The Hierarchy of Validity: A Creative Exploration of Reproductive Justice

Curatorial Statement Birthing is an intimate experience and all mothers—regardless of their race or class— deserve to have a variety of birthworker options. Birthwork covers an array of professions related to meeting the physical and emotional needs of expectant mothers and mothers in post-partum. For the purposes of my research, however, I define birthworkers as those working as a doula, midwife, or OBGYN. Without the knowledge of the multiplicity of options available to them, pregnant women of color’s autonomy suffers.

This project explores how birthworkers in Arizona are differentially perceived and hierarchized by expectant mothers. While doulas are assumed to be mystical, OBGYNs professional and midwives a blend of both levels of professionality, this project explores the hierarchy of validity and importance of acknowledging each birthworking discipline as beneficial to expectant and post-partum mothers.

Through the presentation of this work, I aim to educate readers on the benefits of each birthworking discipline, thereby raising awareness about the need for equal respect and access to all types of care providers during the pregnancy journey, as well as a need to place intimacy at the center of birthworking praxis. Throughout this ‘zine you will learn about the importance of integrating terms such as “reproductive justice” and “equity” into general discourse, the racial disparity evident in the quality of care pregnant people receive during delivery of their child, as well as anecdotal information about each birthworking sector—doulaship, midwifery, and obstetrics— from professionals in each field.

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Glossary Birthwork: covers an array of professions related to meeting the physical and emotional needs of pregnant people and those in post-partum

Note: In this zine, I refer to pregnant “people” rather than pregnant “mothers” as pregnancy is not cis-centric. My language reflects a range of gender identities and attempts to capture a variety of lived experiences.

OBGYN: Medically trained birthworking professional who works in a hospital and delivers babies; can perform a variety of medical interventions including but not limited to cesarean sections (C-sections), episiotomies, and pain management narcotics such as an epidural; often required for high risk pregnancies (Vox).

Certified Professional Midwife (CPM): Medically trained birth professional who provides comprehensive pregnancy, labor, birth, and postpartum services to expectant families in the homebirth and birth center setting. CPMs are trained to administer oxygen, anti-hemorrhage medications, treat shock, provide CPR and neonatal resuscitation. They help to create the birthing environment parents desire while using medical interventions only when necessary (Muhammad).

Doula: Birthworking professional that is not medically trained but instead focuses on providing continuous emotional, physical, informational, spiritual support for a pregnant person pre-labor, during labor, and post-partum (Carathers vi)

Reproductive Health (RH): reproductive healthcare services including but not limited to birth control, fertility, abortion, pregnancy (Schaff 3)

Reproductive Rights (RR): emphasis on legal right to reproductive healthcare at the federal and state levels (Schaff 3)

Reproductive Justice (RJ): emphasis on access (versus choice) to adequate reproductive healthcare; having legal rights is meaningless without the means to realize them (Schaff 3) 2

What is RJ and why is it important?

In the above photograph taken by Nicole Hamic, you can see a woman of color successfully giving birth in a tub with the help of a midwife. It exemplifies the access that pregnant people of color have to a wide variety of birthworkers beyond the traditional OBGYN. Reproductive Justice (RJ) is an intersectional framework which aims to make women’s healthcare an accessible and equitable experience unencumbered by social barriers such as race, gender, or class. Rather than focus on choice, as many white, pro-choice feminists have done, the Reproductive Justice movement, founded and propelled by Black women, places a greater emphasis on access.

When economic injustice is fueled by racism, white women are privileged and women of color are often subject to interlocking systems of oppression. Despite having the legal rights to make decisions about their reproductive health, women of color do not 3

have the necessary enabling conditions (financial, geographic, etc.) to realize reproductive rights (Ross 14). Therefore, in the spirit of SisterSong’s definition of Reproductive Justice, it is important to fight for women of color’s rights to a) have a child, b) not have a child, and c) parent the children we have and control our birthing

options (Ross 14).

