Black Women Birthing Justice will have an essay featured in the forthcoming book Research Justice: Methodologies for Social Change! This powerful anthology explores what happens when communities reject knowledge elites, and take control of the research process for ourselves. BWBJ's collaborative essay is titled By Us Not For Us and shares our experiences gathering 100 women's childbirth stories. Along the way, we became (co)researchers and were transformed in unexpected ways!
Did you know that…
Young women, ages 12-19 are 2 times as likely to die during childbirth than women over age 20?
Black adolescents are 2-3 times more likely to become pregnant than other races?
I’m an AMA mom. You know; an Advanced Maternal Age mom. I didn’t think that I was advanced in age when I got pregnant and I didn’t expect to be treated like a high risk case. In fact, I felt quite youthful, healthy and well prepared for pregnancy. That changed days after the unforgettable call from my infertility doctor when I heard those yearned for words: You’re pregnant! From my first prenatal visit, my confidence in my ability to carry and birth my baby, and my judgment in becoming pregnant as a forty-one year old woman, were questioned. Rather than a natural experience to be enjoyed and savored, my pregnancy was stressful, exhausting and at times terrifying as a result of medical interventions that I now know to have been unnecessary. I became just another high-risk statistic: a double jeopardy pregnancy–“black and AMA.”
Rethinking Black History Month: Black Women's Lives Matter Every Day
This year, I stopped celebrating Black History Month. The celebration was established by trailblazing African American historian Dr. Carter G. Woodson in order to bring attention to the contributions of African Americans to U.S. society, but in my opinion, it has become just another tool of white supremacy to placate progressive whites and people of color by acting as if Blackness matters to this country. This feigning of interest and concern has always been present in the collective consciousness, but as I sit and write this, it is visible in catastrophic ways. We are dying. We are being disenfranchised, diseased and murdered on so many levels. The violence is only silent as far as mainstream media is concern, but the screams do not escape my ears. My work with birthing women makes it impossible to ignore.
This March, we celebrate Women's History Month by acknowledging the struggles
and triumphs of black women who are making history!
Reproductive Justice in Ethiopia: Notes from a Diasporic Daughter
Giving birth is one of the most beautiful, defining moments in the lives of many women. Unfortunately in many developing nations the news of becoming pregnant can be daunting, due to injuries a woman may sustain while birthing her child. The word obstetric fistula is probably foreign to many, especially those individuals who live in industrialized nations. A fistula, otherwise known as vesicovaginal fistula (VVF), occurs when labor is prolonged and a hole is created between the birthing canal and one or more of a woman’s internal organs. Obstetric fistula has a serious negative impact on not only the physical bodies of women, but their mental, and social wellbeing, since it can result in constant leaking of urine as well as social ostracism.
Alyne’s Death and Transnational Solidarity
to End Maternal Death in the African Diaspora
In August 2011, the U.N. Committee for the Convention to Prevent All Forms of Discrimination against Women (CEDAW) found that the Brazilian State had violated the reproductive health rights of Alyne da Silva Pimentel Teixeira, a 28-year-old Afro-Brazilian woman who died a preventable maternal death. The Committee’s decision followed an eight-year legal battle by the U.S.-based Center for Reproductive Rights on behalf of Alyne’s mother and daughter, who were left without financial support after her death. Alyne died on November 11, 2002, due to complications and medical neglect following a stillbirth that was inadequately treated at a health center. She lived in the Baixada Fluminense, an area of the greater metropolitan region of Rio de Janeiro, that has high rates of poverty and a predominantly Afro-Brazilian population.
My awakening to birth injustice began thousands of miles away from my hood of Baltimore City where we see some of the poorest birth outcomes in America. It happened in Ghana, West Africa.
I moved to Ghana in 1999 after working for years as a midwifery apprentice. I felt a strong desire to learn traditional childbirth rituals and customs from African midwives. After a year in the bush, I suddenly became severely ill. My friends took me into town to the military hospital, considered Ghana’s best medical facility. I had to pay the equivalent of $5 US to enter the hospital. As I waited to be seen, I witnessed a woman in labor being turned away because she didn’t have the entrance fee. She begged and begged but the soldier would not receive her. I wanted to help desperately but I barely had the energy to breathe.
