Coercive sterilization is not a thing of the past

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.

Advertisements

Race-based health disparities and the politics of difference

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.

More on the resignation of midwives of color from MANA

I mentioned a bit about the news that a key group of midwives of color, who were previously involved with the Inner Council at the Midwives Alliance of North America, resigned early this week.

More has been released regarding their resignation, so I wanted to post additional information here.

I realized shortly after posting that I in fact do know quite a few of the midwives who resigned–I just hadn’t been in contact with them lately, and did not know they were so active in MANA. Jessica Roach sent me their letter of resignation, which is also posted on this blog.

The first part is a letter from MANA, seemingly in response to the resignation of the midwives of color. What follows is the resignation letter.

Again, because I am not involved in MANA, I don’t want to comment on the situation specifically, except perhaps to say that I feel much solidarity with the women who have resigned. Claudia Booker, Jennie Joseph and Michelle Peixinho I know to be really incredible midwives and passionate leaders–I trust their opinions and experiences.

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.

Jessica Roach also wrote a follow-up letter about the resignation that Claudia posted on her facebook page–I’ll share it at the Radical Doula facebook page.

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.

Continue reading

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.

Continue reading

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.

Continue reading