A bit of a delayed response on this bit of news, but it's still worth sharing. Lawmakers in Utah are considering a proposal to overhaul Medicaid, starting with cuts in the most interesting of places- epidurals and elective Cesareans. The move would be an attempt to minimize the spending the state says it makes for out-of-state college students "freeloading" on Medicaid (because apparently Utah has an epidemic of pregnant college girls) since they might not technically be employed, yet still dependent on wealthy parents residing elsewhere. However, despite there being examples of how the rates of these procedures go down when insurance refuses to pay the high price for them, the motivation of this particular move is troubling.
I agree with the response this has incited that denying a woman an epidural she is desperate for based on her insurance provider is classist and totally misogynistic. On the other hand, exclaiming epidurals an issue of choice just doesn't sit well with me. I guess it's that old feminist line of thought that says we have the right to escape the pain of childbirth, as if the pain of birth was, in fact, meant to punish us for being women. It's not going far enough for me. The right to a healthy, normal, empowered birth is a feminist issue. This argument to protect Medicaid-sponsored epi's reeks of the sentiment that lower class women aren't capable of a normal, non-intervened birth (which is suspiciously useful to the state- can you imagine if poor women everywhere started having supported, empowering births? Watch out!) I agree that women who are systematically denied education and resources contributes to the lack of informed consent, and therefor the cascade of interventions, which makes an epidural sound pretty nice. But nobody here is talking about providing the women effected in this situation alternatives (such as implementing hospital midwifery programs, like this one, and this one). They're just fighting to protect the epidural.
This is a classic case of a few bad apples spoiling the bunch, because sometimes an epidural can be a useful tool, not every college kid has wealthy parents, and the overwhelming majority of pregnant women on Medicaid are there for a damn good reason. It's just disappointing for me to see that the biggest reaction to this has been so unimaginative and classically self-blaming. We should really be taking this opportunity to talk about how to empower the women this would effect, to look at the evidence, and try to create something positive out of a poorly motivated, yet opportunistic, change. The question here should be, "Do we need the epidural?"