Birth politics in a “majority minority” country

There has been a lot of news lately that keeps tying back to the thread I started a while back, about how midwifery can truly be accessible to communities of color.

First, last week we had a big media splash with new census data that shows the majority of babies being born in the US today are not white. This has been true for quite some time in certain parts of the country, like California, but now it’s a national fact. Demographers have been predicting for a long time that we’re heading in this direction, so it’s not a surprise. But it does make for good headlines, and stirs the pot of zenophobia and racist panic.

It also makes extremely clear how important it is that we focus on the needs of communities of color when it comes to maternal health. It’s no longer about an interest group! It’s no longer about the minority! Dealing with race-based health disparities in maternal health is actually about the majority of births. Wow.

Feels like a game-changer to me.

Unfortunately for midwives and birth activists, women of color are still a very small minority of those accessing out of hospital birth. A bigger slice is likely accessing in hospital midwifery care (anyone know those stats?) but we’ve got a long way to go.

Then, yesterday, the news that the Midwives of Color contingent of MANA, Midwives Alliance of North America, resigned in protest. Still waiting to see a statement from MOC about what prompted this move, but MANA already acknowledged it on their facebook page:

It is with heavy hearts that the Midwives Alliance today received the resignation of several key members of the MANA Midwives of Color (MOC) Section, including the Chair. MANA is fully aware of its history of privilege and the issues related to cultural and systemic hierarchies in decision-making. We are committed to working towards a structural change in the way our organization operates in light of the repeated failures to address the needs of our midwives of color. We recognize the disproportionate impact of perinatal disparities and poor outcomes for women, infants and communities of color. MANA has an ongoing responsibility to address these issues in order to fulfill our mission of providing a professional organization for all midwives.

I’m not involved in MANA, I’m not a midwife, I haven’t talked to anyone from the MOC. (I did attend a MANA conference back in 2005/2006 in Mexico City). I don’t know the specifics of what went down, what prompted this major move.

What I do know is this: We have to center the needs of communities of color in maternal health. The disparities alone should have been enough of a reason. Black women are FOUR times more likely to die during childbirth than white women. FOUR TIMES. But of course, that’s how racism works.It perpetuates systems of oppression by marginalizing the needs of those most in need.

But now we’re no longer the minority. Now, the health of the nation very literally depends on our ability to tackle race-based health disparities, particularly in maternal health.

I personally believe that the midwifery model of care is a big piece of the puzzle when it comes to answering the problem of race-based maternal health disparities. And a big piece of the puzzle of making midwifery care accessible in communities of color? Midwives of color.

So I sincerely hope that MANA, or whatever other governing bodies exist in the midwifery world, can get their priorities straight, and do what work needs to be done.

The numbers don’t lie–and they point in a clear direction. We need to be putting all of our attention on race-based maternal health disparities. All of it. It’s a concern of the majority now.


How can midwifery truly be made accessible to communities of color?

Right as 2011 was wrapping up two articles were posted about home birth and midwifery revivals in communities of color. Having written about the question of race in the home birth movement back in 2009 for RH Reality Check in these two articles, I’m excited when new outlets pick up the story. There is much movement in this arena, and also much more than can be done to make sure US midwifery is accessible to people of color.

In New America Media, Valeria Fernandez writes about efforts to revive Mexican midwifery in Arizona:

Marinah Valenzuela Farrell is one of only a few licensed midwives in Arizona. Though it isn’t a profitable venture, helping mothers bring their newborn children into this world is for Farrell a calling deeply rooted in her native Mexican tradition.

“It is really hard to be a midwife,” said the 41-year-old. “You don’t sleep, and you don’t make money. People think you’re crazy because you’re doing homebirths.”

A majority of Farrell’s clients are middle class and white, though as a Latina she aims to make midwifery accessible to low-income women in dire need of prenatal services but too afraid to seek them out in a state virulently hostile to undocumented immigrants.

“I think they don’t know that we exist,” she said. “I think the more the community knows that there’s a midwife who will come and visit them at home and do a homebirth… [attitudes] will change and shift.”

I spoke to the author while she was working on the piece, and a quote of mine is included toward the end.

In The Grio, Chika Oduah writes about black women and home birth. The article includes a video, which is a good primer of the issues at hand with home birth. It also references my Colorlines article about the possible connection between maternal health in communities of color and access to midwifery care.

