Delivery and Justice for All?

I am a change maker. I am a healer. I am an activist. I am a supporter, advocate, and educator. I am a labor and delivery nurse. I wear many hats during a 12+-hour shift, but by far, the most prominent is as a Black woman first.

I am reminded of the origins of gynecology, when my ancestors were used as guinea pigs for painful, intrusive procedures and experiments WITHOUT analgesia, because it was “common knowledge” that Black people, especially Black women did not experience pain in the same way as our White counterparts. Recently I have become very introspective regarding this calling on my life. I have begun to think more deeply on the cultural and social implications of my work, and how history has continued to shape the experience of being a patient of color in a system that has never been on our side. Working as a doula led me to Labor and Delivery, with the final goal of midwifery. I was also informed by my grandmother once I began this journey, that her grandmother was a lay midwife and delivered many babies with no formal education. It is ingrained in me; similar to the way that music and dance inhabit my soul. It is inescapable. In a field largely dominated by White women, it is a joy to have patients see a nurse that looks like them that understands them on a deeper level with an unspoken connection. Birth work is intense, exciting, and a true labor of love, and it is of great importance to my identity.

One would (naively) assume that medicine has taken such strides that race should not still be a factor. It is important to note that the highest mortality rate in the U.S. in childbearing belongs to Black women. Regardless of education level and socioeconomic factors, we are three to four times more likely to die, according to the CDC.* Our babies are also disproportionately affected as a result. As highlighted in the documentary “Death by Delivery,” Black women are suffering and no one can explain why. The documentary delves into a simple answer- racism. It is because of racial bias that one of the most recognized, talented, and valued athletes of our time, Serena Williams had to convince her providers that she had a blood clot following delivery, despite having experienced this condition before. What could have happened had she not taken control of her care and insisted profusely that she be listened to?

The silver lining of the current climate of Black maternal health is the recognition that it has gotten. Collectives such as SisterSong and Black Mamas Matter are doing formidable work socially and politically, and Black Maternal Health Week garnered much attention on social media and in numerous areas of the country. The goal is to show lawmakers and change agents why reproductive justice is of such importance. For those unaware of the concept, reproductive justice is defined as “the complete physical, mental, spiritual, political, social and economic well-being of women and girls based on the full achievement and protection of women’s human rights.” It is with this concept that we hope to aid in destroying disparities. For there to be significant change, it must occur not only at a political level, but also within the hospitals, clinics, and offices where medical care is provided. Providers must eliminate bias from their practice and work to provide equal care across all patient populations.

Until we reach that point, what can we do?  Advocacy and education are the most important factors. If you are pregnant or planning to be, stay abreast of research. Even if you’re not, it is important to be a proponent of your health. Not to the extent that you become addicted to Google and become so consumed in “signs and symptoms” that you become a neurotic mess. Maintain a working knowledge of what is normal and what is not. Seek providers that care for your well being that listen and RESPOND ACCORDINGLY when you have concerns. Lastly, don’t be afraid to speak up for yourself. You know your body more than anyone so when it shows you that something is wrong, listen.

I am confident that we will make significant strides and end this crisis. If you’re interested in doing groundwork there are many avenues to pursue. Find your local reproductive justice organization or simply follow some on social media to stay aware. Read books. Become a doula, or a labor partner. Vote in local and national elections. Advocate for yourself and the women in your tribe. We have the power, strength, and fearlessness of the many women who have come before us. Let’s put it to use.

Resources for further study:

Killing the Black Body, Dorothy Roberts


Death by Delivery

Black Mamas Matter 


Written by Kara Simpson for The Beautiful Project