An Open Letter from Makeda Kamara to Midwife International and the Midwifery/ Birth Communnity

Reflections on racism and oppression in midwifery

An important statement from Makeda Kamara, midwife, and signed in solidarity by over 20 midwives of colors, regarding the actions of Midwife International, their advisory board members/ staff/ preceptors, and the broader midwifery community and leadership.

Please feel free to add your points of solidarity, learning and/or appreciation in the comments section below.

Why ALL Midwives Should Care About What’s Going On with Midwife International

Reflections on racism and oppression in midwifery

This guest post was written by Wendy Gordon, CPM, LM, MPH. The thoughts expressed are her own and may not be representative of all members of Anti-Racism and Anti-Oppression Work in Midwifery, nor of the other organizations with which she is affiliated.

The events over the last few days are causing quite a buzz in the midwifery community, as Midwife International – a U.S.-based training program that focuses solely on the use of clinical sites in low-resource countries as a vehicle for student midwives to gain experience – has been called out for reports of unethical behavior.

Full disclosure:  I am a midwife who participated in a short-term clinical rotation in a low-resource country to “get my numbers” some years ago.  I regret that I did not have much of an ethical or anti-racism lens at the time.  I didn’t think twice (or even once) about the power dynamics of being white, relatively wealthy, and American in a country where most of the people were brown, impoverished, and had been colonized by American military in WWII.

I didn’t think much about these power dynamics, because I convinced myself that the gentle, woman-centered type of care I was trained to provide would benefit all mothers and babies, even across international boundaries and language barriers.  Because the hospital maternity ward I trained at didn’t have enough staff as it was, the only logical assumption was that my presence there would be beneficial to the local midwives.  My American dollars were being spent in that community.  It was so obvious that this was a win-win.

My training helped me to justify that the type of care these mothers were getting from me, even as a student, was better than what they would have had without me there.  Furthermore, my whole life experience as a working, middle-class white person led me to believe that it was perfectly OK for me to elevate my needs and desires over the concerns of people who were poor, lacking formal education, or had brown or black skin.  I could enter that community without knowing their history, their language, their cultural norms, their concerns or their needs, and just assume that whatever I had to offer was better than what they had.  My primary interests were to “get my numbers”.  My training in a white-dominant society demonstrated on a daily basis that there would be no adverse consequences to me for believing and behaving in that way; in fact, it was “normal.”

I had no knowledge of the centuries of white, wealthy, European-Americans practicing on the brown and black bodies of low-income, enslaved and/or colonized communities – not for the benefit of those communities, but for the purpose of advancing medical knowledge for the ultimate benefit of the white folks who were accessing it.  It was rationalized just like I did; it was decided (by the white folks who were doing the practicing and experimenting) that the people of color in these communities were getting better care than they would have otherwise (although they weren’t really asked).  Some call this “medical apartheid.”  I didn’t have to know or care about this; there was no penalty to me as a white person for not knowing it, no adverse impact on my life for not having educated myself about these atrocities, no one in my family was involved or impacted, and besides, that stuff happened in the past, right?

So it is without surprise that I recognize the same cultural training in the formal response of Midwife International’s CEO and President, Sarah Kraft, to the testimonials from people who are speaking out against her actions in their communities.  In an open letter to the members of the Alliance for Ethical Midwifery Training (and also copied to the members of Midwife International’s (former) advisory board and the leadership of NARM, MANA and ICM “to ensure transparency”), Sarah writes:

The statements recently circulated about Midwife International on are not based in truth and we have a strong body of evidence to disprove and discredit the accusations that have been made against our organization. 

Midwife International is committed to holding high standards of quality midwifery care and midwifery education in the international context. Because the individuals who have spread these statements do not meet our credentialing requirements and have not proven to be accountable financially or otherwise, we stand by our decision to dissociate from these individuals, their organizations and their affiliates. 

With gratitude for the voices that help us grow and evolve our pioneering model, we always welcome constructive feedback. However, we consider it unethical and a breech of privacy to engage in public discourse about any of our past and current site directors, students, preceptors, or other affiliates. We therefore request that “Alliance for Ethical Midwifery Training” website be removed until it contains accurate and valid information that has been verified by credible sources.  

For anyone who is currently endorsing this campaign we ask that you educate yourself about all sides of the issue and do homework before jumping in and taking sides. By supporting a negative campaign without knowing the full story, you can harm the very causes you support.  Midwife International stands firmly for ethical behavior, inclusiveness, integrity, and truth and invites the larger midwifery community to stand there with us.

We intend to remain focused and move forward with the development of our programs, and to deliver a curriculum that demonstrates evidence-based midwifery and optimal MotherBaby maternity services ( We will remain accountable to all of our current students and partners and will continue to forge a path for improving international midwifery educational standards, while honoring our true clinical partners and the mothers and babies with whom we work.


Sarah Kraft

President/CEO, Midwife International

Vice President & Treasurer, Midwife International Foundation


It is Sarah’s white culture training that says the white person’s story — even when it remains untold — is always more believable than the person of color: “we have a strong body of evidence to disprove and discredit…” 

It is Sarah’s white culture training that helps her to believe that people of color need white folks more than we need them: “we stand by our decision to dissociate from these individuals…”

It is Sarah’s white culture training that says that the tone used by those people of color is offensive, so we can dismiss what they’ve said: “we always welcome constructive feedback…”

It is Sarah’s white culture training that says that her beliefs about what is unethical trump those of people of color: “we consider it unethical and a breech of privacy to engage in public discourse about…”  (while the ethical concerns of the people being harmed are not addressed at all)

It is Sarah’s white culture training that says that white folks get to decide what and who is to be believed: “we request that … website be removed until it contains accurate and valid information that has been verified by credible sources.”

