I didn’t have the same reaction to this as a lot of other bloggers. No, I don’t think it’s part of a nefarious “Handmaid’s Tale” plot to make women into childbearing vessels. (Click here to read the actual report.)

Let me explain. Once upon a time, many moons ago, I was a childbirth educator and apprentice lay midwife. (Fight the power!) While I primarily worked with women who were planning home deliveries, I was also active in women’s health issues. I know a thing or two about the politics of childbirth.

Once I was at a well-known feminist women’s health center, where my group was invited to give a presentation on home birth. The senior midwife showed some lovely slides of one of the births where I’d helped. (As is quite common with home deliveries, the mother was overheated and had stripped off her clothes as she labored.) When the presentation was over, one of the center’s founders waved her hand wildly. “Yes?” the midwife said.

The woman stood up and said, “I want to know why that woman was forced to take her clothes off. It was very sexist and demeaning. I noticed the baby’s father still had his clothes on!” She was very, very angry - and completely off base. And no matter what we told her, she still thought we were in the business of oppressing women.

That’s what this discussion reminds me of.

The United States has embarrassingly bad infant mortality and morbidity rates, and it’s been that way for decades. For an industrialized nation, it’s obscene that so many of our babies die.

For the longest time, the medical establishment preferred to play the statistics game; usually, they blamed poor minority women for ruining the curve. (Even though, when you put the U.S. up against countries with comparable minority populations, we still do a lot worse.) I’m pleasantly surprised they’ve come around to admitting they could do better.

Poor nutrition and smoking are the main factors in low-weight, high-risk babies. (It’s not incidental that many women smoke to control their weight.) The worse the economy gets, the less money there is to spend on decent food. If the only thing you can afford after paying the rent is Kraft mac and cheese, that’s all you get. But it’s not enough protein to grow a healthy baby.

(Little-known fact: Damage to crack babies is not directly attributable to the drug. It’s caused by malnutrition, because the moms are buying drugs instead of food. If the children are given adequate nutrition, they meet normal developmental milestones.)

In other words, if you have enough money to eat well, the chances of having a healthy baby go ‘way up.

Every once in a while, I realize I’m living on a very different planet from the rest of the (mostly upper-middle class, highly educated) bloggers, because I’ve seen far too many women who are abysmally ignorant about their bodies and childbearing. These recommendations are damned helpful - not the entire solution, because that requires an economic overhaul of the country, but certainly a vast improvement.

I remember one neighbor who used to lock her kids out of the house so she and her husband could get high and have sex. (The kids would wander from neighbor to neighbor, begging for breakfast.) She was eventually diagnosed with cervical cancer and they had to remove her cervix. I was the person who, in a casual conversation a month or so later, got her to understand she wasn’t having any more kids.

And then there was the time when, as a reporter, I was riding with a paramedic crew in Chester, one of the nation’s poorest cities. We picked up an eight-month’s pregnant woman who’d had heavy vaginal bleeding. “How long?” a paramedic asked her.

“Three or four weeks,” was her reply.

Her ten-year-old daughter, a bright little thing, spoke up. “See, mama? I told you you shoulda gone to the doctor.”

And I’ve known dozens of working-class women who continued to smoke and drink throughout their pregnancies. “My mother did it, and I turned out fine,” is a typical refrain.

I remember the Easter Sunday I helped deliver a baby for someone I didn’t know, a Muslim woman who refused to go to the hospital. Her friend called me and asked if I’d attend, but only as a childbirth coach. Her husband would handle the actual delivery, she said.

The house was in the North Philly slums, and it was filthy. The sink was piled high with crusty dishes, roaches were everywhere and I saw a rat. The place was horrible. The pregnant woman was in a bedroom devoid of furniture, save for a rocking chair and a sheet on the floor where she planned to give birth. The husband? He sat on the floor, rocking back and forth with his prayer beads.

The atmosphere was so chaotic, I took over - despite my better judgement. I sent her friend to boil water and sterilize some shoestrings and scissors. (She had to get water from the toilet tank.) I did what I could; the baby was coming fast. Unfortunately, this was a case of shoulder dystocia, something I’d never seen. (The baby’s shoulders were too large for the mother’s pelvis.) I got on the phone with an experienced midwife, who talked me through the procedure of corkscrewing the baby safely through. (Broken clavicle bones are common.)

After the baby was born and the mom was settled in to nurse, I finally found out why she refused to go to the hospital: She’d had three previous C-sections. (I had an angel on my shoulder that day; she could have died.)

This is my point: There are a lot of very ignorant (willfully or otherwise) women out there, and these recommendations are a long time coming. If this was really aimed at turning women into second-class citizens, don’t you think at least one of the people in the government would have leaked that info by now? Considering they’re in the helping professions, and all.

I’ve had a premature infant. I know what it’s like, watching your tiny baby breathe via ventilator. During that pregnancy, I had a top-notch feminist doctor and her midwife assistant who watched my weight, but never once thought to ask me what, exactly, was I eating? (Cheesesteaks and Pepsi, mostly.) Hey, I’m touchy about this - my kid almost died.

I’ve seen a relative go through the painful birth and death of an anecephalic baby, born without a brain. This fatal neural tube defect is easily prevented by folic acid supplements - something recommended in this report.

I’m glad they made these recommendations. And sometimes a cigar is just a cigar.