I was lucky. I had the biggest baby in the Neonatal Intensive Care Unit. My son was born a full-term and healthy baby boy. He was sent to the NICU to monitor a breathing issue, jaundice, and a heart murmur—all issues that turned out to be temporary and minor. He was released from the hospital five days later.
Those five days were a blur. I was exhausted from a multi-day labor and left weak from a postpartum hemorrhage. Yet I walked to and from the NICU every four hours to try to breastfeed and hold my new infant. The NICU was filled with tiny babies, lying under warm bright lights amidst an endless cacophony of beeps from monitoring machines. My baby’s bassinet was next to a much smaller baby, a black baby boy named Cyrus. Cyrus was smaller but must have been older because he was much more active. He was able to do “tummy time” and lift his head, a surreal image of seeing a tiny baby who looked almost ready to crawl.
No matter what time I came into the NICU, day or night. I saw Cyrus’s mom. She held him close and whispered to him while stroking his short hair. Being a new mom is a lonely experience — suddenly your world revolves around a tiny person you just met. Cyrus’s mom and I sat in silence in that strange world of bright lights and loud beeps, trying to give our babies the best possible start to life.
But did we have the same access to a healthy start for ourselves and our babies? We live in a rich nation but you wouldn’t know that from looking at maternal mortality rankings. The US is the only developed nation where maternal mortality rates are rising but when you look closer at the statistics, it’s clear that mortality rates are not rising equally across the U.S. population. Black women are four times more likely to die in childbirth, more likely to experience pre-term birth, and more likely to experience pregnancy complications.
The reasons for these disparities are more than just money and geography. Even well-educated and affluent black women face these risks at greater rates than white women. Racism and bias in our medical institutions mean that black women are less likely to be taken seriously when they report pain and less likely to receive timely medical interventions. There is also evidence that everyday stress from racism and microaggressions increases risks of preeclampsia, pre-term birth, and other risk factors that make delivery riskier for both black mothers and their babies. Mothers working low-wage jobs are disproportionately black and Latina and reports of pregnancy discrimination disproportionately come from women of color, and low-wage industries.
Now in the midst of a pandemic, many of these inequities will be worsened. Research indicates that the presence of a doula can improve outcomes for babies and mothers, especially for black women. Because of labor room restrictions put in place to limit the spread of COVID-19, many pregnant people are now being forced to choose between having their partner in the room and having a doula who can help advocate for them in a racist and biased medical system.
The inequities start long before people are pregnant–they start with access to healthcare. Last year, the Trump administration severely restricted access to Title X grants, a resource that allows low-income women access to reproductive healthcare and disproportionately serves black (22%) and Latinx (33%) people. Without the program, many are left with no affordable healthcare options within a reasonable driving distance from home and the policy is expected to be devastating for communities of color. But make no mistake, these issues didn’t start with the current administration. This recent policy move only exacerbates long standing inequities in who has access to comprehensive healthcare that is evidence-based, affordable, and inclusive.
The LGBTQ community also faces challenges in accessing reproductive care. Trans men, non-binary people, and gender nonconforming people face bias and stress when trying to access healthcare and are adversely affected when access to birth control, abortion, and other reproductive health services is restricted.
These disparities don’t end when new parents leave the hospital. Because of systemic racism and existing power structures, daycare is financially and physically out of reach for many, forcing some new parents to give up their jobs or school, or place their children in substandard care situations. A pandemic that is devastating black communities (because of existing inequities) and hitting communities of color hardest economically will only further exacerbate these problems. Taken together, these factors mean that not everyone in the country has the ability to decide if, how, and when to have a baby and the freedom to raise them how they wish.
Considering these factors, my having the biggest baby in the NICU was not about luck at all. As a white woman, I didn’t have to worry about whether the doctors would believe me when I said I was in pain. When I hemorrhaged during labor, I trusted the doctors would monitor my blood loss and take care of me, if my or my baby’s life was threatened. I had the privilege of deciding when and how I would get pregnant and deliver my baby. But these privileges are not available or freely given to everyone — women of color and the LGBTQ community have to fight for the privileges cishet white women get by default.
This is why white women need to show up for reproductive justice. We must follow the lead of black women, Latina women, Native women and others who have fought for decades to define and demand that reproductive freedom is more than just the right to choose an abortion.
“Reproductive freedom is a life and death issue for many black women and deserves as much recognition as any other freedom,” wrote 12 black women in Atlanta 25 years ago, in a statement that would launch the reproductive justice movement. As white women, we must listen to the struggles and wrongs that others experience every day as they fight for their rights to decide their own reproductive future, whether that’s the right to affordable birth control or the right to raise a child how they want in economically accessible and physically safe spaces. As white women, we must support reproductive justice for all, recognize our privileges, and lift the voices that have long been shouting that reproductive justice is necessary and urgent.
First, we must acknowledge the long and shameful history of white women benefiting from advocacy while oppressing the reproductive rights of others. Under slavery in the US, white women played a central role in upholding systems that keep women of color from fully realizing their reproductive freedoms. From forcing black women to serve as wet nurses while their own children starved, to giving enslaved people to their white children as coming-of-age gifts. These actions by white women have left scars on communities of color that last today. As white women, we must acknowledge these wounds and the impacts they continue to have.
White women still uphold the patriarchal norms that disproportionately harm women of color. After all, it was a white woman who wrote the oppressive and scientifically inaccurate law to restrict Alabamans’ rights to an abortion (Representative Terry Collins) and another white women who signed it (Governor Kay Ivey). It is not enough to simply avoid harmful actions now; we must take active steps to tend to the wounds of the past and dismantle the systems that perpetuate these inequities in different forms today.
There are many ways to get started. My organization, 500 Women Scientists, is hosting a series of webinars to introduce the reproductive justice framework and its intersections with science, LGBTQIA+ , and environmental justice. This is a great place to start to educate yourself and learn how you can join the fight. There is much work to do and paths have already been charted: This year, SisterSong, an organization leading the charge on the Reproductive Justice, released a Blueprint for Sexual and Reproductive Health, Rights, and Justice. There are solutions to these inequities.
We all want to protect ourselves and our children, and we cannot look away when others are being harmed while we thrive. We must insist on a world where we all have the opportunity decide if and how we procreate, and give babies the best possible shot at life, no matter how small their start.
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