It is Sarah’s white culture training that makes her believe that her truth is The REAL Truth: “educate yourself about all sides of the issue and do homework before jumping in and taking sides.”  (while not offering any information at all)

It is Sarah’s white culture training that permits her to think that she gets to determine when REAL harm is done: “By supporting a campaign without knowing the full story, you can harm the very causes you support.”

It is Sarah’s white culture training that tells her that there will be no consequences to sweeping aside the voices of people of color who express that harm is being done to them, so go on and forge ahead: “We intend to remain focused and move forward with the development of our programs…”

It is Sarah’s white culture training that allows her to decide who, if anyone, she will be accountable to, which generally in a white dominant culture does not include the communities and people of color who receive the impact of our actions: “We will remain accountable to all of our current students and partners…”

It is white privilege that permits Midwife International employees to silence dissent by deleting curious questions from their Facebook page; to remove their own names and information about their foundation from their website; to keep recruiting and pretend as if there is “nothing to see here” while sending out a fun-filled newsletter that makes no mention of the issue at hand.  After all, it is the winner who gets to write the history of what really happened.

It is white privilege that refuses to examine the possibility of another version of the truth other than our own; that will actually lash out at those who dare to speak up about injustice and turn the tables back on them, making ourselves out to be the real victims.  It is white privilege that says that the real damage done here is to the good reputations of the  midwives on Midwife International’s (former) advisory board, and that this concern for the reputation of white midwives supersedes the harms being done in communities where Midwife International operates.

The concerns that have been raised (and that keep coming in) about the ways in which Midwife International has been operating describes extremely unethical behavior.  It is one example of how midwifery training – like medical training in other professions – can be medical apartheid. This is a problem for all of us, and it is an extremely complex one. The criticisms leveled at our field yesterday by “Dr. Amy” on her hateful blog are not, as some have suggested, the fault of those who have called for changes at Midwife International. The ethical problems of medical apartheid have existed in our profession for decades, and we as a community have an opportunity right now to begin to address it.

White culture training assures us that there will be no adverse impact to white midwives if we just walk away from this piping hot mess. The folks at Midwife International could just continue to wave their hands, avoid the conversation with the community, and hope that this blows over quickly so that we can all just get back to getting our numbers.  It is certainly uncomfortable to have to think about the complexity of this and the deeper training issues that need to be addressed within midwifery and all healthcare professions.

And when we exercise that ability to turn our backs and walk away without consequence, to go back to our daily struggles that are already hard enough, and we leave this mess for someone else to sort out, then we have opted to once again leave people of color to bear the brunt of our profession’s problems.  When Midwife International is not only allowed to be completely unaccountable to the communities that they purport to serve, but are openly bullying them in front of our professional leadership for speaking about being harmed, they highlight a major, major problem for the entire midwifery community.

What can you do?

  • If you are a student midwife, start to learn about medical apartheid, the complexities of midwifery tourism, and the long history of ethical injustices in learning and practicing on the bodies of people who have less power and privilege than you.  Will you be getting any training at all on these issues, cultural competency, power & privilege, and/or the history, challenges and strengths of the community that you would be practicing in/on?  Demand it of your program, and seek it if you are educating yourself.
  • If you are a midwifery educator in a program that offers international training for your students, what are you doing to adequately prepare your students to learn and practice ethically?  What are best practices for true service learning, and how might you implement these in your program?  Should we be doing this at all? What conversations are you having about this, and how can we broaden these conversations within the midwifery education community?  How can we reach out and be accountable to educators in international sites who are hosting U.S. students?  How can we help Midwife International to be more accountable and transparent?
  • If you are a leader in the U.S. midwifery profession, please don’t walk away from the issue for fear of getting your hands dirty.  In what ways might you reach out to Midwife International to learn more about how they are preparing their students and preceptors, how they are working with host sites, and how they are being accountable to the communities they hope to serve?  How might you lead our profession into the work that needs to be done around this issue, so that we might once again act as an example to other healthcare professions for best practices?


Consider the ways in which you personally can add your voice and your actions to the immediate and longer-term hard work ahead of us around this issue.  Now is the time.

New Resources section

Reflections on racism and oppression in midwifery

Hey everyone!  We’ve significantly updated our Resources section and have organized things into the following pages:

Racism 101

White Privilege 101

Impact of Racism & Oppression on Birth Outcomes

Racism in Midwifery

Multicultural Midwifery History

Intersections of Race, Gender, Class

For Activists

For Clinicians

LGBTQ Healthcare

For Educators

How to Be an Ally

Talking with Children

Feel free to leave a comment in any of these sections with your favorite books, articles, videos or blog posts and we’ll add them to these growing pages.

We’ve also got a page for Workshops, on which we would love to post upcoming events and trainings by region. Let us know what’s happening in your area!  And if you’ve attended a workshop, we’d be happy to post your write-up and reflections here.  Just let us know with a comment here or via our Facebook group and an admin will connect with you.

Happy reading!

Letter to Midwifery Today: Real talk about midwifery and racial oppression

Midwifery, Midwifery students, Reflections on racism and oppression in midwifery, Social Justice
This letter was collaboratively drafted in response to an article posted in Midwifery Today’s E-News on February 13, 2013, comparing the current-day US obstetrical care with chattel slavery and the midwifery movement with the 19th century US abolition movement. Although the piece was removed and the author apologized in a thread on Midwifery Today’s Facebook site, this letter hopes to use this incident to initiate a deep discussion about US midwifery and our history of racial oppression, which is very much alive in the present. The letter has been sent, but we welcome additional signatures here; we will update the list from the comments section at the end of each day. We also welcome criticism and dissenting views from readers interested in deepening the discussion. The original text of the article, as well as the author’s apology, are appended here below the signatures.

