Remarks from SQUATfest: Birth activism as part of the movement for reproductive justice

September 3, 2013

In early August I had the honor of speaking at the SQUATfest conference. It was a first of its kind gathering that brought together doulas, midwives and other birth activists interested in radical politics. It didn’t have a central theme, but I knew that it was going to be a unique space.

I gave the talk below to the attendees on the morning of the second day. I have a lot more to say about the gathering, and the topics I addressed below, which I’ll do in follow up posts. Makeda Kamara gave an absolutely earth-shattering and life-altering keynote address the following day. I don’t believe that it was recorded, but if you ever have a chance to read Makeda’s writing or see her speak, you have to do it. She has incredible wisdom about midwifery, as well as racial justice movements in the US and abroad.

The gathering was inspiring, but it was also another reminder that there is much work left to do, even within the “radical” parts of our movement, particularly around questions of racial justice and dealing with white privilege.

—————–

The reason I started my blog, Radical Doula, in 2007, was because I couldn’t imagine a room like this one existing. I had been a doula for a few years, and as my own identity and politics developed, I looked around me and felt alone.

I felt alone as a queer and genderqueer person. I felt alone as a Cuban-American, a Latina, a child of immigrants. I felt alone as a reproductive justice activist and someone who supported access to abortion as well as access to homebirth and midwives. I felt alone as someone who approached my work as a doula as social justice activism.

I remember one of the first, possibly the very first, conversation I had with another doula who felt similarly. Christy Hall, who is here today, and I met at a reproductive justice conference, and the memory of crouching in the corner with her, infant in arms, talking about being doulas with radical politics is seared in my brain.

So very much has changed since that first conversation all those years ago. The fact that this gathering is happening at all is a major testament to that change.

Needless to say, I no longer feel alone. Instead I’m in awe of the incredible growth in the doula movement, and particularly in the movement of doulas who see their work as part of a broader social justice vision. For so many of us, this work isn’t just about improving a few select people’s experiences with pregnancy and birth–it’s about changing the systems altogether.

This is no easy task. And while the growth and expansion of the doula movement is really good news in many ways, it also presents its own unique challenges.

What I wanted to talk about today is how I see our work as birth activists as part of the broader reproductive justice movement.

For those of you who aren’t familiar, reproductive justice is a movement that was established by women of color in the reproductive rights movement who wanted a framework through which to see their organizing that better mirrored the lives of the people in their communities. It’s an intersectional framework that acknowledges the complexity of people’s lives and the many issues that affects them.

One way I describe it is building a world where everyone has what they need to create the family that they want to create.

While abortion still tends to most of the attention in this work, I think birth workers, are also perfectly suited to be part of this movement and to utilize the framework to support our own efforts.

So what does it really mean to understand our work as doulas, or midwives, or birth activists, as part of the movement for reproductive justice?

First it means we put at the center of our work those who face the most challenges.

Read the rest of this entry »

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I am also not Trayvon Martin

July 19, 2013

It’s been tough to say much of anything online, or otherwise, since the verdict came down on Saturday evening in which George Zimmerman was acquitted of all charges for the murder of Trayvon Martin.

The murder has stirred up intense conversations about race, necessary, painful conversations about race. Because George Zimmerman is a mixed-race Latino, (his mother is Peruvian, his father white) his race has been called into question in many ways throughout this process. Some people of color, and Latinos, have tried to minimize his Latino-ness. The right wing has tried to play it up, claiming that his mixed heritage means that race could not possible be a factor in the murder. Some have labeled him a “white Latino or hispanic.”

I felt personally very pulled by these conversations because I too could be put in a category with George Zimmerman. I am a light-skinned Latina. My parents are both immigrants from Cuba, but my mother’s parents immigrated to the island from Eastern Europe as Jews fleeing anti-semitism and persecution. My father’s side had been in Cuba for multiple generations.

Race is a complicated socially-constructed and politically-shaped reality. For Latinos in the US, this reality is very different than the reality we might experience in our family’s country of origin. People who would be seen as White in Latin America may be seen as people of color in the US. These categories are fluid, ever changing and also extremely important in shaping our lived realities.

I am not Trayvon Martin, and as someone who could be George Zimmerman, I have a unique responsibility to work against racism within communities of color, including Latino communities. It’s a responsibility that weighs heavily on me. It’s also one that I see as distinct from the responsibility of white people to fight racism.

