Nationally Rally for Change: A Full Scale Birth Revolution on Labor Day

Monday, September 3, 2012 10am-12pm. Your mission should you choose to accept it:


A massive uprising is on the horizon. Thousands of men, women and children will gather on September 3rd, 2012 as part of a national movement. Improving Birth’s “National Rally for Change on Labor Day” is being hosted in close to 100 major cities, in all 50 states across the country. Thanks to the intricate works of social media, has been able to organize a massive movement to bring awareness to the lack of evidence-based maternity care in the US. One writer coined it as
“The largest women’s movement in decades.”

Are you going? I am! Find out where the closest rally is happening near you.

Black Women’s Birth Experiences in the South

I am so incredibly excited about Black Women Birthing Resistance:

Over the span of the project we hope to gather stories within 5 Southern states (Alabama, South Carolina, Louisiana, Georgia & Mississippi) from doulas/midwives/ob-gyn’s/reproductive justice, healing and health justice advocates and organizers who are speaking to medical birthing incidences of abuse that highlight the subsequent targeting of Black women’s bodies.

Our work will provide a historical context for Black women’s birth experiences in the South; emboldening Black women to view their individual birth stories within a larger narrative, and to remove the guilt, anger, and shame resulting from traumatic birth experiences.  We want to honor all birth experiences of all Black bodies and genders and have chosen to focus on Black women bodies first to understand the medical industry’s initial entry point on our birthing traditions for the last 100 years.  By uplifting the impact and consequences of these historical practices we will then be able to draw a link to contemporary Black birthing experiences including l/b/g/t/i/q parents and people with developmental, physical, emotional and environmental disabilities.

HT to Guerrilla Mountain Medicine for bringing my attention to this.

On Cultural Competency

Since we’re already on the topic:

I have long maintained that teaching cultural competence through the use of fact-learning about specific populations is deeply flawed and limits thinking.  You know, those books with the special sections on “African Americans,” “Asian Americans” and “Hispanic Americans.”

There are times when I think some facts about specific cultures are useful.  For example, I think it’s helpful to know that some people don’t wear shoes inside the house.  But you wouldn’t need to know that little factoid if you were an observant sort.  And even if you were not, you could simply gracefully remove your shoes when asked.

I used to naively believe that educated people were less racist.  Instead I found they are simply representative of the population at large.  In fact, sometimes they are more racist simply because power and privilege blind them.  Similarly, cultural competence has little to do with formal education.  I used to think that cultural competence has to do with exposure, but now I don’t believe that either.

Read the full article over at Resist Racism.


Teaching Diversity at Midwifery School

Recently, I was asked to teach the diversity course to the first year students at my midwifery school. I was completely surprised and honored to be asked to do so. At my school, the diversity class is a brief 3-hour seminar. That, coupled with one other brief seminar on cultural competency in the second year is the full extent of time we spend talking and thinking about anything that amounts to reproductive justice in my book. It is the only time we have to explore and examine providing birth services to folks who are not White, middle or upper class, straight, Christian, able-bodied, English-speaking, American citizens (etc. etc. etc.) clients. It is something I think homebirth midwives on the whole do not talk enough about, but that’s a whole other post meant for another day. However, I do think it’s crucial to give all midwifery students a good basic understanding of the issues at play here and some tools to keep exploring.

As far as I could tell, the class went over fairly well. It definitely was a good learning ground for myself and how I might design future trainings. I started the class by telling the students that I hoped they walked out of the class with their interest piqued, curious to learn more. Basically, we talked about the meanings of prejudice and oppression, broke down the ways in which oppression is systemic, and then talked about the ways in which we can change things, both on an individual and a systemic level. There’s not a whole lot you can learn about anti-oppression work and reproductive justice in 3 hours, so I viewed this as just the tippy tippy top of the iceberg. My hope was that if I gave them just a taste that they would go home wanting more and delve into more learning on their own.

The next exciting part of this story is that just today I volunteered to offer this training to my class and it looks like it might be offered to local midwives who are interested as well. This seems like a good place for me to get started and hopefully keep talking to folks about these issues. My hope is that some more awareness of anti-racism, anti-oppression, and reproductive justice work can truly transform midwifery.

Reproductive Justice

Do you remember a while ago when I posted about Mia Mingus and Sebastian Margaret’s Disability Justice workshop at the 2010 CLPP Conference? Mingus went through an incredible graphic utilized by Spark Reproductive Justice to help flesh out all of the nuances and aspects to reproductive justice and showed how this same framework could be applied to other social justice focuses such as disability justice and environmental justice. About a month ago, Spark posted that same graphic on their blog and I’m happy to share it with all of you! Check it out.

Outlaw Midwives Zine!

The Outlaw Midwives Zine and it’s time to celebrate. I have been waiting for this zine to come out for so long, I’m doing a little jig right here in the living room. Go check it out here and make sure you tell all of your friends about it.

And while you’re reading, if you look very carefully, you might just find a piece written by yours truly!

Thank you Mai’a for putting this fantastic piece of work together. Can’t wait for the next one.

Required Reading on Racial Health Disparities

On a related note, this post on Thejugglingmatriarch’s Blog should be required reading for all midwifery students and birth workers. It is a beautifully written piece outlining the ways in which our history of slavery as a nation directly affects Black women’s and Black children’s health outcomes today. She says in part:

Nearly 300 years of slavery, and the formal and informal systems of segregation that followed in the century and a half since, have left a specific mark on the lives of black women, leaving them vulnerable to all measure of abuse.  This is especially clear when we look at the issue of reproduction. As slaves, African American women were compelled to create property for their masters, to understand the painful truth that on a legal level, the children they birthed were not their own.  As free people in the twentieth century, they have been roundly condemned for having babies at all, caricatured in the later decades as “welfare queens” and irresponsible single mothers, and/or victimized by campaigns that forced sterilization without consent and tied government economic support to compulsory contraception. Talk about being damned if you do and damned if you don’t.