February 21, 2013

Dear Jan & the team at Midwifery Today:

We would like to start by expressing our appreciation for your efforts to educate midwives over the last 26+ years through your books, magazine and conferences.  Midwifery Today provides an important service to midwives all over the world, and your reach is broad.  It is for this reason that we are writing regarding the February 13, 2013 “Jan’s Corner” piece in your online E-News, formerly entitled “Childbirth Abolitionists” then retitled “Childbirth Freedom Fighters,” which drew a comparison between the contemporary midwifery movement and the movement for the abolition of slavery in the United States.

After many comments from readers on the Midwifery Today Facebook page, this article was at first slightly edited, and has now been removed. Jan, you also apologized in a thread on Facebook. We applaud the removal of the article and appreciate your apology. But we are asking you to do more. You write that you regret your words, and we can all relate to that; we have all said and done things that we wish we could take back. And the intent of this letter is not to make you feel ashamed. Rather, it is to use this incident as an opportunity to open what we hope will be a deep and ongoing discussion about a very serious problem.

The publication of this article highlighted the failure of the US midwifery profession’s leadership to integrate its advocacy for humanized birth with concern for the crisis in maternal and infant health in communities of color, especially African American communities, and to understand this crisis as the legacy of enslavement and racial oppression and violence. While the article is gone from the Midwifery Today site, the discussion it has engendered is too important to disappear without a trace. It is important to us that your readers understand why the comparison between the anti-slavery struggle and the midwifery movement is wrong and profoundly hurtful. Even more than this, however, we hope to show that the struggle to provide a full range of birthing options must address our history of racial oppression if we really want to change birth in this country.

We can all agree that in many areas across the United States, there is an egregious abuse of power in hospitals; laboring women (and women in general) are oppressed; there is a lack of informed choice for the interventions that are being used; and midwives are putting themselves at risk of hostility, large fines, and even criminal prosecution and jail time for making sure that mothers and families have evidence-based, safe, holistic and informed choices about how they bring their babies into the world.  The devotion and personal sacrifice of midwives has changed the lives of many women and families.

The work we do as midwives and birth workers needs no comparison to other struggles to be validated. But it should never be compared to the abolition of the horrors of enslavement.  There can be no comparison between the meanings of “freedom” and “choices” between these two contexts.  People from Africa were forcibly kidnapped, removed from their homes and families, transported across the ocean in the bottom of cargo ships where many of them died, then sold as property to white landowners who beat and whipped them to maintain control over them. Enslaved women were beaten and raped as part of everyday life; some were subjected to experimental surgeries on their reproductive organs with unsterilized instruments and no anesthesia. If they did manage to make it to the end of their pregnancies, their babies were often taken from them and sold to someone else. This short catalog of horrors does not even begin to scratch the surface, but it should help to illustrate why current birth care practices do not compare in their scale, violence, or power differentials to the atrocities of slavery or to the legacies left behind by such brutality.

When we talk about slavery, we cannot avoid bringing along the whole history of racial oppression, violence, and exploitation that came with it, whether we intend to or not.  The impact of slavery runs very, very deep in the families of those who were enslaved.  It is a massive wound that was inflicted over hundreds of years and several generations that continues to impact the health and well-being of African Americans today, even though the practice of what is referred to as the chattel enslavement of African people within the United States has ended. This enslavement was an atrocity carried out by white families over black families.  That is simply a historical fact.  It does not mean that any of us were personally complicit in what our ancestors may have done.  But it does mean that when we talk about slavery, we must realize the gravity of what we are about to say and how it may land with those who carry those deep generational wounds.

The same must be considered when we make references to the colonization of the U.S. and the brutal taking of lands from the Native Americans, Mexicans and First Nations peoples; the Holocaust; the Japanese internment camps; and so many other historical abuses of power by people of European ancestry.  To make analogies between these events of extreme violence and the very different modern-day struggle over birth choices honors neither.  Rather, it co-opts an ongoing intergenerational experience of trauma and oppression that does not allow people to heal.

Midwives have always been part of the fabric of communities. Native American peoples had midwives.  The European colonists brought their midwives.  African midwives were forcibly brought here along with other people who were enslaved.  Every population that voluntarily or involuntarily immigrated to this new “melting pot” had their midwives.  And the midwives provided excellent care to the women and families all of their communities, often extending far beyond the childbearing year.  They were our healers.

When the medical establishment took birth into the hospital in the first few decades of the 20th century, an emerging public health profession simultaneously sought to end the rich legacy of midwifery knowledge and expertise through the gradual elimination of these community midwives across the country.  The medical establishment succeeded in substantially reducing the number of community midwives in practice; those who remained continued to serve all women but were absorbed deeper into the fabric of their respective communities.  As your readers are well aware, some of us still remain underground to this very day.

As the 20th century continued and the occupation of medical obstetrics grew, those populations who had access to hospital care (middle- and upper-class white women, and later, women of various ethnic groups) began to embrace the move toward the “scientific” management of labor in hospitals and the promise of pain-free childbirth.  They were not shackled and dragged into the hospitals.

Today, we must be clear that the vast majority of women in the U.S. choose to birth in the hospital setting.  We are still in the early stages of our midwifery resurgence and many Midwifery Today readers are working tirelessly to improve access to midwifery and safe homebirth as we restore these options to our communities.  And to some extent, it’s working!  The rates of homebirth and midwifery care are increasing — but only for white women. This is meaningful and concerning, especially because there are decades of research that continue to show that women of color are being harmed and dying from maternity-related causes in far greater numbers than white women, and babies of color are sick and dying in far greater numbers than white babies.  Many of us share the belief that the midwifery model of care might make a difference in these gross disparities.  However, reducing disparities requires in part that all of us work to understand the full history of how this came to be and why it persists today.