My understanding of my own identity has been heavily shaped by my knowledge of the political history of race and racial justice organizing in the US. The term woman of color originated as a term meant to build solidarity between Latinos, Blacks, Asians and Native Americans in the US. Loretta Ross has a great clip I originally found at Racialicious that I often refer to:

You can read the transcript at Racialicious, but this is the part that is most important to me:

And they didn’t see it as a biological designation—you’re born Asian, you’re born Black, you’re born African American, whatever—but it is a solidarity definition, a commitment to work in collaboration with other oppressed women of color who have been “minoritized.”

Now, what’s happened in the 30 years since then is that people see it as biology now.

Race is not a biological reality, it’s a social and political one. And that social and political reality differs widely depending on how you are read, how the world interacts with you. Because I am light-skinned, because I speak English without an accent, I walk through the world with relative privilege when it comes to race. But I also have a clearly marked Latino name. I may not even know how that has shaped interactions that happen virtually, or where my name is the first thing someone sees.  There are many ways in which one can be racialized in this country, and that is why the term woman of color, or person of color, was employed—to build solidarity across groups, not ignore differences or presume we all have the same experience.

There is a great post at Black Girl Dangerous, by Asam Ahmad, further extrapolating on this in reference to Trayvon:

We are NOT all Trayvon Martin. People of color keep getting hella mad for being called out on white passing privilege, for being asked to hold themselves accountable to the ways they are not like Trayvon and more like Zimmerman. So many folks seem to be having a hard time acknowledging that this murderer was a Latino who had light-skinned privilege and played into the rules of White supremacy to get away with murder. The fact that so many white folks are identifying with him should tell you something: it is a marker of how some people of color gain access to the toxic privilege of passing for White, of choosing not to identify themselves as poc but coopting into the system of White supremacy instead. Sometimes we do this for our own safety but sometimes, obviously, we do it for other reasons altogether. These are all realities of this case, and they are realities of a hierarchy that accords privilege and oppression on the basis of the amount of melanin in our bodies.

Why do these facts make you mad? Why is it so hard to acknowledge that you have access to forms of privilege that Black folks simply never have? As poc we are so often taught to think of ourselves as oppressed and as nothing else. But oppression is not a static entity and it does not remain constant for all POC. How can this not be obvious to anyone paying the slightest amount of attention right now?

Those of us who are not Black need to be very explicitly clear about this: Trayvon was not murdered because he was a person of color. This verdict was not delivered because he was a person of color. Trayvon was murdered because he was Black. This verdict was delivered because he was Black. Given the amount of intense anti-Black racism that continues to circulate in non-Black poc communities, given the number of ways we continue to benefit from anti-Black racism, it is paramount that we do not forget this. To appropriate the specificity of this injustice, to attempt to universalize this travesty as one faced by all people of color is to perpetuate another form of violence. To not acknowledge the role and specificity of anti-Black racism in this whole charade is another form of violence. This murder and this verdict are very specifically about anti-black racism – about the power of White supremacy and about what it means to have a black body in a White supremacist society.

And our inability to acknowledge these facts are hurting Black folks and African descended folks right now. This is not solidarity. This is not what solidarity can ever look like. It shouldn’t be that fucking hard to sit back and listen to the grieving voices of black people in this moment. It shouldn’t be this hard to not get defensive and keep your mouth shut and just listen.

I’ve been heartened by this and other efforts, like the tumblr We Are Not All Trayvon Martin, have taken on to try and explain the difference between solidarity and appropriation, between allyship and silencing.

Personally, I’ve grown and changed in countless ways over the years in my identity and understanding of my role within the broader community of color. From refusing to write an accent on my last name as a kid and the inclination to be silent about my identity and how I see myself, to instead insisting on spelling out clearly where my privilege lies and what I see as my role, it’s ever evolving. I have big thanks to give to many mixed-race and light-skinned people of color for walking the journey with me.

I’ve realized in the many years that I’ve written this blog, I’ve often assumed my audience was predominantly white. That’s because the doula community is predominantly white, and the full-spectrum doula community I’ve met and interacted with is also predominantly white. I know I’ve been able to feel comfortable, or be welcomed into some of these spaces because of my passing privilege, and it’s something that I think about constantly.

I also know that for doula work to be truly radical, truly transformational, we have to center race as a key factor that shapes the experiences of pregnancy and parenting in this country. We have to talk about it politically, personally, in every aspect of our work. So I’ll start with my vulnerable place, my story, my experience.


