AROM: Letter of Support for MOC Chair and Inner Council Resignation

I’m a little late on the game posting this (it’s been a busy couple of weeks!), but you should definitely know about it. The Anti-Racism and Anti-Oppression Work in Midwifery (AROM) working group was formed very recently and has been especially active since the resignation letter to MANA from the MOC Chair and Inner Council.

Our work includes deepening our knowledge of, and developing ways to break down, systems of oppression and domination, including but not limited to racism/white supremacy, patriarchy/sexism, classism, ableism, heterosexism/homophobia/transphobia, and xenophobia based on perceived nation of origin and religion.

We have published a response letter on the AROM blog and we are looking for more birth workers to join in this crucial work.

We, the undersigned, express our unconditional support for the statement and actions of the former Chair and Inner Council of the Midwives Alliance of North America (MANA) Midwives of Color Section and all midwives of color who feel represented by these positions. We wish to acknowledge the experience of many, many years of devaluation and dismissal of midwives of color by the professional midwifery community. We acknowledge the interpersonal racism that has characterized the interactions in general between midwives of color and white midwives. We also acknowledge the deep institutional racism within midwifery in the United States as a whole, which characterizes our professional organizations, educational institutions, learning environments, conferences, and group interactions. We acknowledge that this situation has its roots in the systematic elimination of midwives of color over the course of the 20th century by the white-dominant health care system’s neglect, devaluation, and violation of the bodies, ways of knowing, and communities of people of color. We acknowledge that, in some cases, white midwives were complicit in this elimination. We acknowledge the fact that, among many negative effects, this institutional racism continues to exclude and marginalize students and midwives of color today. Moreover, in failing to confront this legacy and to actively work to transform it, the midwifery profession as a whole participates in limiting access to care for women of color, and perpetuates the structures of racial and economic injustice and inequity in maternal and infant health in the United States and internationally. Continue reading …

How can you help? Read the letter and add your name as a signatory. Join the AROM Facebook Group. Find other ways to get involved and get inspired by the work we’re doing. Pass the word, repost the letter, tell everyone you know who is involved in midwifery. Begin having discussions about anti-racism and anti-oppression in your community and find ways to work towards birth justice.

Institutionalized Racism, White Privilege, and MANA

Oh my goodness. If you haven’t been following along, there has been a tremendous amount of activity in the last two weeks within MANA, the Midwives Alliance of North America.

Here is a rundown of what has happened so far:

  1. On May 21, the Midwives of Color (MOC) MANA section chair and her Inner Council resigned en masse from their board positions within MANA and the organization itself, citing continued institutionalized racism and continued inaction on MANA’s part. The midwives who resigned are the MOC Chair Darynée Blount and the MOC Inner Council: Jennie Joseph, Jessica Roach, Ayesha Ibrahim, Claudia Booker and Michelle Peixinho. All of these are midwives and student midwives for whom I have nothing but the deepest respect and admiration. They are absolutely top midwifery leaders and activists and are at the forefront of reproductive and birth justice work in the midwifery world. MANA lost some of their best midwives when these women resigned. You can read the entire resignation letter here.
  2. MANA responded on their Facebook page by trying initiate conversations about what happened and where to move forward in the future (these can be an infuriating experience to read, be forewarned). They continue to write letters to their membership and the public at large explaining their position, stating the work they have already done and where they see their next steps, and making public a sort of apology that did not take any real ownership for racism and racist practices they have perpetuated through the history of MANA. You can all of these public statements here.
  3. Jessica Roach, one of the MOC Inner Council Members who resigned, wrote a response letter.
  4. Wendy Gordon wrote a letter of apology. This letter addresses her own shortcomings, examines her role in perpetuating racism in midwifery, and makes a commitment to move forward and make changes in the future. It looks a lot more like the apology letter I would have liked to have seen from MANA.
  5. Perez covered the resignation on the Radical Doula blog here and here. I think she really hits the nail on the head here:

    “Again, for me, the bottom line is this: we can no longer ignore the disproportionately high negative maternal and infant health outcomes faced by communities of color.
    “And it’s going to be damn hard to address those disparities if we can’t even address racism in our own organizations–especially if that racism means that providers of color choose to leave or are pushed out.

    “The needs of communities of color in maternity care can no longer be the topic of an interest group, or a caucus, or a breakout session. It has to be THE FOCUS. And my guess is that if we address the needs of communities of color, we’ll probably change maternity care in ways that benefit everyone.”

  6. There have been some calls for a resignation of the entire MANA board, a radical restructuring of the power systems within the organization, and a new board with MOC members committed to institutional change. Personally, I am supportive of this proposal. I think it’s going to take radical change like this resignation and other organizational restructuring to dismantle the systems of power currently in place and rebuild an organization that actually serves all midwives, parents, and children.