In order to effectively do this, it is imperative for the midwives in leadership positions to be at the forefront of this education, as well as leading action to ensure that all mothers, all babies and all families have access to safe, family-centered, culturally-relevant care.  Our leaders are charged with inspiring midwives to keep fighting the good fight, but not at the expense of reopening the painful wounds of midwives and peoples of color.  Our leaders must actively and continuously examine their areas of privilege in this society — whether they be privileges of skin color, sexual orientation, citizenship, wealth/ class, religion, education, ability, age or gender identity — and it is vitally important that they do their work with a consciousness of the power that these privileges bestow.

It is incumbent upon our leaders to be aware of and to fully support those midwives of color who today are creating highly effective models of care that build upon their legacies of community-based midwifery and are essentially eliminating disparate rates of preterm birth and low birth weight.  In fact, this work represents what is perhaps the only valid comparison that might be made between the anti-slavery movement and the struggles of birth workers today: the resilience and creativity of people of color in fighting for the survival of their own communities.  Midwives and families of color have had to proceed on their own while the major midwifery organizations struggle to understand what is needed.

Midwives are putting themselves on the line in many areas of our country to address an egregious lack of access to safe care and choices for women and babies. But when we isolate the legal struggles of midwives from broader health injustices — such as outrageously disproportionate rates of unjustified interventions, increased surgical and infection rates, and deaths of women and babies of color, as well as growing lack of access to decent basic health care for working people of all colors — we drive a wedge into our own community that hurts us all.  There is an increasingly urgent need for a deep conversation about how midwifery is currently failing women of color.  Babies are dying, and mothers are being harmed.  At the same time, midwives of all colors are being persecuted.  We cannot afford to create further divides amongst ourselves or leave groups behind in any of this work.

Jan, you have a wide audience, which comes with large responsibilities. Many midwives and birth workers look to you and Midwifery Today as an important voice in this profession.  Because of that, we ask that you take the lead on furthering this crucial discussion. The removal of the article and the apology on Facebook were important first steps. We ask that you publish this letter in the pages of Midwifery Today’s print edition. We also ask that you publish your apology on the E-News site where the article was posted. We further ask that Midwifery Today devote an entire issue to the theme of racial disparities in birth outcomes, highlighting the highly effective ways that midwives of color are using midwifery models of care to heal their communities’ mothers and babies. Most importantly, we ask that this issue not stand alone, but initiate an ongoing effort to make the ways that social justice issues intersect with pregnancy and birth–such as racial disparities in health, disability, poverty, incarceration,  LGBTQ oppression and concerns, immigration, and homelessness–central themes of Midwifery Today publications and conferences.

For Midwifery Today to redress this incident publicly would show great courage, and would serve as a sorely-needed example for our professional organizations. This is a crucial opportunity for Midwifery Today to foster a substantial discussion in our profession about racism and other forms of oppression. And given the urgency of these issues, Midwifery Today’s willingness to be a venue for this difficult but necessary conversation could not be more timely.

We also invite you and your readership to join with us in our efforts to learn and to work together to end all forms of oppression in midwifery and the childbirth professions, by first reading the resources we have compiled on the AROM blog ( and then joining us in our Facebook group:  Anti-Racism and Anti-Oppression in Midwifery.


  1. Wendy Gordon, CPM, LM, MPH
  2. Annie Menzel, CPM MA PhC
  3. Jeanette McCulloch, IBCLC, RLC
  4. Jessica M. Roach
  5. Claudia Booker, Midwife, CPM
  6. Jennie Joseph
  7. Nechama Greenwood, CPM
  8. Lena Soo Hee Wood, MEd, CD, nursing/nurse-midwifery student
  9. Thérèse Greenhow Robinson, CMT, LST, CEIM, CD, BPC, BPCA LLI
  10. Neva Gerke
  11. Annie Kennedy, Director, Simkin Center for Allied Birth Vocations at Bastyr University
  12. Marijke van Roojen, LM, CPM
  13. Danelle Aurilio
  14. Elias Kass, ND, LM, CPM
  15. Monica Basile, PhD, CPM, CD(DONA), CCE(BWI)
  16. Audra Phillips, CPM
  17. Brooke Casey, LM, CPM, IBCLC
  18. Gretchen Spicer, CPM, LM
  19. Chloe Raum, CPM
  20. Meg Novak, midwifery student
  21. Amanda Heffernan RN IBCLC SNM
  22. Jennifer Linstad
  23. Dionne Corcoran CPM LM
  24. Racha Tahani Lawler, CPM, LM
  25. Emme Corbeil CPM, LM, CD(DONA)
  26. Kristin Kali, LM CPM
  27. Annie Moffat
  28. Megan Hill, CPM
  29. Beth Ebers , RM, MH, Squamish, British Columbia, Canada
  30. Rachel Zaslow on behalf of Mother Health International
  31. Olivia Kimball of Mother Health International
  32. Audrey Miles Cherney
  33. Grace Hannon LM CPM
  34. Danny Scar, The Prison Doula Project
  35. Aly Folin, CPM, LM
  36. Brynne Potter, CPM
  37. Autumn Vergo, CPM, NHCM, RN
  38. Janelle Lucido-Conate, Future Midwives Alliance
  39. Tracy Hydeman, SMW, Canada
  40. Muneera Fontaine, CD
  41. Michelle H. Kinne IBCLC RLC ICCE CD(DONA)
  42. Anne Hirsch, CPM, LM
  43. Kathryn Haines, CPM
  44. Joelle Ceremy LM
  45. Sarah Davis, LM, CPM, IBCLC
  46. Judith Goldberger RN
  47. Devorah Herman, CPM, sWHNP
  48. Makeda Kamara DEM, CNM, MPH, M. ED
  49. Marnie Cockrill, student midwife
  50. Marie Carnesciali
  51. Toni Hill, CD, CBE, student midwife
  52. Nikki Plaskett, CD, LLLIBPC, RYT, CNA
  53. Aimee Fairman, CPM
  54. Jaqxun Darlin, student midwife
  55. Nicole Morales, LM, CPM
  56. Tehmina Islam, CPM, LM
  57. Kristin Effland, LM, CPM
  58. Krystel Viehmann
  59. Eve German
  60. Erin Tenney
  61. Dana Churness
  62. Suzy Myers, LM, CPM, MPH
  63. Savita Jones
  64. Brenda Burke
  65. Emi Yamasaki McLaughlin
  66. Kirsten Pickard, RN-C, BSN
  67. Susan Smartt Cook, CPM
  68. Jess Kreuger
  69. Sharon Muza BS, CD(DONA), LCCE, FACCE
  70. Lora Hart, Student Midwife
  71. Melanie Parsons, LM
  72. Susan Hodges
  73. Rebeca Four, IBCLC, CD(DONA), LCCE
  74. Asteir Bey
  75. Lora Clem
  76. Sherry Payne SNM
  77. Ananda Phoenix, apprenticing with birth
  78. Alisha Wilkes RN, BSN, Student Midwife
  79. Elizabeth S.K. Reiner, CPM
  80. Gretchen Ryerson LMT, Doula, Student Midwife
  81. Stephanie Lynn Tanner, CHW
  82. Brenda Francis, LPN, SM, CCE
  83. Traci Palagi, LM CPM
  84. Laura Whitley
  85. Heather Chorley, LM
  86. Margy Porter, CPM, LDM
  87. Dr. LaVonne Moore, DNP, CNM
  88. Annique Sampson, CPM, LM, NHCM
  89. Lorie Seruntine, student midwife
  90. Audrey Levine, LM, CPM
  91. Lashaan Everett, RN, BSN, SNM
  92. Mary Lawlor
  93. Geradine Simkins, CNM, MSN
  94. Elia R. Cole, BA, MPH(c)
  95. Elezya Lane, Doula, Student Midwife
  96. Michelle Maisonville, CD(CBI)
  97. Arya Pretlow
  98. Nicole Deggins, CNM, MSN, MPH
  99. Laura Perez, Student Midwife


