Birth justice now! Midwifery and traditional childbirthing in oppressed communities

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“Flame of the Forest: Mother Love” by Jennifer Mourin.

Tamika Middleton and Laura Perez sat down with Michelle Foy to talk about how they are working to bring alternative birthing options to working class communities of color.

Michelle Foy: What is traditional childbirthing and midwifery? Can you speak about histories of midwifery in your families and communities?

Tamika Middleton: Traditional childbearing and childbirthing means different things to different people. The philosophy of midwifery that I use, historically, is the role of the midwife as a facilitator of birth and as a keeper of birth. She was also the keeper of the processes, safety and health of the family in the period surrounding the birth.

In the Black community, midwives were fundamental. Given rampant poverty and going back to the time of enslavement, there was a need to protect the family in order to ensure that we had healthy babies. What you found especially in the South, but other places as well, was Black midwives doing other things, like making sure you have clean clothes, making sure you have food to eat, making sure you have an environment you can birth inside of. Especially working within low-income communities that are least likely to have midwives, working as doulas, we’re doing a lot of that work as well as providing pro-bono services.

In terms of my own family—my grandmother had seven children, all of them were born at home, except my mom who was born in the hospital. My grandmother was very excited to hear that I was having my baby at home with a midwife.

I’m from the Sea Islands, which were isolated from the colonies of South Carolina. In the 1950s bridges were built which connected St. Helena [one of the Sea Islands] to South Carolina. Until then our folks were cut off from those services and midwifery survived much longer as a result, as did a lot of other traditions, specifically African traditions.

Laura Perez: When I think about traditional midwifery and traditional childbirth—I think about woman-centered care. It’s about women as holders of knowledge, about what it means to be a mother, to raise a child, but really what it means to be someone who is responsible for the community. I’m thinking about curanderas and other Latin American traditions. The curanderas were the folks that someone would come to for counsel—either to get pregnant, potentially to end a pregnancy, to have a healthy pregnancy, or to help with the birth and to help afterwards. The curanderas are connected with the family and the mama. What I love about traditional midwifery care is that the origin is holistic. It’s not just about symptoms, and what can I throw at your symptoms, but finding out what’s going on in your life, in your family, where is your happiness, what are your stressors? What is your state of mind, where’s your attention, what are you pleased about your current situation, or do you have anxiety about it? Parteras and curanderas would take that all of that into account to take care of a mama, to be sure that all the pieces are balanced. They were integral people in the community. It wasn’t just about someone who knows how to birth a baby, but how to keep the whole community healthy.

My personal history—my grandmother was not a midwife, but she knew a lot about plantitas, what they do, and what they’re good for. I am working to get that back in my life now. There’s a respect and knowledge about how we work with what we have, what’s in the backyard, what you want to have nearby to address whatever it is that’s going on, something you don’t have to go to the store for.

MF: How is midwifery and traditional childbirthing in contrast to medicalized birth and why is there a movement to reclaim and expand on access to traditional childbirthing?

TM: To build off of what Laura was saying, midwifery is woman-centered and holistic care whereas medicalized birth is very symptom-oriented. It is very much about how to manage birth as opposed to how to help facilitate birth. It’s like “what can we do to make birth look this way,” with the idea that there is a way that birth is supposed to look, whereas the midwifery model understands that birth looks lots of different ways for lots of different women. There is no one correct way to birth. We birth the way our bodies want us to birth.

Also, midwives are embedded in the communities in which they work. This is very different than the medical model—where the hospital may be in your community, but the doctors—there’s often a wall or a veil between patients and their provider. This depends on your class status of course. This can lead to lots of different affects and different kinds of traumas, based on an automatic ranking and privileging. It happens sometimes in midwifery as well—when there’s an immediate deference to the opinions of the practitioner, but I think it happens more and to a greater extent inside the hospital. There’s not space for you to ask questions. There are the “medical opinions” and there is the way that you feel and the medical opinion is always weighed heavier than what the mom feels.

