
• emotional reassurance
• community continuity

And yet despite their importance, many of these women were later erased from mainstream birth history.

MEDICALISATION & THE MOVE TO HOSPITALS

During the twentieth century, childbirth moved rapidly from homes into hospitals. Around 1900 in the United States, approximately 95% of births occurred at home.By the 1970s, hospital birth had become the overwhelming norm.

A similar shift happened in the United Kingdom. In 1960, around one-third of births in England and Wales still occurred at home.By the early 1980s, home birth rates had fallen to around 1%.

Now, it is important to say clearly: Modern obstetrics has saved lives; emergency surgery, antibiotics, blood transfusions, foetal monitoring, emergency interventions.

These advancements matter deeply.

But historians remind us that the shift to hospital birth was not only about safety. It was also about authority.

Who gets to define expertise?
Whose knowledge is considered legitimate?
Who controls birth?

As obstetrics became professionalised, traditional midwives were increasingly portrayed as outdated, uneducated, or unsafe — particularly Black and Indigenous midwives.

In the American South, public health campaigns specifically targeted Black granny midwives, often using racist language and stereotypes.

Many women who had safely delivered hundreds or thousands of babies were pushed out through licensing laws, regulation, and institutional control.

So the medicalisation of birth was not just medical.
It was political.
Economic.
Colonial.
And racialised.

COLONIALISM & CONTROL OF REPRODUCTION

We cannot discuss birth history without discussing colonialism. Across colonised societies, European medical systems were imposed over Indigenous and African systems of care. Traditional birth attendants were often criminalised, delegitimised, or framed as primitive.

Colonial governments were deeply invested in controlling reproduction because reproduction affects:
• labour supply
• population growth
• social control
• economic systems

The control of women’s bodies has always been political. This historical reality continues to shape maternal healthcare systems today. Many communities lost trust in medical systems because those systems were historically tied to coercion, racism, experimentation, and unequal treatment. When we discuss mistrust in maternity systems today, we must understand that mistrust did not appear out of nowhere. It has history behind it.

MATERNAL HEALTH INEQUALITIES TODAY

Fast forward to today.

In the UK, Black women remain significantly more likely to die during pregnancy, childbirth, or shortly after birth compared with white women. Women living in the most deprived areas also experience higher maternal mortality rates. Reports from MBRRACE-UK repeatedly demonstrate these disparities.

These inequalities are not about biology.
They are about systems.

They reflect:
• structural racism
• unequal access to care
• postcode inequality
• dismissal of pain
• communication failures
• economic inequality
• chronic stress
• lack of culturally safe care

For many Black families, home birth is not simply about aesthetics. It can be about autonomy, safety, reducing trauma, feeling heard, feeling humanised.

Many families seek continuity of care because fragmented systems leave them feeling invisible.

THE RISE OF MODERN DOULAS

In recent years, doulas have become increasingly visible within maternity care conversations. A doula provides emotional, physical, educational, and advocacy support during pregnancy, labour, and postpartum recovery. Research consistently shows that continuous labour support can improve birth experiences and reduce certain interventions.

But women supporting women during childbirth is not new.
It is ancient.

What has changed is that this support has become professionalised and commercialised. Today, doula support can cost hundreds or even thousands of pounds depending on location and services. And this raises another important question:
When support becomes commercialised, who gets excluded?

THE GENTRIFICATION OF HOME BIRTH

When people hear the word “gentrification,” they often think about housing and neighbourhoods.

But gentrification can also happen culturally.

It occurs when practices rooted in marginalised communities become:
• rebranded
• aestheticised
• commercialised
• financially inaccessible
• detached from their origins

Home birth is an important example.

Historically, home birth was associated with:
• rural communities
• poor communities
• colonised communities
• enslaved populations
• women without hospital access

Today, home birth is often marketed through:
• curated Instagram imagery
• luxury birth photography
• expensive birth pools
• wellness branding
• minimalist interiors
• private midwifery services

Again, there is nothing wrong with wanting beauty, softness, or peace during birth.

But we must ask:
Who can afford these experiences?
Who has stable housing?
Who has enough space?
Who has enough support?
Who can take time off work?
Who can hire private care?

Because true reproductive choice requires access.
And access is unequal.

BIRTH JUSTICE

Birth justice reminds us that reproductive rights are not only about legal choice.
They are also about material conditions.

A person cannot freely choose home birth if:
• they live in unsafe housing
• they fear discrimination
• they lack continuity of care
• they cannot access midwives
• they are financially excluded
• they do not feel safe within the healthcare system

Birth justice asks us to move beyond individual choice and examine systems.

It asks:
What would equitable maternity care actually look like?

It would look like:
• culturally safe care
• continuity of care
• properly funded community midwifery
• protection for Black midwives and doulas
• accessible postpartum support
• anti-racist maternity systems
• respect for traditional knowledge
• informed consent being taken seriously

Birth justice is not about romanticising the past.
It is about building systems where dignity and safety coexist.

PERSONAL REFLECTION SECTION

As a doula and wellness practitioner, I have seen how transformative it can be when women feel genuinely supported during pregnancy and birth.

I have also seen the opposite. I have seen women leave appointments feeling dismissed. I have seen fear replace confidence.I have seen women feel like birth was happening to them rather than with them.

And what many women are searching for is not perfection.
It is humanity.

They want:
to be listened to,
to feel safe,
to feel informed,
to feel respected,
to feel seen.

Birth experiences stay with women for years.
Sometimes for life.

And when we talk about improving maternity care, we must understand that emotional safety matters too.

CONCLUSION

Home birth is not being rediscovered.
It is being remembered.

Across Africa.
Across the Caribbean.
Across Indigenous communities.
Across rural Europe.
Across generations of women whose names history often forgot.

Birth knowledge existed long before modern institutions. And despite centuries of erasure, that knowledge still survives.

The question today is not whether home birth has value.

The real question is:
Who gets access to safe, supported, dignified birth?

Because birth justice cannot exist only for the wealthy. It cannot exist only for homeowners.It cannot exist only for those with private resources. If we are serious about inclusion, then those historically excluded from birth conversations must not simply be invited into the room.

They must help shape the room itself.

Suggested References & Reading

Suggested References & Reading

Davis-Floyd, R. – Birth as an American Rite of Passage

Leavitt, J.W. – Brought to Bed: Childbearing in America

Fraser, G. – African American Midwifery in the South

Jordan, B. – Authoritative Knowledge and Its Construction

MBRRACE-UK – Saving Lives, Improving Mothers’ Care

World Health Organization – Intrapartum Care for a Positive Childbirth Experience

Office for National Statistics – Birth Characteristics in England and Wales