Original article in Midwifery Today E-News February 13, 2013; Vol 15, Issue 4
Jan’s Corner

Childbirth Freedom Fighters
Did those of you who live in the U.S. see the PBS three-part series on the abolitionists? I hope you did or that you can get hold of it. As I watched, I realized how this anti-slavery movement parallels our movement to free women in pregnancy and birth from the jaws of the medical establishment. This plays out all around the world with some countries being worse than others. The treatment of motherbaby is often abusive—horrendously so. Perhaps nothing is as horrible as slavery and I don’t mean to downplay it in any way by this comparison, but the effects of pregnancy, birth and the first year of life affect both mother and child for their entire lives.
The abolitionists spent 40+ years working to free the slaves. First they appealed to the slaveholder’s reason—just like we are trying to do now with medical practitioners. For the past 37 years, ever since I first became a midwife, we have fought this fight. I first thought, “Okay, once they see how wonderful birth can be from the evidence coming out, they will change.” But this change hasn’t happened—things have only gotten worse. This was the same for the slaves. For us, when I first started midwifery, they hadn’t even invaded the uterus and the prenatal period. Prenatal care was simple and very good with no routine ultrasound(s).
The anti-slavery fight was magnificent, consistent, strong and dangerous—our fight is, too. More and more midwives are getting thrown in jail, persecuted and prosecuted, especially in the United States. We have so many voices and we are unrelenting in this activism. The slavery abolitionists had battles within their movement—we have these, too. Some of us want to be law-abiding and see the bottom-line as mom’s right to choose. It is, after all is said and done, her birth and her baby.
Then the Emancipation Proclamation by President Lincoln freed the slaves. The movie “Lincoln” is about his fight to make emancipation a constitutional amendment. He knew it wouldn’t hold if Congress didn’t change the Constitution. Even after 150 years, the battle for black equality is still going on. Martin Luther King took the freedom fight to another level, but peacefully. Were it not for these milestones in history, imagine where we would be.
We who work in birth are not even at the point of an Emancipation Proclamation, but we are in the abolitionist phase. We are Childbirth Freedom Fighters. Shall we take up this new terminology? It is powerful and has a huge successful movement behind it.
— Jan Tritten, mother of Midwifery Today

Apology in thread on MT Facebook page (2/18/13  1:42pm PST):
I was so passionate in writing about birth freedom and mothers being abused – an issue close to my heart – that I got carried away and didn’t use words and images as carefully as I should have. It was unwise on my part to make this comparison. My sincere apologies to all I have offended. I ask you to please forgive me. The article has been taken down and we at Midwifery Today have again been reminded to be more careful with the content we publish. -Jan Tritten

The article has now been removed from the E-News.

Infant Mortality Awareness Campaign

Healthcare in the US, Midwifery, Reflections on racism and oppression in midwifery

by Jessica Roach on Sunday, September 30, 2012 at 7:14pm
In what is the final day of September and the end of the Infant Mortality Awareness Campaign, I am compelled to write down these thoughts and send them around. I am often vocal about what I believe to be my truths, with some quiet time in between. Speak when it is necessary, reserve your energy for when it is time.

I am the mother of a pre-term, low birth weight baby and the Godmother of one as well. I have held a baby gone too soon born at 32 weeks and had a nephew that didn’t see his first year. If we all look at our families, we see that most of us (1 in 3) have a baby that is of a “statistic” in our lives. It has become so much a part of our norm. That is a statement, not a question, because I do not have any. What I have, is the need to have the real discussion, rather than the politically correct normative blah blah that discusses us and our babies as being “Minority Health Disparities” for the sake of framing language to solicit more funding to “examine” and “prevent” the problem. Do not mistake me here, there is a great deal of good work being done to raise awareness and work towards a solution. I am simply saying, we are still dancing around the core of the issues most of the time.