Coercive sterilization is not a thing of the past

July 8, 2013

This article in The Modesto Bee, authored by Corey G. Johnson of the Center for Investigative Reporting, shows what many of us have assumed: coercive sterilization is not a historical practice—it’s a present reality. While fights rage on across the nation to maintain our access to safe and legal abortion procedures, for some folks, the fight to maintain the ability to become pregnant, and parent those kids, continues.

These fights, primarily because they impact low-income folks of color, don’t get the kind of attention and resources that other battles do. There is racism and classism in this divide, and we have to do all we can to raise hell and attention for the ways population control efforts continue today in this country.

From the article:

Doctors under contract with the California Department of Corrections and Rehabilitation sterilized nearly 150 female inmates from 2006 to 2010 without required state approvals, the Center for Investigative Reporting has found.

Former inmates and prisoner advocates maintain that prison medical staff coerced the women, targeting those deemed likely to return to prison in the future.

The article explains that the reason these procedures required state approval is precisely because of the history of coercive sterilization for incarcerated women. Court cases in the 1970s based on the discovery that Latina women in California public hospitals were being sterilized without proper consent led to a set of rules regarding how and when you can properly consent to a sterilization procedure (like a tubal ligation).

In order to obtain consent, you have to provide consent information and documents in the patient’s native language (Latina women were found to have signed papers in English consenting to the procedure, despite not speaking English) and you also can’t obtain consent during labor or delivery.

In addition, this article explains that federal funds could not be used to provide sterilization procedures to incarcerated folks because of fear of coercion.

From this reporting, which relied on the work of Justice Now, an organization working with folks on the inside to eradicate prisons, coercion is exactly what took place in many of these sterilizations.

One interesting thread throughout the article, which is distinct from the historical incidences of coercive sterilization, is the use of repeat c-sections as a medical rationale by the doctors quoted for these procedures. With repeat c-sections, they say, there is a risk of uterine rupture upon subsequent pregnancies.

The question there, of course, is why so many c-sections to begin with? I don’t buy it, and assume it’s just a medical attempt to cover up what is really a procedure pushed because of judgement about who should parent, and how many children someone should have, particularly someone who is incarcerated.

I increasingly get more and more infuriated about how little attention in the reproductive rights arena goes to the struggles of low-income, people of color trying to maintain their right to pregnancy, parenting and bodily autonomy. If you are truly doing reproductive justice work, than this issue should get as much attention as any abortion rights fight.

Want to know how to support these efforts? A donation to Justice Now is a good place to start.


History of Black Midwives slideshow by ICTC

February 11, 2013

The International Center for Traditional Childbearing published this slideshow about the history of Black midwives in the US. It’s important for all us to understand the role Black midwives have played in the midwifery movement. While this is unlikely to be comprehensive, it’s an important resource in elevating this history.

ICTC also has a doula training program that centers communities of color. Read this guest post for one perspective on their training. They have a training coming up in March in Portland, OR. More info here.


Documentary: Catching Babies

December 17, 2012

This weekend I had the pleasure of seeing the new documentary Catching Babies. Claudia Booker of Birthing Hands DC organized the viewing.

The film is about a midwifery school in El Paso Texas called Maternidad La Luz. It’s a unique place–an intensive midwifery program that trains non-nurse midwives in a 13 month program that is extremely hands on. Two of the student midwives in the film describe catching their first babies just months after arriving at the school.  Students who complete the program can work as out-of-hospital midwives across the country, depending on the laws in their state governing non-nurse midwives.

I actually visited the school in 2007, did an overnight where I shadowed students and midwives as they did their visits and attended births. I went because at the time I was still planning on becoming a midwife, and I was excited by the possibility of attending a school that almost entirely catered to the Latina community.

Because the school is based in El Paso, steps from the border with Juarez, Mexico (the two cities are actually contiguous, the only thing separating them a bridge that represents the border) the vast majority of the women who birth at Maternidad La Luz (it is a free-standing birth center, as well as a school) are Mexican and Spanish-speaking. Many are not US citizens, but living on the border are allowed to travel back and forth with a certain area on what are called “radial visas.”

The film is really well done. The filmmakers are both women of color, which comes across clearly in their perspective and in who they choose to focus on as subjects of the film. We see one African-American student midwife, another who identifies as indigenous Mexica and grew up in El Paso, along with two other student midwives as they take their journey to midwifery. Throughout their stories is the birth stories of the women they support during pregnancy and birth, all of whom are Spanish-speaking women of color.

