Rooted: Understanding the History of Birth Justice and Growing a Movement

The history of midwifery in Florida is at once inspiring and infuriating. In 1920, there were 4000 midwives. In 2016, there are just over 100 licensed midwives in the state. Where did all the midwives go? As birth workers, we stand on the shoulders of many ancestors whose stories have been neglected and disrespected. The saying goes that when an elder passes, it is like burning down a library. So imagine, for a moment, all the wealth of birthing knowledge that has been lost because no one took the time to sit with and listen to the stories of those thousands of elder midwives.

At Southern Birth Justice Network (SBJN), a southern rooted organization based in Florida, we are reclaiming our story, the stories of our grandmidwives and our ancestors, in the name of those yet born. What birth experiences will our daughters have? Our granddaughters? What will birth look like in seven generations? Not an assembly line chopping block of unnecesareans (unnecessary surgical births). We refuse! We resist! We are consciously creating a community of birthworkers, activists and parents to organize, strategize and create the communities we want for our children. Many of us have had traumatic birth experiences, been robbed of our right to breastfeed or the right to parent our children.

Midwifery is and was about survival in the African American community. There are many midwives in our legacy like Lucrecia Perryman, Biddy Mason and Gladys Milton who, through their work as midwives, were able to teach mothering across generations, serving as both a
conduit for the transmission of cultural practice rooted in an African past as well as for innovation in the interest of survival. Our ancestors have paved this path so gracefully, clearing brush and thorns out of our way so that we may see our way forward without blood in our eyes…so that we may walk with less stumbling. There are so many untold stories in our communities, so many sheroes and heroes that remain unsung. The practice of Sankofa, reclaiming our story and carrying our ancestors forward with us, is the responsibility of all of us. The names are too many to call.

Many in our community have lost an important connection with motherhood and parenting because we have lost the connection to midwives. Becoming a mother/parent is more than a biological event. Midwives understand the importance of education, health, nutrition, healing and autonomy over one’s own body. This was incredibly important in the post-slavery era for a people who had been enslaved and had little autonomy over their bodies, health or children. In post-slavery America, there were many barriers to accessing to medical care and also there was significant distrust of doctors and the medical establishment. Physicians such as J. Marion Sims used Black bodies for experimentation, in the name of medical advancement and often to the detriment of his patients such as Anarcha who was subjected to 30 surgeries with no anesthesia. So, midwives did a lot of health care in general, beyond caring for pregnant, birthing and postpartum patients. Midwives represented a safe place that literally held the community’s future in their hands.

In the early twentieth century, the American Medical Association (AMA) (led primarily by white, wealthy male doctors) launched racist and sexist attacks on Black midwives specifically, seeking to discredit and regulate midwifery as part of the movement toward medicalization of birth. As a result of these attacks, in many states, it became a requirement to hold a nursing degree in order to practice midwifery, posing a significant barrier to access and autonomy. Conversely, this increase in state regulation and destruction of the role of midwives coincides with disparate rates of maternal and infant mortality and other health issues in the African American community.

Without our midwives at the center of the community, we have lost access to a channel for transmitting our cultural knowledge, tools and values about health that are rooted in our African and other indigenous traditions. For example, we know that it has often been the midwives throughout history, who have facilitated the release of unwanted pregnancies through spiritual, herbal and manual practices. Part of the early AMA agenda was to make all abortion illegal. They accused midwives of performing abortions and began a campaign to drive them out of business.

Suppression of reproductive choice and midwifery go hand in hand, and are both aimed at restricting people’s right to choose when, where, how and with whom to have our babies. In the same vein, our movement for justice – reproductive justice and birth justice – must be intertwined and cooperative. The Birth Justice framework attempts to unite these perspectives. The focus of Birth Justice is to increase the range of pregnancy and birth options available and accessible for all, meaning pregnant people have full access to quality and compassionate reproductive health care options, from termination to homebirth. We must work together to expand reproductive choice. We must collectively guard against co-optation of our movements. The anti-abortion billboards across the South, blaming Black women for the deaths of Black babies send a dangerous message that we do not have autonomy over our bodies or our choices. These same attitudes persist in hospitals where pregnant people are coerced, threatened and even forced into having invasive procedures, including c-sections. We must build a cohesive agenda for all of our reproductive freedoms.

It is important to center education, access and support for marginalized pregnant, birthing and parenting people in our movements. For SBJN, this includes young people of color, incarcerated people (and those under correctional supervision), LGBT andimmigrants/undocumented families. Folks in these communities often have the least access to quality care and birth options but the greatest need. This is still largely seen as a white women issue of privacy and bodily autonomy based on the models of organizing used for abortion access. While midwifery and doula care continue to be portrayed as boutique health care options for wealthy, educated, white families, the reality is many birthworkers (especially birthworkers of color) are boots to the ground giving to the communities that need them with little or no compensation.

It doesn’t matter that the United States is among the wealthiest nations when my people, Black people (whose backs this nation is built on) are dying at rates that mirror the Global South. As we grow this movement, we need global solidarity for Birth Justice. We need bettereducational options to create more access for midwives of color. We need models ofsustainability for birthworkers in health disparate communities. Whether you squat to release a pregnancy or squat to birth your baby, midwifery care can be life saving and life affirming. We need more advocacy for access to these models of full spectrum healthcare.

Jamarah Amani is a mother, midwife and community organizer based in Florida. She believes in the power of birth and in sharing stories of legacy, survival and triumph as a mechanism for healing. Her mission is to do her part to build a movement for Birth Justice locally, nationally and globally. For more info about Birth Justice, please visit