Let me be clear, because we do not have time for anything else, it is Women of Color, particularly African- American and Native American, that are most affected. I do not believe this is by chance, nor do I believe it should ever be allowed to be discussed by a healthcare practitioner as a matter of fact in the first appointments of pregnancy. It starts to formulate our stories for us, which creates a physiological stress response from the beginning of fetal development. So imagine how our babies feel inside of us. It should never be a “therefore” in risk factors.

Time and time again, it is shown that even when the playing field is leveled and issues such as economics or access to care are removed as variables, our babies are still affected at a disproportionate rate. So what is left? Why is this happening? I have my thoughts and we have the research that backs those thoughts up….and it is the uncomfortable conversation that most are unwilling to have.

I have said it before and I will say it again, this is not about the need for education, but rather the lack acknowledgement of the complete dismantling of our values and customs in order to control mass populations. It is the realities that our “race” is automatically a check box on a form that puts us as a risk factor. Think about that for a minute, being called a risk factor. How does that equate to appropriate support and care from the beginning of pregnancy?

I do not claim to have the answers, no one of us does. It is part of the problem. It takes a village, a core group of support, to raise a child, how could it not be the same in growing one. We do not stand as a singular entity, rather as one of the many cells that create the whole of the being. We are interconnected on multiple levels, the human body is reflective of life as a whole. The social constructs we use to define, are also used to oppress, and if mamas have to start their journeys with their child fighting oppression, their energy is being refocused in a manner that does not allow for healthy birth and birth outcomes. If you want to have a conversation and start to answer the question “why?”, start talking about the atmosphere of colonialism and systemic institutional racism, discuss the lack of trust we have in a healthcare system that treats us as a statistic rather than a human being. Get to the core of the conversation, let us sit at the table, rather than giving advice from outside of it. Mostly, take responsibility to learn for yourself, because it is a distraction from our very survival to spend the time and energy educating.

Tomorrow, is October 1st….and our babies will still be born at lower birth weights and too soon….and many will not see their first year birthday. EVERY day is an awareness day, until our story has changed. The work will not stop for any of us after today. It will not stop until the context of the conversation changes and we are able to tell our stories and dictate our realities vs allow anyone else to define.

So when you wake up tomorrow, remember that being aware is a 24/7. Stay woke, because there is no time to sleep on this, or to wait until next September to have the conversation. Keep having them, until someone is sick and tired enough of hearing it that they will work to change it. Be the solution, rather than part of the problem. Hug a mother, hold a baby, never take either of those two for granted…and keep doing the WORK

For Jaden, Malcolm, and Hendrix (R.I.P)

Dispatches from our foremothers (and fathers and sisters and brothers)

Reflections on racism and oppression in midwifery

What woman here is so enamored of her own oppression that she cannot see her heelprint upon another woman’s face? What woman’s terms of oppression have become precious and necessary to her as a ticket into the fold of the righteous, away from the cold winds of self-scrutiny?

—Audre Lorde


By Lisa Wiley

The vital and gritty and transformative discussions being had within this community online and at large have been mightily inspiring to be privvy to and to participate in. What is continually striking however, to at least this author, is that as we engage in this dialogue, so many follies exposed and so many pearls of wisdom unearthed are mirrors of those that have been exposed and unearthed by feminist movement. 
From the first whispers of the first wave, to the tenacity of tomorrow’s political outcry, the inertia and intentions of feminism have been challenged for their racist and classist denouement. And here we are, midwives and reproductive rights activists vying behind the radical notion that women and families deserve to be met wherever they are at and in whatever capacity with which would ferry them to their highest state of wellbeing — here we are with these noblest intentions, and yet here we are being accused of perpetuating a bourgeois midwifery. From bourgeois feminism, to a white, privileged, monied, complacent, bourgeois midwifery.
This work that we need to do here is not new work. The mistakes that we have made and are making have been made, and just as poignantly, the lessons that we have got to learn have been or are being learned contemporaneously with the work being done within the midwifery and otherwise birth community in order to move forward with clear eyes and tangible knapsacks filled to their depths with self-analysis and introspection and acknowledgement of the role of privilege within our profession and culture at large — to move forward with the radical conviction that to do so and to perpetuate this dialogue and to move forward in direct action will in fact make for positive change. 
It is my aspiration over these coming weeks to, through my own readings and self-examination, cull experiences and learnings and quotations from feminist herstory that might spark poignant and pertinent dialogue in this space, such that we are not either doomed to repeat the mistakes of our forebears or to expend essential time repeating learned and lived experiences. Ideally such dialogues will help us to further and deepen introspection into our own thought and action, and perhaps lend insight into what our next steps should be and to where they should lead. 

THANK YOU to donors! Nearly $3000 for ICTC 2012 scholarships!!

Fundraising for ICTC 2012

$2942.81 for ICTC’s conference scholarships!!!  Thank you all scholarship supporters!!!!

Thank you for joining AROMidwifery in raising funds for scholarships for Birthworkers of Color to attend the International Center for Traditional Childbearing’s 8th Annual Black Midwives and Healers Conference this month in Miami.

The fundraiser launched on August 27th.  Exactly one month later the scholarship closed, and we transferred $2942.81 to the International Center for Traditional Childbearing.  The ICTC awarded more than 10 scholarships with these funds!

Over 80 donors contributed to this vital cause! You know that supporting students and midwives for color is one of the single most important things that we can do for the profession of midwifery. Donors and other supporters also made the campaign successful by sharing on Facebook and other social media. NACPM, MANA, several state midwifery organizations, and the YWCA put their muscle behind the campaign too, sending out email blasts to their membership. At a September anti-racism training organized by the Wisconsin chapter of the NACPM, attendees raised $500 in contributions in one afternoon!