A Midwife’s Perspective
For over twenty years, I have worked with the Harlem Birth Action Committee to activate, agitate and educate women and their families about the over-medicalization of childbirth. Last year, I took a sabbatical and was honored to have the opportunity to accept a three-month nurse-midwifery fellowship in Somaliland, East Africa.
I became a first time mother at the age of 29 and prior to that my hubby and I were very excited to start our family. As starry eyed beginners we started reading every parenting and childbirth book we could get our hands on, and as our due date rolled closer, we took every childbirth and lactation class we could take. We were going to be winners at childrearing!
The month of April marks Cesarean Awareness Month. It’s a time for those of us connected to birth and public health to educate the general public about cesarean sections.
In 2010, after witnessing an onslaught of coercive and medically unnecessary cesareans among family and friends, I decided to become an active participant in seeking change in New Jersey. I formed the Greater Essex County chapter of ICAN (International Cesarean Awareness Network). At the time, the state had the highest C-section rate in the nation, competing with Louisiana and Florida for the top spot. Not only were mothers alarmed, but state officials in NJ were actively working to understand the high rate of surgical birth and to see what could be done about reversing the increasing cesarean trend. Meanwhile, ICAN continued to keep track of the cesarean rates among hospitals in the nation. Why does this matter? Because the higher the C-section rate the greater indication that a hospital’s birth protocols include practices that are not evidence-based, such as induction before 39 weeks, elective inductions, elective cesareans for women who are excellent VBAC candidates and de facto VBAC bans. As a consumer (which we are) this information could be used to choose a birth facility whose rates (ergo practices) indicated a closer adherence to the support of physiological (“normal”) birth and evidence-based care.
May is National Teen Pregnancy Prevention month, a time that reminds me of my teenage experiences with sex ed. At my high school, our school nurse taught our sexual education. She was a staunch Southern Baptist, God-fearing woman. She was a teen parent, who became pregnant after her first time having sex. She also contracted genital herpes, which later led to the development of cervical cancer. Our school administrators were essentially using her as a walking billboard of why we shouldn’t be having sex, in hopes that it would influence us to take the “right path in life.”
My parents were both born in Sierra Leone, and grew up in Lebanon. They fled the Lebanese Civil War in 1975 and ended up in the United States where my brother and I were born. My relationship to transnationalism and cultural hybridity shaped me at a very young age and continues to inspire the soul and sound of the music I’m drawn to create. I began pursuing music full-time after four months of deep emotional work and breakthroughs during a visit to Lebanon. I have musical elements from many different places. I have also had to learn how to navigate the borderlands inside myself and to build intimacy with longing, belonging, and identity. Music became a place to explore and express my deepest prayers, hopes, rage and sorrow for the worlds I am connected to. There’s always been an element of searching for freedom in the music I’m drawn to write and create. Sometimes the search and expression feels very clumsy, frustrating and enraging. Other times it’s sweet, tender, peaceful. Songs have been such medicine in my life. The last five and a half years have been a journey of deep healing, reflecting, growing, learning, and I feel humbled and grateful to be able to have a life where I can pursue what I am most passionate about.
June marks "Pride Month," an annual celebration that aims to make LGBTQIA people visible. For queer people of color like me, Pride is fraught with the irony of invisibility. Historically, queer and transgender people of color (QTPOC), have had our role in the creation of pride erased. As a black queer woman, I take this time to reflect on where members of my community need to receive support, and where QTPOC-centered activism can help existing movements to access a deeper radical potential. The dilemma of QTPOC parenting gets to the root of these issues. In these times, the choice to parent as a queer person of color is a radical act; he journey through conception, pregnancy, and birth for QTPOC entails struggles with racism, queer-phobia and gender policing in the medical industry. I believe that the loving interventions of midwifery and doula care can provide solutions to the challenges pregnant and birthing QTPOC face.
Black people are under siege. This is not new; Black people have been under siege since the first European imagined our bodies as distinct from, even void of, our souls. Though the intensity of the attack seems unbearable at this moment, our history in this country has never been without it. We have always been under siege. And we have always resisted.
To adequately subdue a people, to make suitable slaves, it is necessary to destroy some things. It is necessary to destroy their connection to their land, their connection to their people, their connection to their gods, their connection to their very selves, and their connection to their histories and their futures. In the bleakest of circumstances, there have always been those amongst us who stood in the balance, preventing destruction. Those who were the rebels, the resisters, and the revolutionaries protected the connections, masking them, creating new ones where necessary.