What is clear from the research about this issue is that women of color are less likely to receive midwifery care, and that disparity is larger than the population numbers would suggest. I think this dynamic is complicated by global sociopolitical historical factors. For example I experienced resistance from Latina immigrant women to midwifery care because of the stigma toward parteras (midwives) in their home countries. In many places in Latin America, midwives and home birth are seen as the option used by women who can’t afford to go to hospital for birth–basically an option only for those who have no other option.

That creates class and race stigma on home birth and midwifery care.

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Guest post: Why doulas are important in Native American communities

This is a guest post from Raeanne Madison, who was profiled a few weeks ago in the Radical Doula profile series. This post was originally published on her blog. Her perspective, and the perspectives of other Native American and Indigenous folks, is crucial in this fight for reproductive justice. I’m inspired by her words and her spirit, and honored to be able to feature them here.
Ondaadiziike. The Ojibwe phrase for giving birth. When I was writing this article, I was hoping to combine ondaadiziike with the Ojibwe words for safety and comfort. I was surprised that the dictionaries I consulted didn’t include these words. So I was left with just ondaadiziike. No safety, no comfort to accompany it. This is reflective of modern birth culture in Native American communities, I think. Women (and girls) are giving birth without the accompaniment of safety and comfort. Modern day pre, ante, and post natal care for brown women in the United States is at times unsafe, and usually uncomfortable. Racism, sexism, poverty, and isolation have left women and their babies in desperate need for support, love, and compassion.

It wasn’t always this way. Native women were long respected as life givers. Our ancestors had mysterious, spirited reproductive powers. Women were forbidden to enter the dance arena during their moon time (a practice still respected in modern Powwow culture); not because they were viewed as dirty or hysterical, but because these women were so powerful during this time in the life cycle that they could take away power from anyone in the circle. So they stayed out in respect to their community members. Women took care of each other, Aunties, Grannies, Mothers, and Sisters. But women were also independent, knowledgeable, and assertive in their bodily rights. Reproductive culture varied from tribe to tribe but one thing was constant: women’s powers were sacred.

Enter Western patriarchy. Native women were subjected to horrors manifested in all aspects of bodily harm. Our ancestors were kidnapped, gang raped, and fed to war dogs. Eaten for entertainment in circus like manner. Forced to marry white men and birth babies alone, without the help of their beloved Sisters. Traditional knowledge of menstruation, pregnancy, birth, and breastfeeding were lost, and Native women today still pay the price. Of all the ethnicities in the US, Native women suffer the most when it comes to birth. We have some of the highest teenage pregnancy rates, pre-term birth rates, maternal and neonatal morbidity rates, and some of the lowest breastfeeding rates. Reproduction in our community has become dangerous and unpredictable at worst, and casual at best as women forget just how powerful their bodies can be. Studies have proved that these racial disparities exist because of poverty and racism.

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Interview with Ina May Gaskin about women of color and birth

I had the unique pleasure of interviewing midwife and birth activist Ina May Gaskin (via email) for my latest Colorlines feature.

Ina May graciously allowed me to post the full text of our interview since only a few snippets made it into the Colorlines piece. She had a lot of wisdom about this issue (not surprisingly!). It really is worth the read–Ina May displays a really comprehensive understanding of the issues facing women of color when it comes to out-of-hospital birth care.

Here’s Ina May:

RD: You mention briefly in Birth Matters that when obstetricians were trying to bring birth to the hospital (and learn how to care for birth), one doctor in Chicago paid immigrant women to give birth there. I’ve also understood that initially, particularly black women weren’t allowed access to hospital birth because of segregation/racism and class issues as well.

IM: That’s true. In general, low-income women in urban areas were initially brought into hospitals so that doctors in training could practice on them. That how they “paid” for their care.

RD: Can you tell me a little more about the history of particularly women of color in the US when it came to birthing in the hospital? Did they have a different experience than white women in terms of when they made the transition from home birth to hospital birth?

IM: Yes. For the most part, women of color who lived in the rural south didn’t go into the hospital until the 1970s and 80s. Alabama, Mississippi, Arkansas, Florida, and Georgia still had midwives who assisted women giving birth at home right through the 1970s. When doctors could count on Medicaid reimbursement for the first time, that situation quickly changed, and the midwives who were so needed before were forced to retire. Farther north, the pattern was somewhat different, because midwifery was outlawed in many states. Everyone was pushed into the hospital when this happened, regardless of the color of their skin. Women of color and poor white women were both used as teaching material in the teaching hospitals throughout the country. For this reason, the shift from home birth to hospital birth took place much earlier among urban women of color than it did for those in rural areas of the south.