LP: I say this to folks all the time, medicalized birth—the people in charge of it are Obstetricians (OBs). God bless the OBs because we need surgeons that know how and when to get a baby out. There are times when a placenta is in the way of the cervix, the baby truly needs help and it can’t come out any other way. However the times that this is needed are so small. Surgeons are trained to cut, they are trained to really delve into the problems—they know problems well, as they should. Whereas midwifery—we are not trying to look for problems, we are looking at the whole mama and the whole family and the concept of the mother-baby unit. We assume that everything is whole, that everything is intact, unless there are signs otherwise, unless the mama says something’s up and I can’t put my finger on it. With midwifery care you take everything seriously. You follow up on that, you want more information about it.

The other piece about medicalized birth is that there’s a big focus on technology. That you have the ultrasounds, that you have the lab work, you do all these things with all these tools that supposedly give you more information and you base decisions on those things. Whereas midwives, our best tools are our hearts, our hands and our ears–that’s what is most important. When I feel a baby with my hands in the third trimester, I trust that a thousand times more than I trust an ultrasound. We know that ultrasounds in the third trimester can be off by a pound or two estimating the weight of the baby. When you have an OB saying “oh your baby is nine pounds, there’s no way that you can birth a baby that big.” First of all that’s not true, if a mama grows a nine-pound baby, she can birth a nine-pound baby. Secondly, that’s probably wrong—how many times have I heard, “the OB said I can’t birth my baby vaginally I have to have a cesarean because my baby’s too big” and when she births it the baby is seven pounds. When I put my hands on her belly, I can feel that baby’s body and back, yeah that’s a seven-pound baby. Medicalized birth puts so much emphasis on technology and like Tamika’s saying, the class thing is not to be overlooked. How much trust and deference people give, “well, my OB said”, “my baby would have died, if I had not done this or that.” No, your baby was put at risk because you were in a hospital setting and they didn’t allow you your body to do what it was naturally meant to do. How you would birth your baby was interfered with and therefore that caused risk to you and your baby and they had to intervene. That’s not true in every case, but in many cases it is.

The movement to reclaim traditional midwifery is because more and more women are having Cesarean Sections and having complications and difficulties from C Sections. More and more women are having epidurals and are getting spinal headaches and other side effects of epidurals and other medications. The hospital birth mantra has been, and in some cases with midwifery as well, “the bottom line is healthy baby, healthy mama.” Some women are starting to say, actually well that’s not everything, it does matter what kind of experience I have with my birth process. Women are given little choice or options but to birth in a hospital setting, where so much of her power is taken away. People say, “First baby, have the baby in a hospital, it’s safer. Then you can have your other babies wherever you want.” Then they have a birth center or homebirth experience. In these situations women can see there’s a difference between birthing a baby without a machine, without drugs, and seeing how possible that is and what it feels like to do that versus being in a hospital and being cut open, or having so many interventions and not really knowing what’s going on. That experience is being taken away from so many women—it’s another manifestation of classism and sexism.

The things that pains me the most as a midwife is to hear mamas say “my cervix didn’t dilate, my body did not know how to birth. I just couldn’t do it.” No, that’s not true, you were set up. Like Tamika was saying earlier, to birth in one particular way, that’s not how you birth, but how the hospital wants you to birth. More and more women are starting to become aware from their own experiences or hearing other stories and are starting to say enough and are understanding that buying into this model of birthing is ultimately harmful to women and babies.

TM: Echoing what Laura said, to lift this up, because of my own experience. There is a place for Obstetrics. But I don’t think its place is in everyday normal pregnancy. Right now I’m pregnant and I have two autoimmune disorders. There are some risks that are present because of those disorders. So I have my OB and he helps me rule out my risks. Then I have my midwife. The best possible scenario, even in a high-risk pregnancy, is a situation where OBs and midwifes can work together. It’s amazing that I have an OB who is homebirth supportive and is there to help me assess risks. If you need the technology then you get what you need through the doctor, but can also get the sense of empowerment and the woman-centered care.