Breastfeeding health is an integral component to developing a harmonious relationship between a mother and a newborn child. The Convention on the Rights of the Child adopted by the UN General Assembly in 1989, recognizes the importance of breastfeeding as an essential component of a child's right to optimal health and development. In Article 24, the Convention states:
2(f) Parties shall pursue full implementation of this right and, in particular, shall take appropriate measures….to ensure that all the segments of society, in particular parents and children are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, [and] the advantages of breastfeeding. (Convention on the Rights of the Child, 1989)
On November 17, 2015, World Prematurity Day, a landmark initiative was launched at the University of California, San Francisco, the UCSF Preterm Birth Initiative (PTBi). Worldwide 1 in 9 babies are born too soon (prematurely) and Black babies are most likely to not reach their first birthday. Black and Hispanic women are three times and two times more likely than White women to experience a preterm birth respectively and together account for 29.3% of all preterm births in the United States. Poor birth outcomes for Black women have been well documented and this initiative hopes to finally move the needle on this persistent epidemic.
“So, how does it feel to be a mom?!” After you have a baby, particularly if you’re a first-time mother, you get asked some variation of that question a lot. While the easy answers are adequate for conversation sake (It’s great. I love it. Tiring, but awesome…), the truth of the matter is, there is no quick way to answer that question. I could use every word in my vocabulary and still not be able to explain thoroughly what is at once the most rewarding and terrifying experience of my life. I wouldn’t have time in the course of an average phone call or text message to expound on the moment I looked into my daughter’s eyes and, for once, everything in life made perfect sense. Time slowed down, colors became brighter, music more enchanting, love felt so much deeper. No, there’s no way to reveal just how fervently I pray for her, no way to make another understand how the love I feel for this tiny person has consumed my entire existence and how my heart swells so for her that it’s hard to even remember life before she arrived. Every day is now a waking dream; her slobbery kisses and sweet laugh punctuate the moments and her smile melts me into a puddle every single time. But for the most part, I just stick to “It’s wonderful,” and let that suffice.
Birth justice – obstetric violence – dehumanized care – respectful maternity care – why do we have these conversations?
Globally there are far too many incidents of disrespect and violations to women and their families during pregnancy, labor and birth. Although there is little actual data available the stories are all too familiar. In the Caribbean region, women accessing care are too frequently subjected to a system that does not respect their choices–in life, in their choices of provider and in their choices of care. Often the only time that women enter the health care system is during pregnancy. It is a prime opportunity to offer education and information in many areas–nutrition, exercise, birthing, breastfeeding and parenting. Yet this is not routinely done. Partners and families are not encouraged to participate in the visits during pregnancy.
On October 28th I found out that I was pregnant with my daughter. It was not a joyous discovery because it was followed by rejection from the baby's father, along with verbal and emotional abuse. I wrestled with major depression during my pregnancy while battling with whether I should keep my daughter or not because I feared raising my daughter by myself. But I was grateful to be surrounded by people that cared. On June 17th, 2014 I had my daughter and the road has not been easy. Her father is still not present in her life. I had to let go of the idea of him being present in her life as she approaches her second birthday this year. I grieved a lot through this especially because he is fully involved in the life of his other kids. But I had to hold myself responsible for my part as well. And this got me thinking about other sisters that maybe dealing with the same thing.
I had a plan. To have a natural birth in water. No surgery. No medication. And I even heard the word preeclampsia, albeit in passing, as a reason I would not be able to birth in water if this life-threatening condition arose. I felt informed and then moved through an effortless and healthy pregnancy. Until the 37-week mark.
I felt healthy and ready to deliver any day. However, I didn't know that any day meant almost three weeks earlier than anticipated.
As Adoption Awareness Month is celebrated in the news with group adoptions across the country, we as black women need to question the common sense narratives that we are fed about adoption.
When my partner and I began the process for becoming parents through adoption, I was focused on my journey, and the joy of welcoming a new little person into our family. We were quickly bombarded with a narrative about the journey of our child’s first parents; adoption is a choice, it is an act of love, and the strongest thing a mother could ever do. I wanted to believe all of this, because, everyone wins! The child has a new family, the first parents get a new start, and the adoptive parent(s) are now parents!