African American women have resisted this abuse and victimization since the moment it began, but they have fought against a government and a society with little empathy and a seemingly inexhaustible willingness to continue sacrificing their health and wellbeing for economic gain.  The reasons why are complex, but to put it very simply, American society has evolved into a place where there is an often unspoken acceptance of the notion that black women and children just don’t matter very much.

Crisis in the Crib – Black Infant Mortality in the US

This post was inspired by Courtroom Mama’s mini blog carnival about the documentary Crisis in the Crib by Tonya Lewis Lee. If you haven’t seen the documentary, please go and watch it. You will need Windows Media Player (which turned into a bit of a challenge for this Mac user, but I did it!) and is a little longer than 30 minutes. Courtroom Mama is right that we should all be talking about this. Get ready, because here’s your call to action.

Here’s the deal, plain and simple. Infant mortality rates in the US are embarrassingly high and almost nobody is talking about it. Furthermore, this does not play out equally amongst all babies. Black babies are dying at twice the rate of other babies. In some counties, you have numbers that look like this:

So I’ve seen the numbers and I’ve read articles and blog posts about the infant mortality rate in the US. Let me tell you about the part of Crisis in the Crib that really hit it home for me. The film starts with a scene in a cemetery or memorial with markers for every baby that died in the past year in that particular county. As I watch, I note that the audience and speakers are almost all Black. I remember the mothers I have served as a doula and a midwifery student and start to think concretely about what it would be like for me, the other birth attendants, and for these new mothers and their families if any of them experienced an infant death within the first year of life. So far, they have all been healthy pregnancies and births, but it could happen. It would be absolutely devastating, right? Something like that affects you for your entire life. So I keep pondering this while they move to the next scene.

We are now in an auditorium and Tonya Lewis Lee is talking to high schoolers about the importance of being healthy before becoming pregnant. She asks the audience if they or anyone they know has experienced infant mortality in their families. Students raise their hands and get up to speak. They talk about losing siblings. One student’s sibling was killed by an angry babysitter. Another student’s sibling was born so prematurely it would have been nearly impossible for her sister to live. Later in the film parents talk about losing their children. One father relates that his baby lived only 17 minutes.

Right, folks. This is when it really hit home for me. I realize that this is not my reality. It simply isn’t. I grew up in a relatively privileged household in a majority White area. I wrack my brain and I realize that I cannot recall a single person that I know personally who lost a baby before the age of one. No one in my family, none of my friends, none of my clients (of which there admittedly haven’t been that many). I could raise my hand and share a story about breast cancer, heart disease, diabetes, environmental disaster, 9/11, etc. etc. etc. But infant mortality, until recently, has not even been in my purview. It was something that happened in other places, far far away, with health care systems that were far worse than ours. And now you’re telling me that this is an everyday recognized reality for whole groups of Americans just like cancer is an everyday reality for some of my loved ones? Ok, you’ve got my attention.

For me, learning about the dramatically different infant mortality rates for Americans from different racial backgrounds has been a process. When I first learned about it, I was almost embarrassed to talk about it with people because I figured if it was something this big, I certainly should have heard about this before I signed up for midwifery school, right? Shouldn’t I have learned about this back in high school or earlier? I realized that part of the reason I had never heard of this before, wasn’t taught it in school, didn’t hear it spoken of with outrage on the media, and don’t hear it widely discussed in midwifery circles is due in large part to the systemic racism we all live with on a daily basis.

Right, so I got over my personal embarrassment and decided to learn as much as I could about this. I was quickly overwhelmed – what could I as a future midwife do that would have any dent on the racial disparities in infant mortality? Well, it’s a multi-faceted problem with more pieces to the puzzle than solutions, but I realized that there ARE some things I can do even if I can’t solve the whole puzzle:

  1. Continue to educate myself about racism and privilege. Learn the ways racism affect the body physically and birth outcomes negatively. Continue to oppose and undermine racism, educate others, and in general be a radical anti-racist. Learn as much as I can about Camara Phyllis Jones and her work linking health disparities to racism. This is not necessarily going to help women on an individual level, but every act towards dismantling this oppressive hegemony is important for the whole.
  2. Nutrition and Vitamin D. Vitamin D is an important part of nutrition and can have profound effect on birth outcomes. It is also a race-based problem because here in North America (especially in the cold frozen north like Maine) it can be difficult for anyone to get enough Vitamin D from the sunlight and this gets harder the darker your skin is. Infant mortality rates are high amongst Black women regardless of socioeconomic status or educational level, and it has been suggested that Vitamin D plays a starring role in this truth. I certainly don’t think that Vitamin D is the magic bullet for infant mortality, but I do think it is important to test your clients’ Vitamin D levels and treat accordingly. You can’t undo a lifetime of Vitamin D deficiency in 9 months, but you can start to make a dent and help this birth be a healthier one.
  3. Reduce the number preterm labor and births. Prematurity is a major cause of infant mortality. I’ve talked about this before, but the midwifery world as a whole could learn a lot by paying more attention to the work that Jennie Joseph is doing down in Florida and putting the lessons she’s teaching into action in their own practices. She’s an incredibly important heroine of mine.
  4. Serve women of color as a midwife. Do so sensitively and with humility. Continue to remember that I have (will always have) a lot to learn. Keep learning. Ask questions. Continue to find ways to serve populations of women who are not or have not had access to the care of a homebirth midwife. Work to make myself truly accessible – not just say I am. Show that I have an inclusive practice through my actions, not just my words.

I know that this is just the tippy top of the iceberg here. What other ideas do you have on concrete ways we can help fix this enormous and devastating problem?