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MF: What kinds of organizing and collective work exist today in order to provide access to midwifery and traditional childbirthing, again particularly in and among working class oppressed nationality women, families and communities?

TM: I would lift up a couple of groups—I’m always moved and impressed by the work that the International Center of Traditional Childbearing (ICTC) does and is doing. They are involved in lots of different aspects and are pushing forward the realities of women of color inside these mainstream conversations that are very white-led and white-centered. Pushing for the inclusion of our experiences of birthing.

And then all the folks working under the banner of the Birth Justice movement, which is amazing, important and ground-breaking. How birth justice is connected to reproductive justice, thinking about access to midwifery, but other things that impact our reproductive capacities. Access to birth control, access to general health, and the basics that we need to raise our kids once they’re here in the world.

The work of Mobile Midwives in Miami. They’re doing phenomenal work pushing forward a politic and a framework in working class communities of color. There are a lot of doula collectives and doulas of color collectives that are working to lift up and expand knowledge of the birth worker communities inside communities that are more vulnerable. They ground themselves inside the Birth Justice movement or ICTC.

LP: Two organizations that I want mention are Sacred Grove Traditions and Midwifery Services, founded by Asatu Musunama HallSacred Grove has done midwifery training and education, and doula education and training. They have offered rites of passage ceremonies for young girls going from girlhood to womanhood. They have also put on day-long events that bring together different healers, practitioners and speakers for the community to get information and healing work, whether it’s massage or Reiki, facials or acupuncture. These events are both women and men centered.

Then there’s Sara Flores and her peeps, they founded the RECLAIM collective (Resisting Colonial Legacy and its Impact on Medicine). They are a group of midwives and different healers focused on reclaiming traditional knowledge and timeless sacred practices that are integral to people’s health, both as individuals and communities. They are doing a lot of great things including presentations and events. Both of these organizations work within communities of color, working class communities of color and RECLAIM also does a lot of work in transgender communities.

MF: What’s the current state of traditional childbirth and midwifery, particularly in working class communities of color?

TM: We have a lot of work to do to reverse years and years, decades of propagandizing against midwifery. The job that a lot of Public Health and medical organizations did in our communities, especially poor communities of color, was to paint midwives as backwards, ignorant and in many cases, dangerous. This idea that having your baby at home is dangerous. There’s a lot of work to do, but I don’t think it’s impossible to reverse this. The doula plays a very important role as an in-between, when women aren’t quite ready to step out of the hospital yet, but are looking for something different. In Atlanta, and statewide in Georgia we have an organization that provides teenage moms, especially those who are in group homes, free doulas. It opens their eyes to the possibility of something else, as these very young moms who are empowered in situations that could have turned out traumatically. One of my teen clients asked if she could attend my home birth. She had never thought about homebirth until she until she met me. We have a lot of undoing work to do.

LP: Absolutely, when I think about women from outside of the US or the immigrants I’ve worked with, when they decide to have an out-of-hospital birth, it’s challenging. Their family members, for different reasons, some of them because of assimilation, are not supportive about their decision to have their baby outside of the hospital. They ask, “Why would you do that? We came to this country with all these wonderful services and hospitals. Why would you risk your baby?” These folks don’t necessarily know the maternal mortality rate in the US is as high as it is and the infant mortality rate in communities of color and how incredibly high that is. And given the technology that we have here, this is a real indictment about the current situation.

I have heard some rumblings about underground midwives of color, parteras that work with working class communities of color in the Bay Area. People that are probably not getting paid and aren’t licensed. I don’t know about birth outcomes, I don’t know about how they roll, but they exist and I think that’s a good thing. Because there has to be more choice, more alternatives for people who don’t necessarily want to go to the hospital, who don’t have insurance, not even Medical and can’t pay and they know they want to have their baby in another way.