On November 20th, those of us who support movements to save black and trans lives, remember the black trans women and men whose lives and deaths testify to the intersections of transphobia and racism. But what happens when the mourning is over? Too often black trans faces are hyper-visible when we are memorializing those we have lost, but missing at other times. And trans people are almost completely absent from birth justice and maternal health conferences, working groups and task forces. It’s time to challenge the erasure of trans folks from conversations about birth justice.
What started as an idea, metamorphosed into a day of intention and a space with great history filled with Black women activists, researchers, birth workers, visionaries and clinicians collectively sick and tired of being sick and tired. Tired we were, but invigorated we felt. On a dewy Sunday morning, I stood in a circle of 18 strong, all locking hands. Breathing slowly in ...and then out, the smell of sage filling my lungs, I followed the requests to call out the names of my ancestors and foremothers. Lannie, Betty, Thelma, Anna...When prompted to share one word that would allow me to remain grounded throughout the meeting, I yelled out, “Legacy.” Starting the convening in this way reinforced my affinity to maternal health equity and birth justice work.
Expectant mothers are magnets for attention. Strangers in elevators comment on their baby bumps. Co-workers offer unprompted advice. Family and friends pass judgment on everything from epidurals to pregnancy diet to breastfeeding.
Black Women Birthworkers were honored at the Human Rights in Childbirth U.S. Summit Birthing Justice Forum & Maternal-Child Health Champion Awards Ceremony in Los Angeles on May 26, 2016.
Black Woman Birthing Justice (BWBJ) collective members Chinyere Oparah, Linda Jones, Dantia Hudson and Sayida Peprah were a strong presence at the Human Rights in Childbirth U.S. Summit Birthing Justice Forum. We contributed powerfully in the discussions on creating a U.S. “consensus statement” to define and identify key action steps toward establish birth justice in America. Through the stories and testimonies that BWBJ has collected over the years on the Black experience of childbirth in California, we were able to bring the key birth justice elements of concern and priority for Black folks, to the table. It is always valuable that we are in the room, when conversations are happening about birth in America. Too often, we are only talked about, but not conversed with, regarding our needs.
Walking into the big, bright group room in a Family Practice clinic you, a pregnant person is greeted with smiles and enthusiasm from the group facilitators. A midwife, a doctor, resident, Certified Nursing Assistant, and Registered Nurse. You are guided to make a name tag, take your own blood pressure and weight, and then record it in your own personal prenatal log and resource book. You sit down and await your turn, to get a belly and heartone check, with one of the facilitators, doctor or midwife. This is done in the same room, but away from the group. Music is playing in the background and a snack of cheese, hummus, veggies, and drinks are being munched on. Resource books come out, a self-assessment worksheet is completed, and the chatting begins. “How are you doing today?” “How are things going?” “Oh yeah’ that’s happening to me too” with giggles in between.The facilitator sitting in the circle, chats along and visits, as well. All facilitators return back to the circle.
Reflecting on my daughter’s first birthday, I recall all the tender moments of her birth. One intense push after I felt her head press through the “ring of fearlessness”, her body appeared. I scooped her up out of the water and immediately burst into tears. Entering a state of pure bliss, I cried tears of joy that my baby was finally here. And I rode that oxytocin high for weeks after her birth.
My daughter was in the 0.05 percentile of babies’ birth weight for much of the first year of her life.
She looked perfect to me the day I welcomed her to this world: tiny toes that begged to be kissed, a heartstoppingly beautiful pouty mouth and a head full of spiky black hair. She even had a perfectly respectable birthweight at over 7 pounds. But to the medical profession, she rapidly became a problem: she just wasn’t gaining weight fast enough to keep up with their charts. I took their concerns seriously. I breastfed her on demand–sometimes when she was having a growth spurt it felt like I was glued to my rocker and Boppy pillow. I attended my local breastfeeding support group religiously, weighed her almost obsessively and tried all their techniques. But she remained stubbornly a little 0.05 percentile baby, who often choked and cried when I tried to nurse her.
The Black community is facing a horrific health crisis that isn't gaining enough attention. The high infant mortality rate of Black/African-American women is an alarming statistic. The United States faces 5.8 deaths per 1,000 live births nationally, but behind these numbers hide severe racial disparities. In Oakland alone, the Alameda County Public Health Department reports that black infants pass away twice as often (8.7 deaths per 1,000 live births) as non-Hispanic white infants (3 deaths per 1,000 live births). These alarming statistics have been consistent both nationally and locally for the past decade, and despite numerous calls to action, the root causes have yet to be addressed.