An introduction to how social justice and intersectionality show up in birth work

by Brood

 

CW: This post contains discussions of violence towards Black and Indigenous people, including the direct effects of colonization and white supremacy, and the intersections of transphobia, fatphobia (anti fat bias), ableism, and medical trauma. Please proceed with care.

At Brood, we strongly believe that education is power, and if we were to only talk about the joys of pregnancy and parenthood, we’d be complicit in the web of systemic racism and disparity that exists for many folks. In this post, we’ll cover some of the historical and cultural context that still affects birthing people today. You might have first-hand experience and knowledge of these realities, and for some people, this might be the first time you’re thinking about birth more socially and critically. Whatever your experience, we encourage you to proceed with caution and care. Take breaks as much as you need and have a support person nearby, if that feels reassuring. And if these conversations are new to you, remember to read, learn, and above all else, listen. 

Today’s racial birth crisis is a direct result of institutions built on racism and colonization, and in this article, we’ll explore the ripples of impacts felt throughout the birthing community and the ways in which marginalized people are all too often harmed in the process. We’ll also consider the intersections of transphobia, fatphobia and ableism—and how all these biases interact with one another in the medical field. Be sure to read to the end, where we’ll offer you some tools to navigate the oppressive systems and barriers you may encounter, and how to prepare yourself and your support team as best as possible. Whatever feelings come up here are entirely valid, be sure to pause and check-in every once and a while – and give yourself the gentleness you’d give someone you love.

The information presented in this article is just the very tip of the iceberg and will never do justice to the immense harms people have experienced throughout history and today. This is by no means an exhaustive list and we are not experts of lived experience other than our own. The purpose of this article is to share our knowledge, provide context of the impacts felt by people across different intersections, and remind folks of how this can affect their birth and postpartum journeys.

Considering  current racial birth crises can provide context on how people make decisions in their pregnancy, birth and postpartum experiences — and how marginalized identities are frequently harmed in the birthing process. Maternal mortality rates for Black people is one of the biggest concerns today. Statistics show that in America, specifically, Black folks have an increased risk of health complications and catastrophic outcomes when compared to outcomes for white people. Many factors contribute to this disparity but evidence shows that access to safe, quality healthcare, structural racism—which can include the management and diagnosis of underlying health conditions—and implicit bias are all major players in the way Black people may experience birth. 

Due to these factors, lived experiences, and the basic human need for quality, culturally safe care, many Black families are motivated to seek alternative care such as birthing without care providers (free birth), hiring advocates like Black care providers and/ or doulas, and taking on the emotional labor of educating their community and care providers on how to safely support them while balancing these effects.

In Canada, there is a large movement for Indigenous birth sovereignty as a way to address and combat the harm that colonization has caused. This can look like self-governance, honoring ancestral and cultural traditions, and personal autonomy through care from Indigenous birth keepers. Historically, the Canadian government has caused direct and immense harm to Indigenous families – there is no one way this can be shown, but birth alerts and residential schools have proven to be some of the largest impacts to this day. Families are continuing to fight the daily and generational impacts as they build their families and navigate healthcare and governmental systems that are not built or maintained with them in mind.

There are many intersections of identities and marginalization—such as, trans, gender diverse, two-spirit and queer people—who are impacted as they navigate all facets of reproductive health while being harmed, erased, and disregarded in the process.To combat these felt impacts, many people, care workers, corporations and institutions are beginning to work towards safety and inclusion within these systems—to provide more safety in the ability to birth with ease and respect by validating and supporting all family structures and identities. Ableism and fat-phobia affect many parents in the birth world, typically altering folks’ access to proper medical care, and their ability to feel resourced throughout parenthood.

Marginalized people feel the impacts of these crises and identities daily, even more acutely during pregnancy, birth and postpartum. These felt impacts can range from generational trauma and barriers to accessing care, to medical violence, and racism within healthcare systems. Navigating all this can be taxing, impair the birth process and create more harm to new families. Everyone’s experience of creating a family is different, with their individual lived expertise, politics and understanding of birth impacting this.

To support you, we’d like to provide you with some tools to navigate these systems of power and structure, as well as planning for the potentially harmful impacts. Understanding the barriers you may encounter and preparing yourself and your support team can allow you to have more satisfying and safe birth and postpartum experiences. 

Sourcing the right team for you is essential to an empowered experience where you feel safe, supported, and held in your choices. Doulas, subsidized programs, community-led initiatives, and your wider community can all support you in creating a safety plan, and advocating for your family while nurturing you and bearing witness to your journey. 

We acknowledge that sometimes it’s hard to know where to begin—which is a privilege in itself—so we’ve compiled a list of further reading and a glossary of terms so you can educate yourself, learn, unlearn, and understand better. 

Definitions

(Black) Maternal health crisis: An ongoing crisis in America (and Canada) where

Black and Indigenous birthing people are 2 – 3 times more likely (thank white folks) to die from complications in pregnancy, birth and postpartum.

Structural racism: Are systems in which governments, public services, practices, representation and other norms are working to reinforce racial inequity — it is a feature of the social, economic and political systems in which we all exist.

Implicit bias: Describes when people have predetermined attitudes and stereotypes that affect their thoughts, behaviors and actions towards people.

This is usually tied to a lack of neutrality, and negatively impacts said people.

Unassisted / Free birth: When someone gives birth without the presence, support and guidance of medical, clinical and/or knowledgable care providers — such as obstetricians, midwives, doulas, and/or traditional birth attendants.

Birth alerts: Are a practice (in Canada), where government workers notify the hospital and government systems if they have concerns for the safety and wellbeing of a newborn — these typically target Indigenous families, perpetuating harmful colonial practices.

Residential schools: Was a network of boarding schools that stole Indigenous kids from them families, and deprived them of their ancestral traditions and culture. While causing them harm, violence and deep intergenerational trauma.

Ableism: Discrimination and prejudice of differently abled people — in favor of able-bodied people.

Fat-phobia / Anti fat bias: A harmful and irrational aversion and discrimination against larger bodied people. 

Generational trauma: The psychological, emotional, mental and physical effects of trauma on subsequent generations — this can be experienced by groups and families of marginalized peoples.

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We work and live on the unceded and occupied territories of the Sḵwx̱wú7mesh Úxwumixw (Squamish), səl̓ilw̓ətaʔɬ (Tsleil-Waututh) and xʷməθkʷəy̓əm (Musqueam) Nations. Since time immemorial, the original peoples of these lands have cared for their families and communities. We are committed to honouring their teachings, legacy and their sovereignty.

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