I’ve also seen that there’s a slow trend amongst younger generations, saying “this is how I’m going to do it.” Like young immigrant women and Black women that I’ve worked with, that they are the first in two or three generations that have birthed outside of a hospital, the first to not have C Sections on demand, and the first to exclusively breast-feed their babies. They are doing this because they know it makes sense, but also in the context of a family that doesn’t know how to help them. Families that don’t know anything about vaginal birth, and don’t know anything about breastfeeding because they’ve all formula fed. I do think the tide is starting to turn, but as Tamika said it’s years and years of turning back propaganda and giving new information.

TM: There’s something that you brought up that makes it difficult to provide midwifery care. In Georgia midwives are operating underground, unless you’re a nurse midwife, homebirth midwifery is not legal in Georgia. Midwives cannot accept Medicaid, it has to be an out-of-pocket expense that a lot of folks just cannot cover. We see a lot of midwives operating on sliding-scale, or some form of barter so they can serve those communities. But it makes it very difficult for midwives to actually provide, because of the reality of not getting paid to work with the communities that are most affected by the ridiculous maternal and infant mortality rates. These communities that are most vulnerable don’t have access to alternatives because they don’t have the money.

I live in the South, which has a way to go in terms of making midwifery accessible, and in many cases states are working to turn back the clock where it is relatively accessible. When you have a state like New York where you can get access to midwives, that aren’t necessarily nurse midwives, through your health insurance, that’s a wonderful thing. I can’t use my Humana with a midwife that is not a nurse midwife in Georgia. There are less and less, as time goes on, nurse midwives that are delivering in hospitals, because of the kind of pushback of the medical model. And nurse midwives are often not trained in traditional child-bearing, but in medicalized birth.

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MF: Which brings us to criminalization—can you talk about the criminalization of midwifery and traditional childbirth?

TM: What’s interesting about Georgia is that technically, on the books, midwifery is legal. You can be a certified midwife, however there is no licensing process. While the law allows the certification of midwives you can’t actually receive certification through the state. There are lots of midwives practicing who have national certifications, who have been practicing for years and years and have hundreds and thousands of births, but are still operating primarily underground. We’re fortunate that there haven’t been prosecutions of midwives and I think this has to do with the fact that the midwifery community is very tight-knit, especially I can speak to the experience in the Black community. You definitely come across your midwife by word of mouth—because you know someone or more than one person who’s had a really great experience with them. It also means that the homebirth mamas often look alike—in terms of what their life experiences are, how they dress, what they eat. We’re often very much alike, because we know each other and that’s how we got access to the midwives.

In South Carolina I know there’s an attempt to make it more difficult for Certified Professional Midwives (CPM) to practice. It had been relatively easy to certify in the state, if you had a national certification you could take the certification test and you could accept Medicaid. There’s legislation this past year that would make it more difficult, that would require CPMs to operate through doctors, that would put it more under the medical model. This is more or less how midwives were phased out in the 1940s. The doctor had to sign off on you before you could attend a birth. Slowly but surely doctors decided they didn’t want to sign off on midwives and midwives ceased having clientele.

We are fortunate in Georgia, at least since I’ve been involved in birthing communities, we have not seen any prosecutions and there are a significant number of doctors that are home-birth supportive and make it possible for us to have home-births and take care of our babies.

LP: Then there’s the law in California. It states that in order to practice out of hospital midwifery you have to be a licensed midwife. The law also states how you do that. You have to graduate from a Midwifery Education Accreditation Counsel (MEAC) school, and you have to apply for and pay your licensing fees. The third part of the law is that you have to have a supervising physician. I do not know one licensed midwife in the state of CA that has a supervising doctor, because there are no doctors that will supervise out of hospital midwives, because they would have to put the midwives on their insurance and there’s no way that their insurance would let them do that. The law is set up in a way that it’s not doable, it’s a set up, it has always been a setup, just like in Georgia. Technically every home birth midwife is practicing illegally in the state of California. Going back to what Tamika said earlier, if you can have collaborative care, if you can have the option to consult with a doctor about a situation that occurs in a mother’s pregnancy, or a birth or postpartum because it is outside the scope of your practice as a midwife, it would be so great to work with a doctor to figure out next steps or treatment. This would assume an amicable, positive relationship, and we don’t have that. Midwives are still being targeted and trying to be systematically eliminated, legally or practically, or through arrest and charges being brought against us. The laws aren’t set up to favor us.