In 1997, Loretta J. Ross, a Black feminist and activist, co-founded the SisterSong Women of Color Reproductive Justice Collective with the mission of creating a community which gives women of color a platform through which to discuss and advance the reproductive healthcare needs of their communities. As a collective of women of color, it aims to bring together multi-racial, multi-generational, and multiclass constituencies (“Reproductive Justice”).

Despite RJ’s origin among a coalition of women of color feminists, the social change which RJ has the potential to effect will only occur with the participation of white allies (Ross 16). The reproductive justice movement is an inclusive one which was built with women of color’s needs at the center of this movement and theory.

Because insurance coverage is often a factor when choosing a care provider, it is important that each birthworking sector is covered under insurance. Despite the availability of several birthworker options, typically only OBGYNs are covered.

Currently, the Arizona Reproductive Justice Coalition, a division of the Arizona Birthworkers of Color (AZBOC), is working to pass a bill which would make access to doulas for pregnant people more affordable by making doulas a care provider which is covered under the Arizona Medicaid system, Access. If passed, this bill would make access to a wider variety of birthworker options more economically feasible and might encourage people to not limit themselves to having just an obstetrician on their birth team (Muhammad).

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The Assumed Hierarchy of Birthwork There are three main sectors of birthwork which we will explore, ranked in order of most to least socially recognized and accepted.

As you descend in the pyramid, the professions are generally perceived to be less knowledgeable, trained, sanitary, or safe for pregnant people.

In the 1900s, doctors started to edge

midwives

pregnancy was a “pathological intervention” (Vox). “Granny several

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Medically trained birthworking

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professional who works in a hospital

to smear the credibility of

and delivers babies; can perform a variety of medical interventions including

prop

but not limited to cesarean sections (C-sections),

financially

episiotomies, and pain management narcotics such as

profession,

beneficial

engaged

the

more medical

obstetrics

an epidural; often required for high risk pregnancies

(Muhammad). obstetrics

up

In doing so, the Certified Professional Midwife (CPM): blend of both Medically trained birth professional who provides comprehensive pregnancy, labor, birth, and postpartum services to expectant families in the homebirth and birth

community in

center setting. CPMs are trained to administer oxygen, anti-hemorrhage medications, treat shock, provide CPR and neonatal resuscitation. They help to create the birthing environment parents desire while using medical interventions only when necessary (Muhammad).

Doula: mystical Birthworking professional that does not have a medical degree, but instead focuses on providing continuous emotional, physical, informational, spiritual support for a pregnant person pre-labor, during labor, and post-partum (Carathers vi)

reproductive oppression. They stripped the experienced birthworkers, namely Black midwives in the South, of their right to assist in the labor and delivery of pregnant people and exploited the act of labor by using language that implies birth is done not by mothers, but by physicians whose “authority” is an integral part of having a safe and healthy delivery (Brubaker and Dillaway 42-43).

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What is medicalization and how does it marginalize POCs? As reproductive technology and science have developed since the 1600s, the superiority of certain voices in several life events—namely birthing—has shifted.

Despite the long history of women as healers and the generational passing of birthing knowledge through primarily midwives of color, today’s field of medicine is dominated by male professionals working within the medical obstetrics community. Over time, scientists and medical professionals have deskilled the population and mystified natural human experiences by coming up with medical terminology and practices— epidurals, C-sections, episiotomies, drug-induced labors—which are exclusionary to midwives by the fact that one must earn a graduate degree to understand and perform as an obstetrician (Brubaker and Dillaway 33).

Under the contemporary understanding of pregnancy and the birthing process, pregnant people must defer to the ‘expert’ OBGYNs, and the modern medical technology guiding their practice, to have safe and healthy births. Obstetrics is generally viewed as the most efficient and most legitimate option for pregnant people.

This myth that midwives are not as sanitary, safe, or knowledgeable about the birthing process is propelled by mainstream depictions of midwifery as “witchy,” “spiritual,” and “mystical” (Muhammad).