This focus of the film stood in stark contrast to my own experience when I visited the clinic in 2007.

Read the rest of this entry »


Race-based health disparities and the politics of difference

October 22, 2012

My latest column at RH Reality Check discusses the fact that last week was the tenth anniversary of National Latino AIDS Awareness Day, and delves a bit into the causes of race-based health disparities.

I was inspired to write about this topic after hearing scholar and Professor Dorothy Roberts speak at Barnard College. She’s the author of two incredible books about race and health, Killing the Black Body–an absolute must read for anyone interested in reproductive rights, and Fatal Invention, her most recent book (which I reviewed here last year).

Fatal Invention takes on the question of race and genetics, and addresses the growing movement which tries to connect race-based health disparities to genetic difference, despite very little evidence to support these claims.

From my column:

Latinos do not experience higher rates of HIV and AIDS because of any unique genetic propensity or susceptibility toward the disease, but instead because of the social and economic reality faced by Latinos that lead to higher rates of HIV infections and AIDS-related illnesses. Things like lack of access to health care, homophobia, lower rates of condom use, and language barriers among other causes.

To some it may seem absurd to think that anyone would argue that race-based health disparities are a result of genetic or biological differences among racial groups, but the fact is this argument is on the rise, and it isn’t new. Studies with these kinds of claims grace the front page of the New York Times science section on a regular basis. Rather than acknowledge disparities, some want to highlight the concept of difference—meaning that racial groups have biological differences that account for these statistics, rather than blaming the conditions of racism that shape our lives and our health.

This distinction feels as important to highlight as the problem of race-based health disparities themselves, particularly in an era where the FDA can approve a race-specific drug (BiDil, a drug for congestive heart failure) with little scientific evidence backing the claim that it successfully targets African Americans over other groups.

Our work to address health disparities needs to be based outside of the laboratory or pharmaceutical industry, and instead placed in the broader social context that is likely to blame for these disparities in the first place.

Precisely because I talk so much about these race-based health disparities, I think I, and all of us, need to do a better job of explaining the likely cause. Because if not, in our silence, the assumption can be made that the statistics are simply a matter of differences. This obscures the real and horrific injustice of poverty, racism and all of the other social factors at play.


Responding to the home birth debates

July 18, 2012

My latest column for RH Reality Check is up. With some serious hesitation I decided to respond to the conversation about the safety of home birth started by Michelle Goldberg recently at the Daily Beast. It’s been really challenging to see how polarized these conversations are, how vast the divide is between what feels like two camps: the home birthers (who are assumed to hate hospitals, obstetricians and people who use either) and the hospital birthers (who are assumed to hate midwives, home birth and people who use either). It feels like the potential for debate and rational dialogue is minimized because of this polarization. Maybe I shouldn’t be surprised by any of this. Anyway, my response is excerpted below.

A recent heated dialogue between journalists Michelle Goldberg and Jennifer Block about the safety of home birth has been the latest in a recent media flurry about the rise in home births reported by the CDC in January. A New York Times Magazine profile of Ina May Gaskin, arguably our nation’s most famous home birth midwife, was just one of the most mainstream of the recent articles, and seems to have stirred up much scrutiny of the practice.

I feel compelled to dip my toe into the conversation, if only to try and steer it in a different direction. The source of the back and forth between Goldberg and Block centers on this question: “Is home birth safe?” It’s not a new question; in fact it has been debated since the beginning of obstetrics and hospital birth at the turn of the 20th century.

Unfortunately, though, it’s exactly the wrong question to which to be devoting so much air time. A scant share of all women giving birth in the United States do so at home. Despite the reported 29 percent increase in home births nationally between 2004 and 2009, fewer than one percent of births happen out of hospital. While home birth gets much scrutiny, particularly when wealthy white women are seen as forging a new trend by choosing it, the place where the majority of women give birth in the United States — the hospital — goes largely un-scrutinized.

Hospital births do get a lot of attention in birth activist circles (where I spend significant time, as part of my work at Radical Doula). Midwives and doulas will quickly recite the problems with hospital birth, e.g., why high intervention rates (c-sections, inductions) are bad for mother and baby. But outside of that arena, where it’s arguably most needed, the conversation is stalled.

Here is the reason this matters: we are in the midst of a maternity care crisis. I’ve said it before, but I’ll say it again: our maternity care system is broken. Why? Because our maternal and fetal mortality rates are worse than 40 other countries worldwide, despite the fact that we spend more money than anyone else on maternity care. And where is  almost all that care being delivered? In hospitals.

