Know your history: Coercive sterilization of Latinas at L.A. County Hospital in the 70s

I think it’s really important for doulas, and activists, and birth workers to understand the social and political context of pregnancy and birth in the US. Clearly, I think it’s so important that I wrote a book about it.

A big piece of this history is understanding how the fertility of women of color, and low-income women, and immigrants, and those who are mentally-ill or incarcerated has been manipulated by government institutions, including hospitals.

I recently interviewed the director of a new documentary about one of these instances, where Latina immigrant women in a teaching hospital in Los Angeles were sterilized after c-sections without their full and proper consent. It’s a really heart-wrenching story, but also one of resilience and successful pushback–laws mandating informed consent for tubal ligations arose as a direct result of this situation.

You can read the full interview with the director over at Colorlines.


So what is a Radical Doula anyway?

Earlier today I looked over the language that had been on my Radical Doula??? page since 2009. I’m embarrassed that it took me so long to update it, but it was a good opportunity to revisit my definition of the term and how it’s changed over all these years blogging and working as a doula.

What’s there now is a long missive about this term, how I see it defined, and the context that has shaped my shifts in that regard. You can read the whole thing here, but a snippet to whet your appetite:

One thing that is really important to me is that I do not own the term Radical Doula. I might rent the domain, but I by no means see myself as the arbiter of what a Radical Doula is. It’s a term that very much popped out of my mouth in a surprising way–really it was a way to describe the alienation I felt within the doula community. Over the years as I’ve continued theRadical Doula Profile Series (a way to relinquish ownership of the term and highlight anyone who identifies with it) I’ve noticed that for some doulas, simply being a doula, trying to change the culture of birth, in and of itself is a radical act.

I understand that logic, but it is not what I meant when I started this blog. That does not make it wrong, it just makes it different than my original purpose.

This page used to include a laundry list of the identities and politics I hold that made me feel alienated. It included things like being “pro-choice” or supporting the right to abortion, the fact that I’m Latin@, that my parents are immigrants from Cuba, that I identify as queer and genderqueer, that I approach doula work as activism.

As the doula world has expanded, and as I’ve connected with more and more like-minded doulas through this blog, my definition of a radical doula has moved away from being centered on that laundry list of identities. Those still matter, don’t get me wrong, but I think what matters more is a political understanding of the role of the doula.

Being a Radical Doula, for me, is about understanding the politics of pregnancy and birth in the US, and working to use our role as doulas to interrupt this. I very much understand that our power to really change the balance of power is minuscule–but simply having a power analysis at all allows us to frame our work as doulas in a different way.

This different way means working hard to make our services as doulas accessible to people who wouldn’t otherwise have doula support. The mechanics of this will look different for everyone, from volunteering with a program in a public hospital, to offering a sliding scale or barter system for your fees. It could be getting trained on how to support pregnant people with disabilities, or people who speak another language, or are queer or trans or gender non-conforming. The how will vary for all of us, but the bottom line is this: we care about working with marginalized communities, about providing doula support to those who would not otherwise have it.

For me birth activism is about working to improve the pregnancy and birth experiences of those who are already suffering the most–not just improving the experiences of those who already have the best outcomes. It is not that those who already have the best outcomes (which, in most cases, could still be significantly improved) don’t deserve better–it’s that if we work to improve the experiences of the most marginalized, everyone’s experiences will improve. It doesn’t necessarily work the other way around.

To me, being a Radical Doula is committing to the hard work of facing issues of racism, classism, ableism, homophobia, transphobia head-on in our work with pregnant and parenting people. It means understanding birth as just one instance in a wide spectrum of pregnancy-related experiences that include abortion, miscarriage and adoption, and understanding why doula support across that spectrum makes sense. It’s about providing non-judgmental and unconditional support to pregnant and parenting people, ultimately in service of social justice.

As always, I invite you to explain why you identify as a Radical Doula by participating in the Radical Doula Profile series.

Radical Doula Profiles: Caitlin Caulfield

This is a series highlighting folks who identify as Radical Doulas. Are you interested in being part of the series? Go here to provide your responses to the profile questions and I’ll include you!

A photo of radical doula Caitlin Caulfield.

Caitlin was born and raised in Alaska where she grew up among the birch and spruce taiga forest of the Interior. She graduated from Smith College with a degree in Anthropology and Elementary Education in 2008, and since then has worked as a bookseller, a farmer, and a teacher.

Caitlin trained as a doula with Warm Welcome Birth Services in Western Massachusetts in January of 2011 and is now working as a doula while pursuing further studies in midwifery. As a queer femme, Caitlin has a particular interest in working with queer and trans families of all shapes and sizes. She believes that birth is always radical! You can learn more about her doula practice, Malia Kai Birth Services, at or email her at

What inspired you to become a doula?

I have had a passion for birth and women’s health since my brother was born at our home in England when I was three. The midwife who attended his birth would bring child-size replicas of some of her equipment such as slings and thermometers, and I would faithfully follow along on my dolls as she did postpartum checks on my brother. Growing up, my interest in babies expanded as I learned about the importance of women’s health issues around the world and deepened as friends began having children.

I think that everyone giving birth deserves to have physical and emotional support from someone they trust and feel a personal connection with, who can help them articulate their needs and desires and advocate for themselves. Being a doula is phenomenally powerful because it means deeply listening to someone else.

Why do you identify with the term radical doula?

For me, radicalism has a lot to do with intersectionality. By which I mean: recognizing the many, many factors (race, culture, class, ability, age, gender, sexuality, religion, and more) that influence all of our lives, and attempting to keep them all in mind as we work to improve the world (slowly, surely…). It means connecting my birth work to my feminism. It means not talking about birth in the USA without talking about the wide disparity in birth outcomes between white women and women of color. It means approaching birth work from a reproductive justice perspective which equally validates the right to have an abortion, and the right to carry and raise your children (no matter how poor/young/brown/queer you are). And it means working in broader justice movements to create and sustain support networks that make all of this possible.

As a radical doula, I am always trying to make connections between ideas, communities, and people.

What is your favorite thing about being a doula?

The babies! I can’t lie. The babies are my favorite. Watching the transition within minutes from goopy, purple, vernix-covered little beings into small rosy people is incredible.

I also feel so honored to be present for such an intimate moment in a family’s life, and to see the immense love on the faces of friends or family members who are present.

If you could change one thing about birth, what would it be?

Just one thing? I would like all hospitals to start practicing evidence-based care around pregnancy and birth, with a lot fewer unnecessary interventions. And I would like all pregnant people to have easy (early) access to compassionate, quality, culturally appropriate prenatal care.