Marlo D. David, PhD, writes a letter to Black midwives on the politics of reproductive justice and how Black birth workers possess the transformative power of cultivating the community frameworks necessary for intersecting justice movements, like sustainability and climate, within marginalized communities.
Dear Tameka and Jennie,
I hope this note finds you well and in good health. It’s been more than 20 years since I met each of you, separately, when I sought out your care while I was pregnant. Though the two of you don’t know each other, you are forever joined in my mind. I’m sure you’ve collectively caught thousands of babies since we first met, guiding their squishy bodies out into the world. You’ve probably held hands and locked eyes with countless birthing people as you managed their care in both home and hospital.
Yet, I would like to think that maybe—just maybe—you might remember delivering my two sons Tunde and Ade.
I want you to know that the home births of my two oldest sons under the care of two Black midwives—your care—revealed to me a standpoint that I would come to know as reproductive justice. SisterSong, a national and multi-ethnic organization, identifies reproductive justice as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” At the time I met each of you, I did not fully understand that my need to define my own safe and sustainable birthing space was political. It just felt right. Now, more than 20 years later, this political ethic undergirds my relationship to multiple intersecting justice movements, including climate justice. I did not understand that Black birth workers possess the transformative power to cultivate the very community frameworks for sustainability that climate justice calls for because these birth workers center the experiences of marginalized people and provide a sense of safety and community that may not otherwise exist.
Tameka, I met you in your nag champa-scented bungalow in Santa Cruz in 1998. You had soft things draping every surface of your home. Your sun-kissed face and free-spirited hair captured the wildness of the mountains and sea that cocooned the city, but make no mistake, you were nothing but East Bay realness. My husband and I relocated to Santa Cruz that month, and I was already four months along. We packed our car and drove cross country with no idea where we were going to live. Announcing that I planned to give birth “at home”—when, in effect, I had no home—sent my best friend into tears. “Marlie,” she cried over the phone, “Why are you doing this!?”
I wanted to have a midwife assisted home birth because my husband was born at home by a pan-Africanist mom delivered by a group of nurses who provided underground home births in Gainesville, Florida, back in the Seventies. I was influenced by his past. His radical birth occurred prior to the publication of Spiritual Midwifery (1976), the hippie handbook often credited with reviving interest in midwifery and home birth in the United States. When I became pregnant, I devoured the copy of Spiritual Midwifery that my mother-in-law loaned me, and pursued a “natural” birth, unmedicated and non-medicalized. But the midwives I met in Santa Cruz or that I read about in Spiritual Midwifery did not reflect my reality as a Black woman.
My mom, always frank and forward, said she didn’t think it was safe to have a baby at home. Like many Black women of her generation, the idea of birthing at home was a throwback to a bad time before Black women had access to professional obstetric care in hospitals. (Likewise, breastfeeding practices among Black women took a dive in this moment while formula was promoted as better.) Yet, despite her reservations, my mom resolved herself to support me in every way she could. She booked a flight to California for the week I was due. Once we got settled in an apartment, friends told us they knew a Black woman from Oakland who was a doula training to be a midwife. That was you: Tameka. Tunde was the first baby you delivered in the role of lead midwife.
Three months after Tunde was born in Santa Cruz, we moved to Orlando to be closer to family networks of support. I became pregnant again within the year, and I knew instantly to look for another Black midwife to provide care. Working with Tameka, I realized that it mattered to me who provided health care, especially when it came to physical exams. It mattered to me that I got to choose who would be with me while I labored. It mattered to me that I felt respected and informed while pregnant. My well-being hinged on a necessary feeling of mutual regard and trust. Even my mother who was so worried about my home birth, witnessed the powerful difference between my midwife assisted birth from her own birthing experiences in hospitals where she felt disrespected or ignored by rude nurses.
That’s when I heard about you, Jennie. You were running a small clinic in the Black part of Orlando known as Pine Hills. Along these long stretches of asphalt and strip malls, you had carved out a sanctuary called The Birth Place. You showed up to our first appointment, petite and bespectacled, ordered and demure, but warm and so sincere. I found out that you trained as a nurse-midwife in London, and you were on a mission to bring midwifery care—in hospitals and homes—to Black women. You asked me how I wanted my birthing experience to go in your British accent tinged by a hint of Caribbean cadence. Ade was born in my bedroom on a beautiful Saturday morning in April. In the past 20 years, I know you have met and surpassed your goals to bring holistic birthing services to Black women and you’re an international voice in the maternal care movement. Your model of prenatal care has been studied and confirmed to significantly reduce and even eliminate health disparities in preterm birth outcomes and reductions in low birth weight infants.
Looking back, I didn’t know how lucky I was to be in spaces where you both lived and worked. When it came time to birth my third son, Freedom, I lived in a place with zero Black midwives or doulas available. There was one Black obstetrician in town, but I was fearful of an obstetric approach. By then, the crisis of Black maternal mortality had risen into the national conversation, and my understanding of reproductive justice had deepened. I chose to have a midwife assisted birth in a hospital. She was not Black. In cities, small towns, and especially in rural communities, finding Black birth workers—midwives, birthing doulas, lactation consultants, postpartum, and miscarriage doulas—can be difficult or impossible.
That’s why I wanted to reach out to you now to let you know how much your care still means to me after all of these years, and how much I wish more birthing people could avail themselves of the kinds of care you offered to me and my family.