Read the rest here.


Call for Submissions: Saving Our Lives: Black Women, Pregnancy and Childbirth

July 17, 2012

Black Women Birthing Justice, a group based in Oakland, is putting together a much needed anthology about Black women, pregnancy and childbirth.

Details:

Birthing Justice – Saving Our Lives will be an anthology of critical essays and personal testimonies that explore African American, African, Caribbean and diasporic women’s experiences of childbirth from a radical social justice perspective. We seek writings by midwives, doulas, natural childbirth advocates, reproductive rights activists, moms and moms-to-be, sociologists, feminist and Africana studies scholars, and historians that document state control and medical violence against black pregnant women, revitalize our birthing traditions, and honor and record empowering and sacred birth experiences. We are particularly interested in essays that document activism and resistance.

Read more here, and consider submitting! Such an important conversation.


“Model Minority” myths and maternal health

July 5, 2012

A belated post about my column last week for RH Reality Check, in response to the Pew Foundation report about the “rise of Asian Americans.”

Last week’s report from the Pew Research Center, The Rise of Asian Americans, has stirred up much controversy. Many advocates in the Asian American and Pacific Islander (API) community are arguing that the findings further a damaging idea about Asian Americans — the “model minority” myth. Advocates have said that these myths, which include the idea that Asian Americans are wealthier, more educated, and happier than other groups (all purported in the Pew report) are damaging because they hide the real challenges that exist for Asian Americans and Pacific Islanders, in particular for certain national and ethnic minorities that fall under the API umbrella.

One place this “model minority” concept can have negative implications is in discussions of health disparities. Whether due to population size or misconceptions about the health of Asian Americans, we do not often hear about the specific health disparities facing the API community. In the discussions about race and health, people of color are often grouped together, and disparities are talked about in terms of the gap between white people and people of color (Asian Americans included). These simplifications ignore the differences between racial groups, and even within nationalities and ethnicities within those racial subsets. Because of the Pew report, and as part of my focus on race-based health disparities and maternal child health, I decided to look further into the data on Asian Americans and Pacific Islanders.

What we do know is that API women suffer from higher rates of certain negative maternal and child health outcomes than their white counterparts.

Read the rest here.


New column: More on maternity care and race

May 31, 2012

My second column is up at RHRC, an expansion on my thoughts about the new census numbers and maternal health.

The Center for Medicaid and Medicare Innovation just announced 43 million in funding for new approaches to prenatal care that address the problem of premature births — something that leads to much higher mortality rates, and a host of other complications for newborns. But once again it looks like midwifery will be kept out of this discovery process — the only eligible providers are those who see at least 500 births per year — something that few midwifery practices or birth centers do. These requirements are based on the desire for statistically significant findings, but they might just exclude those who can actually produce the results they are seeking.

It’s hard to imagine that a medical provider who is forced to carry a high volume of clients will be able to provide the care necessary to eliminate race-based health disparities. If Medicaid doesn’t make room for alternative, potentially life-saving maternal health models, we risk endangering the health of generations to come. The challenges are clear, what we require are the innovative solutions. Our nation’s health depends upon it.

I also owe a big thank you to Claudia Booker, who got in touch after I wrote this post, to talk with me about the challenges of making a living as a midwife who serves mostly low-income women of color. Much of our conversation didn’t make it into my column, but it’s an absolutely crucial conversation for us to have: how can midwives make a living and still serve low-income women? Medicaid, only an option in a portion of states, makes it extremely difficult to make a living and stay true to the midwifery model.

Without it, midwives have little chance of reaching women of color, and midwives who want to work exclusively with low-income populations will have to make a living through alternate means. Our providers have to make a living, and if they can’t make a living serving low-income women, we’re screwed.

Thank you Claudia, for pointing out that making midwifery accessible to communities of color also means making the midwifery profession accessible to those who want to serve communities of color. That’s going to require an innovative business model for midwifery.

One thing we talked about was having a diverse clientele–for each midwife to serve clients who can pay the full fees (either through private insurance or out of pocket) and low-income clients via Medicaid or a sliding scale.

The challenge, she said, is racism. Namely that it can be difficult for midwives of color to attract clients who can pay (who are more likely to be white), and these biases make it difficult for all midwives to have a diverse client base. She pointed out that we all want providers who look like us.

I have a lot more to say on the subject. For now, you can read my column, and stay tuned for more.


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