Like any other division of American society, the medical community is subject to implicit and explicit racial biases which disadvantage pregnant people of color, predominantly Black mothers. For example, Black infants are more than two times as likely to die than white infants, and Black women are three to four times as likely to die from pregnancy-related causes than white women (PBS NewsHour). In addition to medical professionals not taking Black pregnant peoples’ concerns seriously, Black pregnant people of color are subject to “toxic stress,” micro-aggression induced

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stressors on the body during labor which make labor more difficult and traumatic.

These trends are consistent among Black pregnant people of all socio-economic statuses, showing that this is not a class-specific issue, but rather a racialized experience (PBS NewsHour).

Because of doulas’ and midwives’ distance from the hospital setting and rejection of certain medical practices (i.e. pain management drugs, episiotomies, C-sections), as well as their greater focus on developing an intimate relationship with their client, pregnant people of color often feel more supported and heard when they have a doula and/or a midwife on their birthing team.

Although they typically work in out of hospital settings, doulas and midwives are no less knowledgeable about the birthing process. In the below photograph taken by Phyllis Assan, a Black Doula and photographer, you can see a Certified Professional Midwife checking the vitals of a pregnant woman of color during her labor in a tub.

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Kierra Otis Kierra Otis (she/her or they/them) is a Ph.D. student studying Gender Studies at Arizona State University, a doula, and co-creator of the Rooted Doula Collective, a collaborative community of Black doulas based in Arizona which offers full-spectrum doula support—birth support, miscarriage and stillbirth support, medical abortion support, and postpartum support—to enrich and protect the experiences of Black pregnant people and families.

Sofia Murillo: I want to start by asking you if you could open with a story of how you came to doula work, what inspired you to do this, what motivates you, and how you began your collective?

Kierra Otis: So, I have been a doula for almost 3 years now. So I would say—and you’ll hear this from most doulas I think—but I have always been a very nurturing person.

Like, I have some photos of me when I’m like a baby baby—like trying to help other babies. That’s just kind of always been how I am…

Part of the reason I found women and gender studies was because I got involved with campus activism in Missouri after the Fergusson uprising. I was working with a lot of Black, queer feminists who were women and gender studies majors, and so I was like, “Y’all are rad. I need to do this,” and I saw the business of being born and I was like, “Oh my goodness,” like this all makes sense to me…

So I just emailed a bunch of birth centers and I was like, “Hey, umm, I don’t have any training but I would like to be a doula. Can you train me?” And one got back to me…It was a predominantly white birth center here in Phoenix. It’s very white, heteronormative, middle-to-upper class. It’s everything that you think about when you think about like white, umm, I don’t know, white birthwork and midwifery and whatnot.

So then, with the uprisings this summer—well between COVID and the uprisings—we know with COVID Black and brown people are being predominantly affected. They’re

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the ones who are dying, and this birth center that I was at was just treating COVID like a joke. They were just making funny little Tik Toks and memes and they weren’t taking it very seriously and they also wouldn’t let me do virtual support…So then I was like, okay, I know I want to do something for Black people. And there's a few collectives here in the Phoenix area that I was kind of thinking about as I was coming up with Rooted Doula Collective.

SM: So this collective you started this year, this summer?

KO: In July, yeah.

SM: It’s like your own baby.

KO: Yeah, we're in the postpartum stage.

SM: So I know that Rooted Doula Collective places reproductive justice as one of its main tenants. But could you expand a bit on how you implemented RJ into your collective, into your practice, into your work? What does it mean to have RJ as one of those tenants?

KO: I tend to boil down RJ just—like I know there's so much more to it—but I just think of like the three, you know, rights: the right to have children, to not have children, and to parent children safely in sustainable communities. And so, I think reproductive justice is useful because it helps to talk about some of those racial, ethnic, and sexuality-based disparities that happen in pregnancy and birth outcomes… So I think the main way that RJ comes through into our collective is through the full-spectrum aspect in that we acknowledge that people have different reproductive journeys.

We're non-judgmental. We support whatever is going to happen, and also hold space for all of the emotions that come up because, sometimes, you know, you might feel really sad about terminating a pregnancy, or you might be sad that you're in the situation that you're in, having a pregnancy.

