RaceSex & Gender

birthing while black: on reclaiming our time, maternal health disparities & the importance of doulas

March 29, 2018
220 Picks

By Jesi Taylor, AFROPUNK Contributor

Partus sequitur ventrem, the legal doctrine and framework that determined the status of children born to enslaved people from the seventeenth to nineteenth century, belongs to a genealogy of racial violence and misogynoir. As Columbia University professor Saidiya Hartman argues in The Belly of the World: A Note on Black Women’s Labors, “the theft, regulation and destruction of black women’s sexual and reproductive capacities [defines] the afterlife of slavery.” This regulation and destruction takes many shapes and forms and continues to impact the lives of black women and their unborn children. One prime example of this type of biopolitcal violence are childbirth practices that result in disproportionate rates of harms suffered by black women* and their children, both born and unborn. Denise Bolds, writer, social worker, and doula, suggests a “very viable, very common sense solution to all of this”: historically-motivated, doula-assisted birth work.

Leader of the Birthing While Black movement, Bolds explains the importance of historically-motivated birth work because the history of what is happening to the black woman when she goes to give birth “goes all the way back to slavery, back to doctor J. Marion Sims doing his experimentations and instrumentation for gynecology and obstetrics on black female slaves without anesthesia. A practice that had continued through the centuries to today where a black woman will go in to give birth and will not be asked if she needs anything for pain. She will not be treated with the same amount of compassion or respect as others because that ‘slave mentality’, that slave regard is still present today.” In fact, numerous studies have shown that many medical professionals hold racist and sexist biases that interfere with proper pain assessments and treatment recommendations. Further, according to the Center for Disease Control, women in the United States are more likely to die from childbirthor pregnancy-related causesthan other women in the developed world. Though maternal deaths have disproportionately impacted the black community, policy and legislation has failed to adequately address these concerns.

Bolds claims that “until we change the health model as we know it, that’s what it’s going to be. We are in this situation and we have to make changes.” Faced with the challenges that accompany biomedical imperialism, the idea that industrial profit outweighs emphasis on health or care in the field of medical services, Bolds insists that we “fight that narrative, fight them in their pockets, and fight with legislation and policy.” In a recent interview with Vogue Magazine, Serena Williams shared the story of her birthing experience that offered insight into the far too common phenomenon of traumatic black births. While the trauma suffered by birthing women like Serena reveals several problems with childbirth practices in the United States, it’s important to note that, as Bolds reminds us, “someone is making a profit off of that high-risk pregnancy, off of that drug they’re using for induction, someone is making a profit off of all of these things.” According to Bolds, this could be where the role of historically-motivated, doula-assisted birth work comes in.

Without fair and equal access to quality medical services, combined with the gutting of Medicaid and other funds that help to cover the costs of childbirth, women will continue to lack support during birthing. Doulas, as explained by NYC-based Doula Project, provide “compassionate care and emotional, physical, and informational support to people across the spectrum of pregnancy.” In addition to helping birthing women advocate for themselves in a space where their autonomy is often ignored or forcefully diminished, Bolds adds that doulas give birthing women the tools and confidence to say “I am aware of what’s happening and I am aware of the history of medicine in this country. I am aware of how that will impact me and how that will impact my children and future generations.” Bolds goes on to share that “when [her] client has an empowered birth with [her] and they testify, they share their birth story they’re crying because it’s such a rare thing to get the birth you want, to be treated with respect, and to come out of that birth unscathed.”

Given the legacy of J. Marion Sims and the pressing concerns that come with biomedical imperialism, Bolds emphasizes the importance of knowing why childbirth practices are the way they are. “[Doctors] don’t want to say, ‘you can squat, you can get onto all fours’, they tell you to lie on your back. That’s how they learn in med school and any deviation from that throws them off and gives them the fear of malpractice. Plus, [lying on your back is one of the most unnatural positions there is for childbirth! That’s not the way you have to do it. You don’t have to give birth that way but that’s what leads to unpleasant birth experiences.” Doulas, especially those with a knowledge of the racist history of gynecology can teach birthing women to advocate for themselves.

To Bolds, Birthing While Black really “symbolizes the awareness and the awakening of women to say, ‘I’m not going to be treated like that. I’m not going to be living silent,  I’m not going to be the female slave that you’re expecting. I have a voice. I have autonomy. I have direction of what this is because I know that what I do in this birth room with my partner, with my doula, is going to have a positive or negative impact on my child.” In the afterlife of slavery, birthing black women may have a source of power and autonomy not yet realized with the help of historically-motivated, doula-assisted birth work.

*For the intents and purposes of this article I use the words “women”, “woman”, and “mother” not to exclude the narratives and experiences of pregnant people of other gender identities but to shed light on concerns facing a specific population of pregnant people.