The Wisconsin antiracism workshop collectively donated $500!

This sort of collective energy has real transformative power. If just one month of effort can yield such rich concrete results, think of the long-term change we can make. If we work together, midwifery can be a movement for racial justice in pregnancy and birth. We can realize a vision of sustainable support for birthworkers of color, helping all mothers and babies, families and communities, to thrive.

Thank you so much for being part of the collective effort that realized this goal in such a short time!  Many hands make light work and we are grateful for yours! We look forward to working with you again.

Thank you, thank you, thank you for your generous donations!


“I promise, I will do something this time”: Scholarships for ICTC’s Black Midwives and Healers Conference 2012

Fundraising for ICTC 2012

“I promise, I will do something this time.” 

Join AROMidwifery (Anti-Racism and Oppression Work in Midwifery) as we support scholarships for the 8th International Black Midwives and Healers Conference

Think back to the first time you felt moved to fight against racism. Was it at a conference? After reading a book? Was it after watching Power Point slides demonstrate over and over that black mothers and babies die at a rate twice that of white mothers and babies in the US? Think of that feeling in your gut just moments after you wished you had said something or done something against a racist comment, but didn’t quite have the courage yet. Now hold that feeling and listen again to that promise you made to yourself . . . “Something must be done. I promise, I will do something this time.” Now is the time to do something.

I want to be a midwife as much as I want to breathe. I know this is something I can do.  I have the resources and support I need to achieve my goal. I also know that when I am among a group of midwives, chances are, they will look like me, talk like me, and among them I will feel comfortable, welcomed, and safe. They will see me as a unique individual, rather than a representative of my ethnic group. They will accept me as one of them. This is my privilege – my white privilege; always present, even as a student midwife.

I also know there are many other people who want to become midwives as intensely as I do. Yet women of color who hear this call don’t have the privilege that I have. Generations of economic injustice mean that aspiring midwives of color often lack the financial support that many white student midwives can count on. Moreover, when students and aspiring midwives of color are among a group of midwives, there is a good chance that the majority of the people in the room will not look like them. They may not feel truly accepted, safe, or welcomed. If they speak in these groups, they may be expected to represent their ethnic group, rather than being listened to as individuals. They very likely cannot find preceptors or peers of their own skin color. This is institutionalized racism, and it is always present in the United States, even in midwifery.

In the past year I have begun to learn about my white privilege and how it comes at the expense of others. I operate in an educational and professional system that was designed for my demographic. I have to work hard and my struggles are real, but there are no obstacles in my way because of the way I look or where I come from–in fact, these factors work in my favor. A student midwife of color has to work harder than me to find funding for study and to be accepted for a preceptorship. And it’s not because I’m better or smarter than her. It’s because I’m white.

These are hard realities to face, often too hard for many white people who deny that this reality exists. It’s hard to know what we as individuals we can do. It’s easy to get caught up in feeling guilty or helpless. But these feelings themselves keep white privilege powerful. If we want to make real change, we must face these difficult feelings and move to action. I know that this work may not be done in my lifetime, but I am driven to find a way to start.

One very small way I can do this is to support women of color in coming together in a safe and unified space that supports unity, power, and a sense of belonging – a privilege I already have.   

During the first CPM Symposium this past March, there was a courageous group of women who shared the hurt and frustration of institutionalized racism within the natural childbirth community. This was a gift to all in attendance. It is a gift to realize you have hurt someone. It gives you the opportunity to stop the hurt and help to heal. There is an immediate need to heal and begin to repay this gift.

White midwives asked, “But what can we do?” There was an answer. There is a need to fund scholarships for women of color, both students and midwives, to attend conferences. It is time to take a step in answering that call.

Helping to fund attendees of the Black Midwives and Healers Conference is a particularly important first step, because several of the brave women of color at the CPM Symposium expressed that this conference can provide a rare safe space for practicing and student midwives of color.

It takes courage to really face your privilege, but once you realize that privilege for one is harm for others, it cannot be ignored. Please join me in taking a small step toward challenging white privilege and making the North American midwifery community inclusive and empowering for all women. Help AROMidwifery and ICTC support midwives and students of color by donating to our scholarship fund for the 8th International Black Midwives and Healers Conference.

AROMidwifery is working to raise as much financial support as possible in the next 5 weeks.  All funds raised will go directly to the International Center for Traditional Childbearing (ICTC) on October 1, 2012 to be used for scholarships to attend the 8th Annual conference in Florida. 

Please join with AROMidwifery in its fight for justice by clicking the button below and donating. Even $10 can help give one more midwife the space needed to feel safe and connected to her own birth community and empowered in her calling to become a midwife. Think of all the times you have wanted to do something but didn’t. Let this be the time that you do something.


Neva Gerke, Student Midwife

Bastyr University

p.s. By donating today, you can take action by helping a birth worker of color gain valuable skills and support at the Black Midwives and Healers Conference. Now is the time to take action.

p.p.s. If you are yourself a student or birth worker of color who would like to apply for funds, here is the application page on the ICTC’s conference site.

Five lessons for antiracism work and healing

Reflections on racism and oppression in midwifery

By Janelle Allyn Lucido-Conate

I’ve been doing a lot of marinating in this work and I’d like to respond to the up-swell of awareness that is happening right now.

First, I want to disclose that this work is intimate to my life. I live in a bi-racial, bi-cultural, bi-national, bi-religious family with my husband and daughter. I’ve come to understand a couple of things along this path.

One is that, the work we are taking on is deeply personal. It lies in the thoughts we don’t even admit to ourselves. As we deepen our own awareness and those ripples move outward I believe that the most potent way to share our new found understanding is by revealing our innermost thoughts and assumptions that we are slowly becoming aware of.