SM: It seems like as a doula, you have to give a lot of yourself and a lot of your time to your clients and sometimes it seems like that could translate as their life and their 10

needs come first, especially when you're on call, I assume. So, how do you balance the personal and work life?

KO: Yeah, yeah that’s a really great question. So, let me think. Yeah, it definitely feels like you're giving a lot of yourself sometimes, and I think that you know doulas tend to be people who are caretakers, but they're also not the best at letting other people care for them… And I find that it's just really important to constantly prioritize and reprioritize self-care. And this is something that can be hard for doulas to learn, especially if you have a client that you know is going to go into labor at any second.

That means that you always need to be eating, and that means if you're tired, you probably need to take a nap. You just always need to be ready to go be somewhere else for a long time. And, I think, even outside of the physical… it can be really hard to mentally and emotionally remember that the outcomes are not your responsibility.

And that's so hard because a lot of us get into this work because we want to change outcomes. But then we get into the work and we realize we can't. We can't really, we can't do that for the client. Like we can do that with them and advocate for them, but we're not going to be able to do it on their behalf.

SM: Do you feel like the birthworking community of doula, midwife, OB is hierarchical, and do you feel like your profession isn't as respected by the ones that are higher up in the hierarchy?

KO: Oh yeah, that's a good question. Yeah, there's definitely a hierarchy. It would be like OBs, then midwives, then doulas… And I mean a lot of that hierarchy just has to do with the history of Obstetrics, and how white men came in and experimented on enslaved Black women to come up with all these procedures and then pushed out midwives, who were predominantly immigrant midwives of color. And then I guess we see it right now with COVID, where they don't even let doulas into the hospital because they're not viewed as an important part of the birth team.

SM: Have you ever had a client who’s race, gender, class, sexuality influenced their choice of birthworker or what combination of birthworkers they wanted on their birth 11

team?

KO: Yeah, I think that most of the Black clients that I've worked with have been aware of maternal mortality, especially in a hospital setting. And so I think that's why they start out at a birth center in the first place.

And I think that having a doula is kind of like…like sometimes I feel like I'm a watchdog because I'll just like be in the room, and I'm there. And then suddenly the nursing staff asks, “Oh is it okay if we do your vaginal exam?” Where normally they would be like, “Okay, we're going to do a cervix check.” And they just tell you. Or they're like, “Okay, we're thinking about doing this. We're going to step out. Consult with your doula.” Like they know that doulas are there to like protect…

SM: Be an advocate for the person.

KO: Yeah. Yeah, and often like I don't even have to advocate. I just have to be there and be like, “How do you feel about that? Does that procedure sound good to you? Is that something you want? Do you have any questions?”

Connect with Kierra! https://www.rooteddoulacollective.com/ Follow her @rooteddoulacollective on Instagram

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Lakisa Muhammad Lakisa Muhammad (she/her) is a Certified Professional Midwife (CPM) and a provider of home birth services in Arizona. Before working as a midwife, Lakisa worked as a doula and after many years working as a birthworker, co-founded the Arizona Birthworkers of Color (AZBOC), an organization which seeks to help birthworkers of color in the State of Arizona be seen, heard, and honored for the work they do.

Sofia Murillo: What inspires/ motivates you to be a midwife?

Lakisa Muhammad: My career in birthwork began like many birthworkers, particularly birthworkers of color, in that my own pregnancy and labor and delivery was the catalyst for me wanting to explore birthwork and serving other families… The more I learned about birth, the more fascinated I became with it, just, as its own category. I don’t know, as its own thing… I was yearning just to learn more and more…

My transition from being a doula to being a midwife really was based around a family that reached out to me and hired me to be their doula. I met this beautiful Black family having their first baby. They had done all the research, they hired a doula, they wanted to take classes, they had even researched hospitals and C-section rates, and they wanted to choose the one with the lowest, and they’ve done everything that they possibly could have done in order to ensure that they were going to have the experience that they desire. You know, a beautiful, peaceful, safe birth of their first baby. Their birth was almost the opposite of everything that they wanted… I spent a long time processing that birth and just thinking about where did we go wrong, like what could they have done differently that would have led to the experience that they wanted?