Frankly, MANA’s response it is too little way too late. A lot of it looks like white guilt and lip service to me, without any real sweeping change that will effect anything substantive. Within the past year, they launched a social justice agenda, brought some anti-oppression trainers on-board, and started to offer workshops at MANA conferences. What is needed is deep, sweeping institutional change and a strong commitment to undoing the the harm caused by racism in the past and in the future. We need to re-examine our priorities as midwives and own up to our own role in the racism inherent in white-dominated midwifery as it stands today. No ifs ands or buts. Each and every white midwife needs to learn about anti-racism and anti-oppression work and commit to continuing this learning process for the rest of their tenure as a midwife. They need to examine their own role in the racist attitudes, actions, and statements perpetuated by them, their fellow midwives, and their midwifery organization. It is each white midwife’s duty to learn about white privilege and own their own shit. Not only is this imperative for the profession as a whole, it is crucial that we do this in order to serve our clients better and all birthing parents.

I think midwifery has an incredible opportunity here to really effect the racial disparities facing Black and Native American families specifically when it comes to maternal and infant mortality. Will we let the opportunity slip us by? I sincerely hope not. I am done pussy-footing around here and I am sick of forgiving ignorance and racism as par for the course when it comes to midwifery. Our clients deserve better, our students deserve better, and we ourselves deserve better. I am fed up.

I want to state for the record that although I am a student midwife, I am not a member of MANA. I was considering joining my professional organization when I had enough extra money to do so although lately I have been re-thinking things. I already knew that MANA had a serious and long-standing problematic relationship with race and racism. However, watching how MANA has dealt with the resignation and the aftermath, I am less than impressed. I don’t know that I can, in good conscience and at this time, join an organization that midwives the likes of Jennie Joseph and Michelle Peixinho feel they can no longer be a part of.

Anti-Oppression Work and Midwifery

Anti-oppression work, diversity work, and a open-eyed look at our own areas of privilege is a crucial part of midwifery education, not only for working with clients across the board but for forging successful ties with fellow midwives and other colleagues. In the direct-entry midwifery world I feel that it’s a topic that is not often explicitly talked about, which leads to problems. When we don’t talk about it, we assume it doesn’t exist. If it doesn’t exist, why would we need to examine ourselves and our own beliefs, behaviors, and interactions with others?

And when that happens, you get a situation like we currently have. Direct-entry midwifery in the US is the domain overwhelmingly of white, middle class, straight women serving largely white, middle class straight women. How can we pretend that we serve all women when this is the case?

To be fair, some of this is beyond our control. Until we have a healthcare system in the US that allows for insurance reimbursement for the services of direct-entry midwives, we will be understandably limited in who we can serve based on their incomes and financial status.

But when it comes to who feels comfortable, safe, and welcomed in a homebirth midwifery practice we start to get into questions of race, racism, and privilege (not to mention class and heterocentrism). Serving all women is not just making yourself available to them, but also means working to make sure that your practice is actively inclusive.

I don’t have the answers, but I do have some ideas on what needs to happen:

  • We need to serve more women of color
    • This means that we need to have practices that feel welcoming to women of color
    • This also means we need to understand and practice cultural competency
    • We need to help women of color view direct-entry midwifery as a valid choice for their prenatal and intrapartum care. This is a big hurdle in some locations particularly because of some shady and racist dealings beyond our control – like the government providing midwives (largely white CNMs) in the rural south to poor Black women because they believed midwives to be less well trained (and therefore cheaper) than doctors. Or the government giving depo provera to Black women as a form of temporary sterilization because it viewed these women as A) unworthy of reproducing and B) not competent enough to make their own choices about their own care. Shitty things our government has done that may not be our fault but that we nonetheless need to actively work to combat in order to stop being complicit with these actions. Start by learning about the reproductive justice movement.
  • We need more midwives of color
    • One of the first ways we can change this is by being more inclusive of the way we educate direct-entry midwives.
  • We need to radically change our midwifery education system:
    • Raise the levels of women of color enrolling in midwifery education programs
      • I look around at the class pictures of previous classes at my school and am shocked to see almost entirely white women (or women of color passing as white, hard to tell from just a photograph). I know my class is more diverse than previous classes, but only just. And while Maine is no Los Angeles, it’s not as white as you might think.
    • Raise the levels of women of color graduating from midwifery education programs
      • When I can count on one hand the number of women of color the oldest direct-entry midwifery school in the nation has graduated, we’re talking about a serious problem. One that is insidious in midwifery education and has been a problem for a long time.
    • Ensure that all midwives graduating from MEAC-accredited institutions participate in in-depth anti-oppression training by trained and skilled facilitators. Most of the trainings currently available are insufficient, poorly taught, and/or irrelevant to the work we need to do. This needs to change so that we can:
    • Turn (white) midwives into anti-oppression activists. Get them involved with the reproductive justice movement. When midwives understand oppression on an institutional level and can examine their own privileges, they will understand why it is so critically important that we tackle this issue as a group.
    • Help midwives understand that by becoming radically inclusive, they are putting one more chink into the armor of the allopathic, western medical system that works on an oppressive sexist, racist, top-down power structure. To be a midwife in the US is to be an activist. Period. To be a midwife should also include being a reproductive justice activist.

So those are my few ideas. I hope to continue to deepen and flesh them out in the coming years of my training and practice. I hope to be able to make some real change in the right direction. What do you think? What are your ideas? How can we come together to make a better and more inclusive Midwifery Model of Care for all women?