In California, there’s a Midwives Advisory Counsel (MAC), that works with the California Medical Board. It’s the medical board that oversees the MAC, which basically has no authority. On the Medical Board you have people like cardiologists that make decisions about midwives. How does this make any sense?

And then the whole question of licensure and regulation and should midwives even be regulated and licensed? Traditionally it’s been a set up, when you set up laws ways to regulate it’s a way to prosecute, it’s a way to track and a way to limit midwives.

Some people would argue it’s about consumers and consumer rights. But this is in contrast to traditionally midwifery and traditional childbirth, where the midwives were in the communities, you knew them, you had a relationship with them, you can ask people who worked with them closely, so you don’t have to worry, “are they licensed, what do they know and how many births they’ve been at.” You know because of your community, you’ve met them, you trust them and you want to work with them. It’s not about a piece of paper that they have or money that they’ve given to a school or a licensing body. I personally really struggle with this. I’m in the process of getting licensed and I don’t feel great about it. I don’t see it as any kind protection, or that it’s legitimizing me as a midwife. But I do feel like the politics of midwifery, are that you have to be licensed. If you practice outside of the scope of the law, you are dangerous and you are targeted. But I also feel that getting licensed makes me more of a target, they weren’t even aware of me before. I want to practice midwifery the best I can, the best I know, but the law says there’s a certain way I have to practice it. What does the law know about midwifery? As Tamika said every birth, every pregnancy, postpartum looks different for every mama, women have different experiences.

TM: Another piece of this licensing problem is it predetermines who can become a midwife. The money it takes to go to these schools and to get licensed, which makes it very difficult for certain communities of folks. This echoes the historical reality of Black midwives in the South, who didn’t have access to those licensing procedures. The move towards licensing and certification was inspired by the white homebirth movement that came up in the 1960s and 1970s. It made it so elder Black midwives who had been practicing for years could no longer practice as midwives. It’s so important to think about the historical context. So much of what we’re seeing, we’ve seen before, we’ve seen the damage of it and what it does to certain communities of folks. It’s accessible if you are a middle-class or upper-middle class person, who can access certain kinds of funds. You can’t go to community college to study to be a midwife. I know folks who have had to move to another state in order to get financial aid to train and study to be a midwife.

And the malpractice insurance is the major reason why there is only one birth center in the entire state of Georgia, which is in Savannah. There’s been an effort to build a birth-center in Atlanta. It’s a slow-moving process, even with a doctor backing them, they’ve gotten a lot of opposition.

LP: The next step for the birth revolution, if you will, is to push for community college programs for midwifery training. Birth is seen as a medical event now, and midwives know it is not. There are some medical aspects to it, but being a midwife is not like being a doctor, not like being an OB. It is very unique to itself. I would love to see a way for working class people in communities of color be able to study this, because it is part of our heritage and tradition, to know this information. It speaks to the broader issue of what the broader care system we have in the US looks like. It’s not of the people. The food we eat, isn’t local, it’s got all kinds of dangerous stuff in it. To reclaim our health, our bodies, our right to our well-being on our terms and not have to deal with going to a hospital or a clinic outside of our communities to make sure we can take care of ourselves. This may be a ways down the line, but it’s something we should look to.

MF: How did you become interested in traditional childbearing and midwifery? Would you be willing to share your birth story(ies)?