What I came up with—and the only thing that I could in all of my meditating and thinking about this birth—was that they weren’t supposed to be there. They weren’t supposed to be in the hospital, they weren’t supposed to be there with those care 14

providers. That was not the setting for them. But then thinking about our birth community at that time, well what options did they have? Especially if they wanted to give birth with a care provider who looks like them, who would have understood where they were coming from, not just medically, but also culturally and socially. That option was not available to them… So that, you know the little voice inside your head that says, “it’s you”? That’s what I heard. “No, you’re supposed to do that. That’s your job.”

SM: I love that! That’s great. I love that origin story. I’ve heard similar stories from other birthworkers and people in the community about women of color, but specifically Black women’s experience in hospitals, and how different it is from what they want, or expected, or planned for… Would you say you prefer the setting of a home birth or birth center as opposed to a hospital?

LM: You know, I think it’s—we have to get to the point where it’s more individualized care for women who are not low risk. For women who have health concerns, the hospital is what’s needed. For people who are not comfortable in the home setting, but not comfortable in the hospital, a birth center is what’s needed. I think for each individual family, being able to offer what they need within our community is vital…

I think really addressing that hierarchy that you spoke of is an integral part of making that happen here in the U.S. Traditionally, midwives, particularly out-of-hospital midwives, Certified Professional Midwives, are looked down upon oftentimes…I have consults with families where I really need to break down to them as a modern midwife, “Yes, I use herbs. Yes, I use essential oils. Yes, we focus on nutrition and hydration and all of these things, but I also carry pharmaceuticals. I also carry oxygen to your birth if we need it. I’m also trained in resuscitation of you and your baby.” We have these medicalized skills, but a lot of people don’t recognize that. You know, I jokingly say that they think we just come and boil water and have some towels and use some Crisco and you know that’s it! But that’s not an accurate depiction of the modern midwife. Like there’s so much more that goes on.

SM: I guess my next question would be, have you worked in tandem with other 15

birthworkers, such as doulas or OBs, in maybe a hospital setting or an out-of-hospital setting, and what was that dynamic like?

LM: I’ve worked pretty frequently with other doulas in the home birth setting. As far as in hospital, my only experience would be in transport or transfer of clients who were no longer safe in the home birth setting, and we needed to move into the hospital setting in order to keep their baby and themselves safe. There’s a huge stigma around home birth. When we move into the hospital setting, many clients—and I know this from the perspective of a doula and also as a home birth midwife—many clients, if we have to transport, they are sometimes mistreated. They are sometimes looked down upon. Midwives are talked down to and treated in a demeaning way. Families are sometimes demeaned and almost scolded that they even thought that they could do this at home…

But on the other side of the coin, I also have experienced some really beautiful integration of care, where doctors are humble enough to listen to me as a midwife and as I’m describing what is going on with my client and telling them what’s happening and what I would recommend be the next level of care, the next thing that we do. I have had doctors who are willing to listen, and those have been the best scenarios for not just myself, you know because it’s not about my ego so much. I can take the blows. But it’s really about the family and protecting the experience… So things like that, I think, you know, in working together and in tandem, we can make things better not only for each other and building relationships, but for the families that we serve.

SM: Can you speak a little bit about how you perceive the intimacy level with your patients and, versus doula work if you can?

LM: Intimacy and trust are really the hallmark of home birth midwifery. The ability to get to know your clients and allow them to get to know you is really foundational. The home birth setting, you could say, is a low resource setting. We’re not in the hospital, we don’t have an OR around the corner, we don’t have all these hardcore medications 16

and all of these things that can fix whatever it is that’s going wrong. So there is a certain level of foundational trust that has to be had between this family and their midwife… I believe in home birth midwifery in particular, we seek to—we being midwives—seek to eliminate that constant thought of, “Is she telling me the truth? Is this right?” …We can only do that if we’re working hard in the prenatal period to get to know one another, to build trust, to build that relationship, to build a rapport with one another… When you go into the hospital, we don’t know what nurses are going to be on duty that day. We’ve never met before, or sometimes we’ve never met the doctor that’s on call. So where is the trust in that? Where is the relationship with this person who is there for me in one of the most intimate acts that we will ever do in life, giving birth and bringing forth our children? And we’re doing that with strangers. So intimacy, trust are vital to the midwifery practice and to our relationship with our families.

