We need midwives who are unapologetically anti-racist

AOM's Indigenous Midwifery and Health-Care Equity, Quality & Human Rights departments respond to MANA President's Report from January 2021
 

I don’t have to tell you where creating barriers to community midwifery and replacing it with ‘scientific mothering’ has landed us. The poor outcomes of our maternity care system where 98%+ of births occur within an obstetrical hospital model speak for themselves. Especially – most especially – for vulnerable populations. Instead, I want to tell you about one of my anthropological experiences as a community midwife and family practice physician. – MANA President’s Report, Jan. 17, 2021

The recent MANA President’s Report by Sarita Bennett, President of the Midwives Alliance of North America, was incredibly troubling and painful to read. In it, Bennett recounts her experience of providing health care as a rural emergency room physician to a community of white supremacists, during which she “learned about their lives, mindsets, ideologies and plans, not so much as individuals, because that wasn’t important to them – but rather, about what it meant to live the neo-Nazi doctrine.” The post was particularly hurtful and re-traumatizing to many Indigenous, Black and racialized midwives and birth workers who continually navigate through various forms of racism and oppression at great cost to the integrity of their personal well-being, and to their time that could be used to further other work. Indigenous, Black and racialized communities have been challenging misconceptions and stereotypes, knocking down obstacles and creatively forging different paths to dismantle injustice and to service our communities. Having to shift our attention from this already tiresome work to process and respond to harmful commentary from within our own profession feels unnecessarily burdensome and compounds existing inequities.

We need midwives who are unapologetically anti-racist, whose strength is not measured by their sense of duty to provide “objective, compassionate care regardless of personal differences,” but is measured by their courage to use their position of privilege to amplify the voices of the most marginalized and confront racism wherever they encounter it.

It was hurtful to come across a voice from midwifery leadership, our own peer, who uses feminist language and claims to understand “how important it is for communities to ‘grow their own’” by reflecting on “anthropological experiences,” a colonial approach to ‘understanding’ other cultures; and then to call on us to “love ourselves enough to find the strength to draw healthy boundaries.” This is a callous dismissal of the violence inflicted on Indigenous, Black and racialized bodies by white supremacists and the systems that enable such dangerous ideologies to thrive. There simply is no healthy boundary to co-exist with racism and white supremacy. It is not enough to not be racist, we must all be anti-racist. This means, using our voices to speak against racism and white supremacy ideologies, and using our positions of privilege, power or influence to create actions that will lead to meaningful change. We are not looking to “respectfully” co-exist with racism and colonization. We do not need more data or evidence to show how wide the disparities are in access, dignity, safety and quality of care that Indigenous and Black birthing people receive compared to white families. We need midwives who are unapologetically anti-racist, whose strength is not measured by their sense of duty to provide “objective, compassionate care regardless of personal differences,” but is measured by their courage to use their position of privilege to amplify the voices of the most marginalized and confront racism wherever they encounter it.

Racism might manifest in different ways but is always oppressive. It is embedded in the structures of our political, judicial, health-care, educational systems and day-to-day world. Racism can seem subtle for those with the privilege of moving through this world without “noticing” the toxicity and oppression of racism. For many Indigenous, Black and racialized people, racism or racist discourse is many things, including violence, denial of opportunity, injustice, multi-generational trauma, murder, theft of land and resources, theft of our children, loss of language, heritage, etc.; but it is not “personal differences.” It is simply wrong and must always be called-out, no matter the form racism assumes. Minimizing neo-Nazi ideology to “personal differences” ignores the horrific genocidal tactics inflicted by such ideology. In the words of Toni Morrison: “Oppressive language does more than represent violence; it is violence; does more than represent the limits of knowledge; it limits knowledge.”

We cannot afford to be complicit or complacent, and we definitely cannot pause to congratulate ourselves on creating a practice where white supremacy is overlooked in an effort to provide objective, compassionate care.

Indigenous and Black birthing communities are dying at the hands of health-care providers. This is not just a problem in the United States; shamefully, it is an issue we too often fail to address in Canada. Just recently, the Canadian government began a review of anti-Indigenous racism in Canada's health-care system to create a National Action Plan in response to the death of Joyce Echaquan, a 37 year-old Atikamekw mother who was killed at a Quebec hospital. Sadly, Joyce is only one of countless other Indigenous peoples who have lost their lives as a result of racism and a double standard of care in our health-care system. We cannot afford to be complicit or complacent, and we definitely cannot pause to congratulate ourselves on creating a practice where white supremacy is overlooked in an effort to provide objective, compassionate care.

Although it is important to reflect on “old processes and relationships that contribute to inequity in the organization’s foundational power structures,” organizational reflection must use a decolonized, anti-racism lens if the goal is to truly face inequities. To actually change “initial conditions,” one must have the humility and courage to face both history and one’s current position, for “not everything that is faced can be changed; but nothing can be changed until it is faced.” (James Baldwin)

To Sarita Bennett: It is incumbent upon you, as a midwifery leader, to role model what reflective, anti-racist action looks like. Engaging Indigenous, Black and racialized midwives about ways to change the organizational culture of MANA and the midwifery profession as a whole is critical. We ask that you retract your message. We ask that you provide an apology to Indigenous, Black and racialized people. We ask that you engage Indigenous, Black and racialized midwives as leaders in organizational change. These actions are essential.