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Behind the Billboards

Photo of billboard with a young black child's face and the words "black children are an endangered species"

My latest article for Colorlines went up today, an in-depth look into the black anti-choice movement behind the recent billboard campaigns. The subtitle reads:

On more than 170 billboards nationwide, a campaign is exploiting America’s racist medical history to foster the belief that abortion is black genocide.

The research for this piece was intense–it required a lot of time spent on anti-choice websites, reading their rhetoric and language. It also required wrapping my mind around 100 plus years of history of eugenics and discriminatory policies on behalf of the US government toward women of color, low-income women and disabled women’s reproduction.

It also included the opportunity to interview Dorothy Roberts, an amazing activist and researcher and expert in this arena. If you haven’t read her seminal work, Killing the Black Body, drop everything and go find a copy. Seriously. Her work lays out so extensively how the battle for reproductive rights in this country has been racialized from the start–a fact that our movement often neglects.

This book should be required reading for all doulas and birth workers. The history of the treatment and manipulation of women of color’s reproduction by the medical community, the government and the social system is so hugely important and so often neglected by our movements. As doulas, it’s our obligation to understand this background and use that understanding to provide sensitive and compassionate care to the folks we work with.

From my article:

Women’s reproduction has long been at the mercy of state control, particularly for women of color. For black women, this history dates back to slavery. As Dorothy Roberts outlined in her seminal 1998 book, “Killing the Black Body,” women held in bondage had no control over their fertility whatsoever, and they were relied upon and manipulated in order to produce the next generation of labor. Even after emancipation, eugenics and paternalistic ideas about who was fit to reproduce influenced government policy in the U.S. These policies overwhelmingly impacted the lives and health of women of color, as well as low-income women, women with disabilities and others deemed “unfit.” There is a deep history of forced sterilization across communities of color—some of which actually did result in the near elimination of certain Native American tribes.

These practices are not ancient history, and many incarnations still exist today: primarily through economic and social welfare programs that limit women’s access to certain forms of contraception or place caps on how many children they can have when receiving welfare. For example, undocumented women I worked with in Pennsylvania were able to get coverage for sterilization as part of their emergency medical coverage during pregnancy, but could not receive coverage for other forms of birth control since their Medicaid ran out shortly after giving birth. Women’s reproduction—but more specifically, the reproduction of women of color and low-income women—remains a practice in which the government is invested and deeply entwined.

I’ll leave you with one of Robert’s quotes from the piece:

“They are essentially blaming black women for their reproductive decisions and then the solution is to restrict and regulate black women’s decisions about their bodies,” Roberts says of the burgeoning black anti-abortion movement. “Ironically, they have that in common with eugenicists.”

Read the whole thing here.

On the death of the DREAM Act

The DREAM Act died this weekend.

Ever since I saw the news on Twitter I have a felt a heaviness in my chest. A sadness, a disappointment at my lack of surprise, my resignation. These two years of the Obama Administration feel like disappointment after disappointment. The wins are barely wins, most are just compromises.

I know that this is the way our political system works and that radical politics are rarely reflected in policy. I know that.

But then there are the injustices.

There are many in our country–too many to name.

But this one hits close to home.

I’m the child of immigrants. I’m the first generation born in the United States. My parents could have been DREAMers. They both came to the US from Cuba as pre-teens.

Two weeks ago I wrote an article for Colorlines about the privileged status Cubans have been afforded in the US:

Ever since the Cuban Adjustment Act of 1966, Cubans who have made it the United States have been put on an automatic path to citizenship. Cubans in the U.S. have reaped the benefits of this special status, my family included. My parents came to the U.S. with their families as pre-teens in the first wave of exiles from Cuba. Their respective families had different motivations for coming, but both were fleeing the new Castro government and its intrusion in their lives and their businesses. What for them, as for many who came over in the original wave, was meant to be a temporary visit until Castro was defeated, has become a multi-generation resettlement. I was born here, along with some other 652,000 Cuban-Americans, all of us with the advantage of parents who have been able to work and live legally since day one. It’s virtually impossible to be an undocumented Cuban in the United States.

If it wasn’t for this policy toward Cubans (fueled by Cold-War anti-communist fears) I wouldn’t be where I am today.

It’s not just that my family and Cuban community has had such access to citizenship and other immigrant groups have not.

It’s not just that the political whims of FIVE PEOPLE can close the door on the possibilities for millions.

It’s not just that our governmental policy is still motivated by hate, fear, racism and zenophobia.