Connect with Lakisa! http://amothersworthbirthservices.com/meet-lakisa https://www.arizonabirthworkersofcolor.com/ Follow her @amothersworth on Instagram

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A History of Obstetrics Despite originating with midwives, birthing practice was slowly taken over by the growing community of male obstetricians after the Renaissance (Zeller 6). As physicians began to realize the money that could be made in birthwork, they started to discredit Black female midwives by playing into the stereotype that women are intellectually inferior to men (Zeller 8). To bring this myth full circle, physicians branded birth as a “pathological” event which required complicated medical specialty training that could only be learned by a highly trained physician. They then created scientific technology that validated this claim (Vox). With the development of tools like obstetric forceps—which female midwives were legally restricted from using— and pain management tools like “twilight sleep”—chloroform which did not remove the pain from childbirth so much as remove the memory of pain—physicians began to take over the field of birthing and simultaneously strip pregnant women and midwives of their autonomy and agency in the birthing process (Zeller 9).

In addition to the emergence of these medical tools meant to “aid” in the delivery of a child, obstetricians introduced new surgical measures like cesarean sections (Csections), which are now the most commonly performed major surgery in the U.S. despite the fact that research has shown that mothers who deliver via elective Csection are 2.3 times more likely to be re-hospitalized in the month following their birth due to infection and complications with the surgical incision (Cook 2).

When pregnant people have their child in the hospital setting they are subject to the “cascade of interventions,” a cyclical pattern of medical intervention that limits pregnant people’s agency in childbirth and disrupts the natural physiology of labor and birth by a) interfering with naturally occurring hormones (administration of Pitocin, a labor inducing drug), b) creating opportunities for infection (performing an episiotomy or C-section), and c) making it harder for the pregnant person to push their baby out (administering of an epidural which numbs the lower half of the body) (“The Cascade of Intervention”).

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Intimacy in Praxis Over the course of the year that I spent doing research into the various birthworking fields and their impact on pregnant people’s birthing outcomes—specifically pregnant people of color’s birthing outcomes—I found that the most integral piece of the puzzle to facilitating a successful pregnancy is to center intimacy in birthwork practice.

Because of systemic racism and the culture of medicalization that has invaded the birthing sector, pregnant people of color often experience negative birthing outcomes—whether it be the denial of pain management medications, unwanted medical intervention, or at its worst, maternal mortality. These negative outcomes are a result of a disconnect between pregnant people of color and their care providers that comes with treating pregnancy like a transaction rather than a collaborative experience in which all parties trust each other to have their best interests in mind.

In the hospital setting, pregnant people are not afforded the levels of intimacy and respect that can help them have a more enjoyable, safe, and healthy birth. Doulas and midwives, two fields which center this mutual respect and emotional support in their praxis, provide better mental health outcomes for pregnant people of color because of their emphasis on the holistic approach to birthing. Part of this is because, in contrast to solely having an OB on your birth team who may or may not be present at your birth because of conflicting schedules, doulas and midwives work very closely with expectant families to build a relationship and a level of trust between them that is realized by their presence in all stages of the birthing process. Beginning and ending the birthing experience with the same person and knowing that you have an advocate for you and your child in the birth room is something that, at this time, is special to the fields of doulaship and midwifery.

What does a lack of intimacy in birthwork praxis look like?

