Birth Justice
Birth Justice is a movement that works to protect the rights of all birthing people, so they can make the best decisions around their pregnancies, miscarriages, abortions, labor, birth, postpartum, breastfeeding, and to have their children grow in safe and loving environments.
Birth justice is a movement founded and led by Black women and women of color.
The framework of birth justice recognizes that systems of oppression and survival through trauma affects the decision to have or not have children, and affects the health outcomes of all involved, especially when having to navigate a racist and sexist medical system. When mothers and parents are uplifted, the entire community is strengthened.
Major themes around birth justice include bodily autonomy, and access to healthcare that is holistic, culturally reflective, and humanizing. This means that Birth Justice supports the right to control when, how, and with whom birthing occurs, such as access to traditional healers, midwives, doulas, breastfeeding support, pelvic floor therapists, and other community members.
Birth Justice is part of a larger movement to defeat reproductive oppression.
The work involves dismantling the inequities of class, race, gender, sexuality that lead to traumatic and negative births, especially for Black women, women of color, poor women, survivors of violence, immigrant women, queer, gender nonconforming, nonbinary, and trans people, and those living in the Global South.
Birth Justice occurs when all who birth are empowered during pregnancy, labor, childbirth and postpartum to make healthy decisions for themselves and their babies.
History of Birth Justice
Births in the United States used to be attended by midwives. That was until the early 1900’s, when the burgeoning medical and hospital system transformed what was safe, physiological birth to a medically facilitated event, wrought with interventions that serve the establishment and profits instead of birthing people. The shift to this system relegated existing community midwives to the margins and shifted birth from the community into the hospitals.
The United States is the only “developed” country where maternal mortality is increasing and racist disparity in maternal mortality is a gaping problem.
Since the Transatlantic Slave Trade, Black people’s bodies and reproductive capacity have been essential to the primitive accumulation in racial capitalism. This occurred through the exploitation of their physical and reproductive labor - in the case of US chattel slavery - to continuously produce more workers in an enslaved workforce, and to provide wet nursing and midwifery services to those who owned them. Later on, Black people became nonconsensual test subjects for medical experimentation, birth control experiments, and other medical advancements such as in the case of Henrietta Lacks, whose cell lines were stolen to create the foundation of controlled medical experiments.
In the early 20th century, the American Medical Association created a campaign to shift birth from community settings into hospitals, medicalizing the birthing process and subjecting it to medical interventions and management. Only white, male physicians and white female nurses were allowed to advance in deeply racist medical schools, and through legislation, midwives were excommunicated and even outlawed from attending births under the guise of maternal and infant protection.
Instead of making birth safer, this resulted in excessive and dangerous surgical and obstetric interventions, and fed the booming medical industry. Such strong financial incentives made it impossible to counteract medicalized births with safer alternatives. Today 98% of births are still occurring in the hospital because of this history.
Barriers To Change
The barriers to Birth Justice becoming reality are racialized and political. Just as in the history of the erasure of midwifery, the same issue persists today with the training and licensure of more midwives. Physicians and medical associations, as well as white nursing and midwifery organizations protect their interests by maintaining unnecessary educational barriers like the requirement of obtaining a nursing degree or graduate degree to practice midwifery.
Organizations that impede the movement toward Birth Justice include The American College of Obstetricians and Gynecologists (ACOG), the American Medical Association(AMA), American Nurses Association, private and malpractice insurance providers, the hospital industry, and white led American College of Nurse Midwives (ACNM) and the Midwives Alliance of North America (MANA).
In order to address this, we must immediately eliminate barriers to practice community midwifery, open more Black led birth centers, increase community education around safe pregnancy, birth, and child rearing, and make birthing safer for all.
