Women of Color, Ina May, and "Death by Delivery"

Addressing Internalized Racism in Pregnancy and Birth

Okay, friends, I'm not gonna lie. I am really struggling with the news of Ina May Gaskin's recent damaging remarks. This weekend Gaskin was filmed while being asked to address the racial disparity in the maternal mortality rates in women of color. You can watch the video here and skip forward to the 47ish minute mark. 

According to the Center for Reproductive Rights, black women are, on average, four times more likely to die in pregnancy or while giving birth than white women. In New York City their odds are even worse; black women in NYC are twelve times more likely to die than their white counterparts. The Center for Reproductive Rights outlines several correlating themes, such as lack of access to information, lack of adequate prenatal care, and poverty. 

Ina May is recorded saying that if WOC worked harder, prayed more, and were healthier, they would be fine. She said that racial disparities do not exist in pregnancy and birth, and trivialized the data saying it may not be accurate. 

As a doula who has cherished my copy of Spiritual Midwifery and a WOC who has seen and been moved by the injustice of others, I am at a loss. How could Ina May openly deny that women are dying? How could she imply that women aren't doing enough to keep themselves alive? It was like listening to a climate change denier or someone blaming a rape victim. It was deeply troubling. It seems as though Ina May wasn't sure what to say in response to the question and that this is what came out of her mouth. Many in the birth community are rising up against her. Petitions have been started by women for organizations and individuals to publicly denounce Ina May. I hear that anger and I think it was warranted, but I'm torn. 

I love Ina May! Spiritual Midwifery was the first book about birth I ever read! I recommend her books to every one of my clients. She is full of wisdom gained from many years of midwifery practice. Yes, she learned a lot from the women she worked alongside in Guatemala. Many have argued she appropriated their knowledge, and maybe naming the maneuver she learned from the midwives there for herself was a bad call. But she has always been forthcoming, proud even, of the knowledge she gained from those midwives. 

Ina May has since released an apology: 

"It has come to my attention that my answer to a Texas Conference Q & A question has caused a great deal of hurt, and was insulting and demeaning to many, especially Women, and People, of Color. While the intent behind my answer was anything but racist or demeaning, I understand that impact is more important than intent, and I personally offer my genuine and deepest apologies. I have spent a great many years of my career shining the spotlight on the massive racial disparities in maternity care, and my comment at the conference is not a true reflection of my belief, and what I know to be true - that racism, and its denial, are the true root of the egregious inequalities in maternal and infant healthcare for people of color. I'm still learning, and still growing as a person and as a professional, and I am grateful to the many Women of Color who have offered their support, and continued education. It will not fall on deaf ears." - Ina May

Some have said it's too little too late. Some have said that Ina May is boasting about herself and her career. I don't see it that way. I hear her humility and I accept her apology. But it doesn't change that there may still be deeply rooted, systematic, institutionalized racism in her. I say that because as Ina May fumbled for her words, racism came to her lips. It's not just her, though. Many of us have internalized racism without even knowing. Even as a Latina I know I have to check myself when I begin to think in generalizations. 

So, what do we do? How do we fight this? We acknowledge our privilege and internalized racism. We learn as much as we can from WOC about their experiences. We spread awareness of the disparities WOC face in their pregnancies and births. Use the resources available to us. There are many organizations that are working to address this human rights issue. Black Mamas MatterThe National Birth Equity Collaborative, and The Center for Reproductive Rights are a few of those that are already doing the work for birth equity. 

If you want to know more about this issue, I recommend watching Death by Delivery, "a searing portrait of the cost of racism in America." The documentary shines a light on "the staggering rate of maternal mortality for black women." I've also recently been introduced to the work of Margaret Charles Smith, an Alabama midwife who "was an African American leader in the field of maternal care and midwifery." You purchase her biography on amazon

I hope that the birth community in general will become more sensitive to the needs of black mothers and other marginalized people in our communities. I hope we can grow from this.