As told to me by midwife, Lakisa Muhammad: “I’ll tell you, there was a birth I had as a doula. Oh, it was so many years ago, that 20

baby may be eight or nine years old. But quite a few years ago, and it was a young mom having her first baby. She was a woman of color. She did a beautiful job, no medication, no nothing, pushed that baby right out, surrounded by family, which is really, really beautiful. Her doctor comes in, ironically enough—it hardly ever happens—but her doctor was the one that caught her baby. You know we’re all celebrating, it’s so beautiful. And I went to go throw something away in the trash can on the other side of the room by the door. The nurse was there doing her paperwork, filling out some things, the family’s bonding, and you know, looking at the baby. The doctor comes over, and I hear him say to the nurse, ‘Was it a boy or a girl?’”

What does intimacy in birthwork praxis look like?

As told to me by doula, Kierra Otis: “I had one lesbian couple that I was so excited to get, and they worked in the hospital.

But, yeah, I don't know, like I had a really good time with them, and I got this like really amazing picture… Because usually, so usually when the babies are born, like their head will come out and then there's kind of like a pause, and then like the rest of your body will be birthed. But this baby just like shot out! So I got a picture of her like, her feet were like still in the vaginal canal, but like the rest of her body was out. It was such a special picture. And then one thing they really wanted was like to not be separated from the baby, which I don't get why that's like so hard for the hospital to honor. I mean I guess I can speculate like their, their protocol is to take the baby, weigh the baby… And I was like, ‘What are you doing?’ But I was all the way on the other side of the room. And so I'm like running behind the OB who's stitching up this mom because she tore. And I look over at this nurse. And I was like, ‘They wanted to hold the baby. They didn't want all the staff…like can you please give the baby back?’

And she was like, ‘Oh, I was just gonna…’ and I was like, ‘no, they want the baby back.’ And so when I went into the postpartum visit, they were like, ‘I don't even remember that much from the birth, but I just remember you like diving in and like going to get [Baby] back!’ And I was like, ‘Yeah, I had to get her.’”

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Works Cited Brubaker, Sarah Jane, and Heather E. Dillaway. “Medicalization, Natural Childbirth and Birthing Experiences.” Sociology Compass, vol. 3, no. 1, Blackwell Publishing Ltd, 2009, pp. 31–48, doi:10.1111/j.1751-9020.2008.00183.x.

“The Cascade of Intervention.” Childbirth Connection, National Partnership for Women & Families, 2021, www.childbirthconnection.org/maternity-care/cascade-ofintervention/.

Carathers, JaDee Yvonne. Radical Doulas Make “Caring a Political Act”: Full-Spectrum

Birthwork as Reproductive Justice Activism. ProQuest Dissertations Publishing, 2019.

Cook, Tanya N. Exploring Childbirth Outcomes: An Analysis of the Interactional

Components of Pregnancy, Labor, and Birth. ProQuest Dissertations Publishing, 2013.

Muhammad, Lakisa. Personal interview. 29 January 2021.

Otis, Kierra. Personal interview. 17 November 2020.

PBS NewsHour. Why Are Black Mothers and Infants Far More Likely to Die in U.S. from

Pregnancy-Related Causes? YouTube, YouTube, 18 Apr. 2018, www.youtube.com/watch?v=AODAk-accVc&list=PL9U6ypT-Dibnh9CDcI-ovjlIZld-Y0JL&index=9.

“Reproductive Justice.” SisterSong: Women of Color Reproductive Justice Coalition, SisterSong, Inc., www.sistersong.net/reproductive-justice.

Ross, Loretta. “Understanding Reproductive Justice: Transforming the Pro-Choice Movement.” Off Our Backs, vol. 36, no. 4, Off Our Backs, Inc, 2006, pp. 14–19.

Schaaff, Bridget "B". Queering Reproductive Justice: A Mini Toolkit. Edited by Candance Bond-Theriault, 2019.

Vox. Sex, Explained. Ep. 5: "Childbirth", Netflix, 2020.

Zeller, Stacy K. Power and Knowledge in the American Birthing System: A Historical and

Theoretical Exploration for the Marginalization of the American Nurse Midwife.

ProQuest Dissertations Publishing, 2001.

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Created by Sofia Murillo