An overwhelming theme taken from this week’s reading can be how race affects birth/child-rearing outcomes, as well as a group’s conception of reproductive justice. In the introduction chapter to her dissertation, “Birthing, Blackness, and the Body: Black Midwives and the Experiential Continuities of Institutional Racism”, Keisha Goode lays out the demonstrated linkage between race and birth outcomes. Black women in the United States experience higher rates of infant mortality, maternal mortality, premature births, and low birth weight than their white counterparts, regardless of socioeconomic status (Goode 2015). This she attributes to internalized, personally-mediated, and institutional racism. Women’s stress responses to racism in these forms triggers chemical/hormonal reactions that adversely affect the health of mother and child. Conceptualizing these systems of racism is a good jumping-off point for processing the diverse perspectives from our readings this week.
Borrowing Goode’s definition of internalized racism, this system of oppression is “the internalization of negative stereotypes or images” (Goode 2015). The case can be made that internalized racism completely overturned the birthing practices of women in the United States over the course of fifty years. As Goode describes in her essay, the medical branch of obstetrics was a burgeoning field and doctors did not have the same access to pregnant women as midwives did. So began a racist, anti-immigrant, and anti-poverty smear campaign that depicted the use of midwives as reserved for lower classes, immigrants, and women of color. In a matter of decades, at-home births attended by midwives became obsolete. We see glimpses of the perceptions that prompted this cultural shift in the film All My Babies. While heart-warming upon viewing, this film was actually produced by the Georgia Department of Health to educate illiterate midwives on birthing practices during the medical transformation of the birthing field. In the film, we see a convention of black midwives being addressed by a white male doctor in a lab coat. He brings up a recent case in which a baby had died due an infection in the cut of the umbilical cord and implies that it was the fault of a midwife for not taking the sanitary precautions needed. His words echo in the mind of the midwife that the film follows as she reflects on a recent healthy birth she attended (Stoney 1953). This resonates with the publication Goode cites that depicts midwives as dirty and ignorant. Whereas once obstetricians sought the insight of veteran midwives, this represents a reversal in the mindset regarding midwife expertise. This shift has had devastating effects on the health of black mothers and babies in the US (Goode 2015).
In her dissertation, Goode lays out the definition of institutional racism – differential access to goods, opportunities, and/or resources. Institutional racism has been at the core of the more insidious practices around women of color’s reproductive health history in the US. Jael Silliman, et. al chronicles the use of sterilization practices and the implementation of racist policies by the US government that target women of color in Undivided Rights: Women of Color Organize for Reproductive Justice. Among a long list of practices aimed at women of color that range from unethical/questionable to horrific, the authors bring up the push for sterilization drugs on the market that have not been properly tested on women of color, the Depo Provera shot being one such example (Silliman, et. al. 2004). Over one summer during college, I interned at a teen pregnancy program. I remember that providers frequently pushed the Depo shot as a reliable form of birth control for the recent mothers, with the underlying assumption being that since they had already had one child at a young age, they could not be expected to self-regulate their family planning routines. Countless teens in the program received injections of the Depo drug. It was not long after that that this prescribed form of birth control fell out of favor.
Undivided Rights also details federal policies directed at men and women of color that covertly control fertility. The authors bring up how this became a focus of federal welfare policies in the 1980s and 1990s. So-called “family caps” denied additional benefits to women who had more children while receiving public assistance (Silliman, et. al. 2004). In my former role doing policy work in the domestic violence field, we focused a lot of our legislative energies on the state budget at the beginning of the term. The proposed 2011 budget included “full family sanctions” – the denial of benefits to an entire family for the parent’s failure to meet department of social services requirements. The paper put out by the Legal Defense Fund, “The Sanction Epidemic in the Temporary Assistance for Needy Families Programs” discusses how the imposition of full family sanctions is often subject to the DSS workers’ whims, who no doubt bring their own internalized and personally-mediated racism into the equation (Legal Momentum 2004). Working in the domestic violence field, I often accompanied clients to DSS to apply for public assistance. The requirements that the department set before clients could ever receive any assistance would be difficult to comply with, even in the best of situations; when factoring in domestic violence, housing crisis, transportation, child care, and literacy issues, they were near impossible.
Women of color have built movements around resisting these racist/classist/heteronormative reproductive health policies and practices distinct from historically white women’s agendas. As stated in Undivided Rights, “The groups in this book created their own definitions of reproductive rights-definitions that are grounded in the experiences of their different communities and that link oppressions. It is because of these intersections that women of color advance a definition of reproductive rights beyond abortion.” Because of the intersections of oppression that women of color face, reproductive justice does not just mean fair access to birth control and safe abortions – their movements have taken on environmental and spiritual identities, for example. The aspect that is most troublesome to me in their accounts of these movements, however, is how the lifeblood of the work has been supported by traditionally white women’s/men’s funding sources. The Mother’s Milk Project, a movement among the Mohawk nation in Akwesasne, was sustained with the support of the Ms. Foundation, a predominantly white women’s feminist organization. The Latina Roundtable on Health and Reproductive Rights, a coalition designed to protect reproductive rights for Latina women, was supported through a grant from the Ford Foundation. This begs the question of, given the history in which hegemonic systems have prevented women of color from having the same access to reproductive justice as white women, what is lost in the movement by receiving funding from these funders? Having worked in the non-profit sector, I understand firsthand how the strength and growth of grassroots movements can be squashed without an adequate funding stream. However, with grants come deliverables set by the source, and sometimes stipulations on who can do certain types of work. After thinking about these pieces, I wonder: what would these movements look like if there was more available funding from sources governed by women of color?