It’s not just that no amount of fighting, of DREAMing, of pushing can change our intractable system.

I worked with a mother recently in my role as an abortion doula (more on that later) and she told me about her son. He’s a DREAMer. He’s a stellar student, he has big business ambitions, wants to open up hotels and restaurants. He knew about the DREAM Act and it sickens my stomach to think of him and all the other DREAMers out there who lost their chance (after ten years of pushing this damn bill) because of FIVE PEOPLE.

Where is the justice in that?

Arizona governor signs racist anti-immigrant bill into law

I just had to comment on this news today, which is that Arizona Governor Jan Brewer signed into law just a few hours ago a bill that essentially mandates the racial profiling of immigrants.

President Obama is against the bill (thankfully), but that doesn’t mean it won’t immediately and negatively impact folks living in Arizona.

Arizona Gov. Jan Brewer signed a state bill Friday that requires police to determine whether a person is in the United States legally, which critics say will foster racial profiling and discrimination but supporters say will crack down on illegal immigration.

As a Latina and a child of immigrant parents, it is so upsetting to see folks in Arizona have their rights and lives trampled on in this way.

The way that immigrants are criminalized in this country is outrageous.

Immigrant woman reunited with child after losing custody

A story I wrote about last June, looks like it finally has a happy ending. A year later, Cirila Baltazar Cruz has been reunited with her daughter.

Cirila gave birth in a Mississippi hospital, and initial reports indicated that the hospital staff deemed her unfit to be a parent because she couldn’t communicate with an interpreter. Cirila speaks an indigenous language from Oaxaca, explaining the  inability to communicate with a Spanish language interpreter.

So sad it took a year, but so happy for this mother and daughter to be reunited. According to the Native American Times, they are headed back to Mexico and the Mexican government has gotten involved.

A news release from Mexico’s Secretary of Foreign Affairs said Cruz’ situation was “a clear case of discrimination and violation of the most basic human rights of a Mexican citizen.”


Via VivirLatino

Worried about women of color? Thanks but no thanks anti-choicers. We’ve got it covered.

I have another piece up at RH Reality Check today. Apparently it’s my week for publication! This one has a lot more opinion and snark than yesterday’s. I was responding to the recent efforts on behalf of the anti-choice community to argue that abortion is being used by groups like Planned Parenthood as a form of eugenics against women of color.

Latinas and other women of color don’t need to be protected by paternalistic ideologues motivated by a political agenda that disregards the needs of women of color and their families. So thanks for your concern, anti-choicers, but I think the women of color advocates working within the reproductive justice movement have got it covered. We’re working in those clinics you attack, we’re helping to shape policies and provide services in our communities, services that allow us to decide what our needs are.

We know whom we can trust to make decisions about family creation: women themselves. We don’t need limits on what services we can access.  And we don’t need your ideological bullying.

The next time one of your crisis pregnancy centers, one of your dramatic billboards, or one of your bogus pieces of “sex and race selection” legislation actually works to support women through whatever choice they make for their families—we’ll talk.

Read the rest here.

From NAPW: Advocating on behalf of Precious Women

I just received this message in my inbox from the National Advocates for Pregnant Women. Their ED, Lynn Paltrow had a lot to do with me starting this blog (read the origin story here).

Her message gave me chills.

It seemed that an appropriate way to recognize this holiday weekend would be to post it here. Read it, support NAPW if you can, and learn more about the work of their organization.

Dear Friends and Allies,

Over the weekend I saw the movie Precious. This movie, about “an overweight, illiterate teen who is pregnant with her second child” is a soaring tribute to human dignity and, for me, captures the reasons why NAPW takes the cases we do.

Recently, NAPW chose to work on behalf of R.G. — an African American teenager from Mississippi who became pregnant when she was fifteen. She suffered a stillbirth one month after turning sixteen. What was the state’s response? They arrested her and charged her with murder.

NAPW learned about the case shortly before R.G. was scheduled to go on trial as an adult. We learned that her mother’s efforts to obtain help from other organizations had been rebuffed. NAPW reached out to her local counsel and offered our assistance.

The state claims the stillbirth was caused by R.G.’s cocaine use. Never mind that researchers have not been able to link cocaine use to pregnancy loss. Never mind that no country in the world has passed a law making it a crime for a teenager to suffer a stillbirth. And never mind that a Mississippi Supreme Court judge has expressed serious concerns about the qualifications of the doctor hired by the state to prepare the autopsy report.

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