DeShawn Taylor, M.D.
Founder & CEO, Health Justice MD
Giving birth while Black in America is as dangerous if not more dangerous as it is in parts of the developing world. When we talk about whether to birth children, we cannot ignore that maternal deaths have been steadily rising in the United States, in stark contrast to the world’s other affluent countries. Beyond the maternal death rate, women experience life-threatening postpartum complications. More than half of these deaths and near deaths are from preventable causes, and a disproportionate number of those suffering are Black. Black women are three to four times more likely to die during or after delivery than are white women.
When we talk about not birthing children, we must recognize that the right to safe and voluntary sex, birth control, and motherhood has always been restricted, controlled, and criminalized for Black women. Reproductive oppression refers to the regulation and exploitation of individuals’ bodies, sexuality, labor, and procreative capacities as a strategy to control individuals and entire communities. While much of mainstream discussion and organizing about women’s reproductive lives are centered on issues of choice and access to safe and legal abortion, Black women’s reproductive lives are impacted by multiple social conditions that interfere in their right to not have children, but also in their right to have children, and raise them with dignity in a safe, healthy, and supportive environment.
Because reproductive oppression affects women and girls in multiple ways a multiple approach is needed to fight this exploitation and advance their wellbeing. There are 3 major frameworks.
- Reproductive Health, which focuses on the provision of services to individuals.
- Reproductive Rights, where the goal is to protect the legal right to reproductive health care services, particularly abortion.
- Reproductive Justice, which attends to movement building and intersectionality — how systems of oppression intersect to create unique issues for people situated at multiple margins.
Although distinct frameworks in relation to their approaches, together they provide a comprehensive solution. Ultimately as in any movement, all three components: service, advocacy, and organizing are crucial.
While mainstream feminist groups continued to focus on choice, groups like the National Black Feminist Organization, the Third World Women’s Alliance, and the Committee for Abortion Rights and Against Sterilization Abuse were focusing on wider issues. The term reproductive justice was coined in 1994 by a group of American Black women in Chicago who founded Women of African Descent for Reproductive Justice. Four main tenets of reproductive justice include: 1) the right to bodily autonomy, 2) the right to have children, 3) the right to not have children, and 4) the right to parent children in safe and sustainable communities. These women shined a light on how the lives of Black women could be re-envisioned within the framework of a value-led society. It was an urgent call to directly link human rights and reproductive rights. Reproductive Justice analyzes how our ability to determine our own reproductive destiny is linked directly to the conditions of our community. Reproductive Justice addresses the social reality of inequality, specifically the inequality of opportunities that we have to control our reproduction when we are oppressed.
Why Reproductive Justice Matters for Black Women
The racism that causes so many Black women to die in pregnancy and childbirth comes from two directions. First, a racist society creates conditions that make Black people sicker than white people before they’re pregnant, leading to worse health outcomes in pregnancy and childbirth. Racism, poverty, unsafe neighborhoods, police brutality, mass incarceration, unhealthy food, toxic environments, unaffordable housing, and so on are all social determinants of health that contribute to obesity, diabetes, high blood pressure, and other conditions that make pregnancy and childbirth more dangerous for Black women through a phenomenon called weathering. Second, a racist medical system treats Black people and their babies differently than white people and their babies, resulting in avoidable deaths.
In the summer of 2020, the American Medical Association put out a statement that declared racism a public health threat in which the medical community was complicit: “The AMA recognizes that racism negatively impacts and exacerbates health inequities among historically marginalized communities. Without systemic and structural-level change, health inequities will continue to exist, and the overall health of the nation will suffer … Declaring racism as an urgent public health threat is a step in the right direction toward advancing equity in medicine and public health, while creating pathways for truth, healing, and reconciliation.” In addition, the AMA board of trustees released a statement acknowledging that “racism and unconscious bias within medical research and healthcare delivery have caused and continue to cause harm to marginalized communities and society as a whole.”
Reproductive justice is an intersectional theory that calls for us to move beyond a demand for privacy and respect for individual decision making to include the social support necessary for our individual decisions to be optimized. This framework includes the obligations of our government to provide the conditions for our choices to be safe, affordable, and accessible. Our government and our society are ignoring the inherent and systemic racism and bias that is killing women, especially Black women, in numbers that are not just disproportionately high but growing. Forcing pregnancy and childbirth due to policies that harm Black people more than white people, continues historical patterns of violence against the bodies of Black women. Oppressive and discriminatory policies must be examined and dismantled. A paradigm shift in consciousness for many, and radical transformation of society is required to acknowledge black people as fully human and deserving of fair and equal treatment. Strategic policy change requires us to step outside of frameworks that only look at health care and consider the full scope of factors and policies that influence Black American lives. Reproductive justice shows us the way.
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