TM: Interestingly enough, I had every intention of growing up to become an OBGYN. I was pre-med in undergrad. I had never met any midwives growing up, and until my own homebirth I had no idea that my grandmother had her babies at home.

It was my activism that drew me further and further away from wanting to be an OB. It had a lot to do with understanding the lack of access to care in poor communities of color and set my mind on doing something about that. I had conversations with a mentor, who is a pediatrician, who said, “that’s the kind of work you can do when you’re about to retire, as you spend most of your career trying to pay off your student loan debt.” And I thought, I don’t want to do that!

One of my colleagues at Critical Resistance became a doula and I was like, “what’s that, that sounds amazing!”

We moved to Atlanta from New Orleans after Hurricane Katrina. I knew almost nobody here, and two weeks into graduate school I found out I was pregnant. The hospital at Georgia State is Grady Hospital, so that’s where I went. I was disappointed and frustrated by my treatment and my experience. My partner was working and couldn’t go with me to the hospital. I was young, 22 and I was being treated with this assumption of the “poor black girl who’s gotten herself pregnant”. It was very infuriating. I knew that I was not going to have my baby at that hospital.

Of course I didn’t have any health insurance and a friend of mine told me about the midwifery program at Emory. It just so happens that they had just stopped taking Medicaid a few weeks before. It’s happening everywhere as all the midwifery practices are no longer taking Medicaid because of the reimbursement rates and the slow reimbursement process.

My friend said, “I know this midwife, and she only works out of people’s homes, so you will have your baby at home.” So I met her and it was wonderful, she was wonderful. I had my baby at home, my first. It was a six-hour birth, it was just me, my mom, my partner and two midwives. It was more than I could have imagined it could be. I got to take a nap, and when I was in transition, no one was panicking, “oh she’s not moving, what’s happening”, they were all clear I was in transition and I could take a nap. It was a wonderful experience. This is how I became a doula and eventually a student midwife. It brings everything back full circle for me—I could pinpoint that I was seven years old when I knew that I wanted to help mommies have babies.

As soon as I found out I was pregnant again, I knew I wanted to have a homebirth with the same midwife again. But it’s a lot different this time with the Lupus and the Sjogren’s syndrome. This go-round I have to have a lot more ultrasounds than I would like to have. Sometime we have an idealized birth picture and sometimes there’s a wrench thrown in those plans. Lupus and Sjogren’s is definitely a wrench in those plans. But as I said I have an OB who is very home-birth friendly.

LP: When I was a teenager, 15 or so, I heard the word midwife. I asked my mother, what does that mean? And she said it’s a woman who helps a mother birth a baby. I looked it up in the dictionary. And then I knew that’s what I wanted to do. There was a part of me that knew it was part of my heritage as a female and part of my heritage as an indigenous woman from South America. I couldn’t imagine doing anything else. Because of the way I grew up in lots of different circumstances, I had pretty low self-esteem back then. As soon as I had the thought that that’s what I’m going to do, I immediately thought, “there’s no way I could do that.” In my mind back then it was like being a doctor.

Regardless of feeling like I couldn’t do it, I still spent all my teen years focused on women’s reproductive health. I read Our Bodies Ourselves from cover to cover more than once, I was the go-to person in high school to talk with and think about sexually transmitted infections and birth control. I ended up volunteering for a lot of reproductive rights groups and worked at an abortion clinic. Finally an ally of mine, after hearing that I wanted to do this forever, said “why don’t you become a doula and see what you think.” I then enrolled in school and now 30 years later after my initial decision, I’m finally getting to do it. It makes me use every part of my being that I like to use, my humor, my mind, my body, my spirit, everything that I enjoy doing I incorporate into my life as a midwife. I still feel like I have a learner’s and beginner’s mind. I’m starting to work with an herbalist and learn more about curanderismo and working with plants. How to work with the earth to address particular needs.