Second, is that we are extremely ashamed of those thoughts. So they are difficult to share. But this is where the power lies, I promise you. When we release ourselves of shame and acknowledge our part in racism and oppression we are released from their grasp. We gain power over our thoughts rather than being subject to them.Third, is that racism and oppression cross all lines. It is something we hold collectively as a society. Each person, regardless of the color of their skin, country of origin, sexual orientation, or culture carry oppression inside of them. Each of us must face and heal these intimate thoughts–those secret ones we don’t want to face or even acknowledge much less admit to others. As we continue in this process of awareness and healing our collective consciousness begins to heal and we can move away from the ‘shoulds’ into true integrity which is love of ourselves and each other.Fourth, is that the work of awareness and healing comes in waves and each wave brings more nuance. Total awareness would knock us all over for good. So we integrate slowly and steadily. As we grow our awareness of the nuance grows. And so we must each hold a healing space in our hearts for everyone on this path whether they are totally unaware or completely healed and transformed by the journey. This is not unique to one race or class or orientation. It is true for all of humanity.

Fifth, we each play a role. Each of us, as we follow our soul’s longing for love and healing, finds ourselves in unique situations making choices as best we can with the awareness that we have at the time. There is no shame in this. This is important to remember as we engage with others in this arena. We each have a role. And there is abundant love for all.

Many blessings and peace dear ones on this path.
Love, Janelle

A student’s transformation: What a difference one anti-racist student midwife can make

Reflections on racism and oppression in midwifery

This response to K. Heron’s graduation speech by one of her fellow students (previous post) testifies to how powerfully transformative the presence of anti-racist peers can be.


There are a lot of growing pains happening in the midwifery world right now.  The MOC chair and inner council resignation from MANA is really the sort of outward symptom of a larger sickness that has been plaguing midwifery in the U.S. for quite a while now.  But these are clearly actions that need to be taken, because they raise important questions that need to be asked.  We need to ask ourselves why are African American women 4 times more likely to die of pregnancy-related complications than Caucasian women?  Why is it that 9/1,000 Native American babies are dying, versus 5/1,000 white babies?  Why is it that so many more white women seem to have access to midwifery care?  Why is it so hard for people of color to get the education needed to become a midwife?  And the deeper, more meaningful question—why is it that these types of disparities have persisted, and even increased, over time while our health care system has made so many advances in maternal care?

These questions point to an insidious kind of racism that persists in the U.S.  It’s not just something that affects midwifery and maternal/infant health care, but it can be easily identified there.  This is the sort of thing that is much harder to get at and combat because it isn’t one thing that you can point at and say “that, that’s what needs to be fixed”.  Combating racism is kind of like pealing the layers of an onion—when you take off one layer, another one is there underneath to make the sting that much deeper.

So what do we do?  How do we, as midwives and midwifery students, change something so intangible and huge?  How do we shift an entire culture?  The answer is we start with ourselves.

My friend K. Heron of the blog Bloody Show pointed this out in her wonderful graduation speech that she gave in June.  Luckily, she posted the speech on her blog, so that we all have the privilege of reading it.

I know that I have had to do a lot of work over the last couple of years to really look at my own ideas and how I have unconsciously perpetuated a system that oppresses many while giving advantages to only a few.  Before I got into midwifery school, I had only vaguely thought about these issues.  Being a white woman from a fairly upper-middle class background, I had only limited experience with poverty and racism.  I, like many, thought that simply not being outwardly racist or demeaning was enough.  I didn’t think about the privilege and responsibility that comes with the color of my skin in our culture.  It never occurred to me that I didn’t live a world where skin color didn’t matter.  That there were millions of people out there struggling while I had (and still have) so much.

But that changed dramatically when I met K at midwifery school.  She started talking about things I had never thought about, and really opening my eyes to the world as it is.  A world in which my friends that are a different race than me have a much harder time becoming midwives, receive worse care in the hospital, and actually know babies and mothers that have died from pregnancy-related complications.  And what was worse—the realization that I was unwittingly participating in this cultural racism, idly standing by.

As with any large, culture wide problem, the impossibility of it seemed like almost too much.  What can I, one lowly midwifery student, do?  How much impact can I actually have?  And how do I start making changes, when I don’t even know where to begin?

Luckily, K has some great ideas about that, too.  I love folks that are solution oriented!  She makes some great suggestions in her bullet pointed list—things like “Take a good anti-racism or anti-oppression training in your area” and “Seek out allies to start having conversations about race with” and “Advertise and do outreach to women of color in your community” and just generally “Get involved”.  These are practical things that I can do, right now, to help change the face of midwifery and midwifery care in my own community.  That feels pretty effing good.

And I like this attitude of solution.  So often I see people throw up their hands and say that they can’t think of anything.  I have come to understand that this is tantamount to perpetuating racism—that doing nothing has an impact.  But there are so many ways to do something.  This list is by no means exhaustive of all the options or possibilities.  Get creative!  Who can you talk to that may have new ideas?  After I shared K. Heron’s post on Facebook, a woman whose birth I attended contacted me to have a conversation about this very topic of racism/discrimination in midwifery care.  What a great idea!  I had been having all these conversations with midwives and midwifery students about institutionalized racism, now it’s time to hear from midwifery consumers!

The upshot of all of this is really to get us to look deeper at ourselves.  To ask the internal questions that are hard to ask, but must be revealed.  It is in this way that we can begin to truly offer the kind of care that every pregnant person deserves—because K. Heron said it best “Maternal Health is a Human Right”.

Sky Connelly is a midwifery student currently enrolled at Birthwise Midwifery School, and apprenticing with North Star Midwifery in St.Paul, MN.  She writes the blog Mana Midwifery.  She spends most of her free time riding her bike, walking her dog, swimming in the lake, and reading Harry Potter.  You can follow her on Twitter @ManaMidwifery.