Unlearning Racism, Relearning Care: Moving Maternal Healthcare Disparities Towards Equity

Content Warning: This post discusses racism, historical and ongoing trauma related to gynecological abuse, and maternal mortality which may be triggering to some readers.

Privilege discloser: Before reading, please be aware of our biases and privileges. While we do our best to create inclusive and anti-racist spaces, it is critical to recognize that our insights are influenced from the lens of privileged perspective. I am a 34-year old white, non-disabled doula living on Očhéthi Šakówiŋ and Wahpeton territory. I am a divorced queer parent with 3 children on a single income with a support system of "chosen family".

In February, Black History Month, we celebrate the incredible contributions and resilience of the Black community. As white birth workers, it's also a time to confront the disparities that Black women face in maternal healthcare. The statistics are more than numbers; they represent real lives impacted by systemic inequities deeply rooted in our history and present.

The field of gynecology and the practice of midwifery in the United States have a troubling history of exploiting Black women, compromising their autonomy and well-being. This dark past still influences how Black women are treated in healthcare settings today, underscoring the shift from highly respected granny midwives to a healthcare system that frequently sidelines Black women's care. This reflects wider societal issues that demand our attention.

For white birth workers and healthcare providers, understanding this context is essential. It's not enough to recognize the problem; we must actively engage in solutions. Offering birth work for free or services at a discounted rate, though well-meaning, can unintentionally undermine the value of skilled care and foster a harmful savior mentality.

At MedCity Doulas, we are committed to meaningful change in our industry and culturally. This includes ensuring fair compensation for Black doulas and birth workers, acknowledging the value of their expertise, and creating a sustainable model for all involved in birth work. We are dedicated to unlearning racism and implementing anti-racist practices in our work. This commitment is about more than just words; it's about taking actions to break down the barriers leading to unequal health outcomes.

Change requires a collective effort, here are ways we can all contribute:

Educate and Reflect: Learn about the history of racism in healthcare and its ongoing impact. Reflect on personal biases and how they might affect your professional practice.

Amplify Black Voices: Listen to and elevate the experiences and needs of Black birthing people. Their voices should guide our efforts to improve maternal healthcare.

Advocate for Fair Compensation: Support policies and workplace practices that ensure equitable pay for Black birth workers. Recognize the value of their labor and expertise.

Commit to Anti-Racist Practices: Actively engage in anti-racist education and practices within your professional and personal spheres. This is an ongoing process of growth and change.

This Black History Month, let's renew our dedication to building a healthcare system and society that respect, uphold, and advance the dignity, justice, and equity of every birthing person and their baby. Achieving this goal requires honesty, bravery, and collective action.

Below are some reputable sources and organizations that provide valuable information on the topics of racial disparities in maternal healthcare, the history of midwifery and gynecology, and efforts towards equity and justice in maternal health. This is just a starting point for those interested in learning more about the intersection of race, history, and maternal healthcare:

Centers for Disease Control and Prevention (CDC) - Pregnancy Mortality Surveillance System: The CDC tracks pregnancy-related deaths in the United States and offers insights into racial disparities in maternal mortality rates.

American College of Obstetricians and Gynecologists (ACOG) - Racial and Ethnic Disparities in Obstetrics and Gynecology: ACOG provides resources and policy statements addressing racial disparities in healthcare.

Black Mamas Matter Alliance: An organization that advocates for Black maternal health, rights, and justice. They offer resources, research, and ways to get involved in the movement for equity in maternal health care.

National Birth Equity Collaborative (NBEC): NBEC focuses on solutions that optimize Black maternal and infant health through training, policy advocacy, research, and community-centered collaboration.

SisterSong: This organization focuses on reproductive justice for women of color, providing education and organizing efforts to improve maternal health outcomes.

"Medical Bondage: Race, Gender, and the Origins of American Gynecology" by Deirdre Cooper Owens: This book explores the history of gynecology and its ties to slavery and experimentation on Black women. It's a crucial read for understanding the historical context of today's disparities. [ISBN: 9780820351353]

"Killing the Black Body: Race, Reproduction, and the Meaning of Liberty" by Dorothy Roberts: This book delves into the history and ongoing impact of the control and exploitation of Black women's bodies in the United States. [ISBN: 9780679758693]