Another thing I love about midwifery so much, there’s no end point. You can never learn all there is to know about midwifery and birth, pregnancy, babies, mamas, and postpartum. That really turns me on, that I can keep learning and learning and learning. I have some mentors who are old-school midwives and I love being with them, hearing their stories. They were midwives before there was a licensing law, before you could transport to the hospital, so they knew everything they had to do to take care of that mama and that baby.

MF: There’s obviously a lot happening around shifts in health care today, access to health care nationally and much that is still unknown and in negotiation around what is or is not included in Obamacare. Can you talk about midwifery in relationship to Obamacare?

TM: There’s not much to say for Georgia, given that out of hospital birth is not legal. GA is a Southern Republican-led state that is working it’s hardest to avoid Obamacare, rejecting the Medicaid expansion. For poor working class communities that rely on Medicaid this is a real problem. Out of hospital midwives are not going to see any of the affects of that.

LP: What’s exciting about Obamacare related to midwifery, women who spend anything on breast-feeding related products, like breast-pumps, you can get reimbursed for. Also the expansion of the access to birth control.

MF: Can you speak to whether traditional childbirth possible in a hospital and any other closing thoughts you have?

LP: Traditional childbirth is not possible in a hospital. It’s not woman-focused, it’s outcome focus and ultimately really is about the money. Hospitals are for-profit industries, where a big source of their revenue is birth. They are not hesitant to do C Sections, they get paid a lot more to do C-Sections, they get paid a lot to give epidurals, Pitocin, any medications. A woman has the slightest elevation of blood pressure, give her magnesium sulfate.

People talk about a natural birth in the hospital—that means the baby came out of their vagina—it doesn’t mean that they did it without medication. I would love for traditional birth to happen in any setting, but it is a set-up. A dear midwife friend says, “if you want Italian food, eat at an Italian restaurant.” You can’t expect natural birth in a hospital.

TM: I like that…the last thing I will say is, for communities of color and immigrant communities, the reality is that midwives were and still are essential to the survival of those communities. Midwives in slave communities were full-spectrum. It was not just about helping babies coming into the world, sometimes a midwife would say, “this is a pregnant woman, what’s the best thing for her and her survival.” Sometimes that meant, what are the herbs for her to have an abortion. It meant a lot of different things, the midwives were there to do whatever was needed to be done.

LP: And to add to that, or what herbs or other things can we give her when she does get raped by the supposed slave owner, so that she doesn’t become pregnant.

TM: Exactly. We sever ties that are indigenous to our communities and we sever ties to that survival knowledge, that sacred healing knowledge. For example, the cotton root bark. This is what you put in that mama’s soup, so she can put on the weight that she needs, as she’s struggling, she doesn’t have enough food to eat. When we sever our ties to midwifery and the very mechanisms to survive, we sever our ties to the people who held the ground for us in our communities, the kinds of foundations that we build our communities on. When we’re seeing ridiculously high rates of maternal mortality rates, for the Black community specifically, it doesn’t matter if you’re poor or middle class or college-educated, there are still incredibly high maternal mortality rates, and that’s not for nothing. This is because we have severed ties to our very survival mechanisms.

Tamika Middleton is a community organizer, doula, student, and mother. She is passionate about and active in struggles that affect Black women’s lives. She is also passionate about birthing and healing, and as such is active with Kindred southern healing justice collective, and is the co-coordinator of Black Women Birthing Resistance: a Southern Cultural Justice Project. She also performs as a member of the NALO Movement.

Laura Perez is a newly graduated midwife from the National Midwifery Institute, making her a Certified Professional Midwife. When the state of California legally sanctions her with a license, its quite possible that she will be the first Latina home birth midwife based in San Francisco. She has been studying women’s reproductive health since she was a teen. Laura is one of the co-founders of Exhale, a national and multilingual after-abortion talk line that offers support and resources to women, their partners and families. She was also honored with being the first person to receive a student midwife of color scholarship for training at the Yayasan Bumi Sehat health clinic and birth center in Bali, Indonesia.

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