Unpacking the invisible knapsack of pregnancy privilege

This post is about pregnancy and privilege, known and unknown. It's not outside the realm of discussion to begin with a very in-your-face, obviously-privileged video. Thus, let's start with the ever-popular, Sh*t Crunchy Mamas Say:This is part of the trend of videos making fun of quintessential groups of people, like hipsters and hunger-games-fans and vampires. It started with two guys making a video about Sh*t Girls Say, which, in its own right, just points to all jokes initially hilarious because they point out women's supposed faults or objectification. All funny because it's naming, in many ways, groups of people who many lump into generalizable cohorts and how ridiculous all of their predictable language sounds as a cohesive sound-byte. Many times the content is funny because it takes a group either with privilege, or in an interesting way without privilege, and makes fun of them. For example, in the initial Sh*t Girls Say, these two men are seeking to point out women's stupidity or social ineptitude, and thereby attempt to argue the seeming superiority of men. One group privileged, the other less-than in some capacity.Peggy McIntosh wrote an incredible essay in 1988 entitled "White Privilege and Male Privilege: A Personal Account of Coming to See Correspondences Through Work in Women's Studies," from which the famous "Unpacking the Invisible Knapsack" is excerpted. And I quote: "I think whites are carefully taught not to recognize white privilege, as males are taught not to recognize male privilege. So I have begun in an untutored way to ask what it is like to have white privilege. I have come to see white privilege as an invisible package of unearned assets that I can count on cashing in each day, but about which I was "meant" to remain oblivious. White privilege is like an invisible weightless knapsack of special provisions, maps, passports, codebooks, visas, clothes, tools and blank checks. Describing white privilege makes one newly accountable. As we in women's studies work to reveal male privilege and ask men to give up some of their power, so one who writes about having white privilege must ask, 'having described it, what will I do to lessen or end it?'"I get goosebumps and fired-up every time I go back to this essay, remind myself of its impact, and think about it in new ways. Name it, and say it. Save it on your computer, read it today, read it tomorrow, read it over lunch, and discuss it over drinks with friends. Name it and say it again.I personally identify as white. There are a number of items in this list that I did not initially think of when considering my own white privilege, when privilege as concept and fact was introduced to me during my undergraduate education. Goodness was that a frigging light bulb into my own humanity. Examples from this essay I myself and perhaps other white people might not immediately embrace in their knapsack, Longchamp wristlet, or Timbuk2 messenger bag, include:

• I can be sure that my children will be given curricular materials that testify to the existence of their race.
• I can swear, or dress in second-hand clothes or not answer letters without having people attribute these choices to the bad morals, the poverty, or the illiteracy of my race.
• I can do well in a challenging situation without being called a credit to my race.
• If my day, week, or year is going badly, I need not ask of each negative episode or situation whether it has racial overtones.

The essay is worth reading in its entirety, a few times over. Clearly there is overlap with all hierarchies of privilege: male, gender, class, race, language and education. Clearly this list is not all-encompassing. Clearly this list is beautiful and important.A recent re-read of this essay, and a few challenging prenatal visits, have led to my own rethinking about privilege in relation to pregnancy. So much conversation around homebirth, and little conversation about birth power in minority groups. So much conversation about affordable care, and little conversation about where current state and federal systems are still failing. This is not to say that all the realms of conversation are not important. This is not to say that each empowered woman experiences deficits in care, and knowledge, and power in their own way. This is not to say that the needs of all pregnant women at all times in their pregnancy are important to her and should be addressed. They all are important, they all impact each other, and all are vital to the advancement of positive healthcare for women. However, recognizing those facets of ourselves and our approaches and our system that are entrenched in levels of privilege, and naming that as a way to change and improve the system, is essential. A few of my thoughts regarding points of privilege throughout pregnancy are as follows.1. I can feel confident that my healthcare provider will speak my language as their first language.2. I know that recommended dietary modifications will likely fit within my cultural boundaries.3. I do not worry that resources regarding my condition or my care are written at my educational level and in language I both speak and read.4. I am aware that I can question care, decline procedures, and request alternatives to any process suggested to me, described as important, or presented as the only option.5. I am able to choose my care provider based on their background or experience, their personal or practice approach, regardless of my insurance.6. I know the differences between medical students, residents, and attendings, and understand that I can ask for a different level of care provider if my pregnancy mandates care by a physician.6. My partner lives in my same home, state, or country, or I know someone in my family or community who can attend my visits, help me through the pregnancy, or be my support person at the birth.7. I can find or afford care for my other children during my healthcare visits.8. I am able to make healthcare decisions without the required input of my partner or family.9. I can tell people I'm happily pregnant without concern for assumptions around the size of my family, my ability to choose my family size and planning methods, and my use of the state or country's benefits systems.10. I have access to the water and food that my provider describes as important during my pregnancy.11. I know of and can utilize transportation services to and from my prenatal visits, emergency care, and place of labor and birth.12. I can afford the sliding scale when medical coverage changes in my postpartum period.13. I know my family medical history and my personal medical and surgical history to a point where I can explain them to my healthcare provider.14. I learned enough anatomy to understand the pictures of fertilization, fetal growth, birth, or postpartum contraceptive methods.15. I have the means and understanding to choose my preferred place of birth.16. I do not worry that if I have an emergency, that the closest hospital will have interpreter services in my language or dialect.17. I embrace cultural or religious belief systems that are in the majority, and am not fearful to share my preferences for my own body parts, fluids, or care provider.18. I live in a community where it is safe to be outside, to exercise, and to be visible as a woman and pregnant, without fear of attack or negative approach.19. I have a pregnancy that was not forced, coerced, brought without my consent or will, and that I have chosen to continue or terminate on my own terms, with support from those around me.20. I have no fear that my body, its markings, its cuttings, its tattoos, its genitalia, or its difference from other presumably normal bodies will be treated well throughout the pregnancy.21. I am confident that my pregnancy will not prompt questions of "how?" or "why?" based on my age, orientation, gender, or former personal opinions about pregnancy.22. I feel powerful in my pregnancy.And I quote Peggy McIntosh, yet again: "In my class and place, I did not see myself as a racist because I was taught to recognize racism only in individual acts of meanness by members of my group, never in invisible systems conferring unsought racial dominance on my group from birth...To redesign social systems we need first to acknowledge their colossal unseen dimensions. The silences and denials surrounding privilege are the key political tool here. They keep the thinking about equality or equity incomplete, protecting unearned advantage and conferred dominance by making these subject taboo. Most talk by whites about equal opportunity seems to me now to be about equal opportunity to try to get into a position of dominance while denying that systems of dominance exist... What will we do with such knowledge? As we know from watching men, it is an open question whether we will choose to use unearned advantage to weaken hidden system of advantage, and whether we will use any of our arbitrarily awarded power to try to reconstruct power systems on a broader base."Now as a worker within a social system, within a healthcare process that assumes a lot and leaves time to explain little, each day is an opportunity. An opportunity to rethink, to leave space for safe conversation, to share knowledge, to encourage asking questions and requesting other options. As a provider, I work to recognize my power to provide time, space, and relinquish that power to my clients. As a white woman, I work to recognize the times when my privilege was the minority and the dominant, and how each of those made me feel. As a person, I recognize that privilege is both a concept and a reality, and that through human recognition, kindness, and empathy, we all have the power to feel privileged through knowing, learning, and growing with each other.