Reflections, Pt. 2: Centering Reproductive Justice in Healthcare

The opening plenary “Towards a Collaborative Approach to Advancing Black Maternal Health, Rights, and Justice” with trailblazing birth workers, clinicians, and researchers from across the United States set the tone for the conference: Black women knew how to give birth successfully and safely before Western Medicine came into existence. We are not broken. - Mama Shafia Monroe Birth Justice is patient-centered, drives untraditional partnerships, and steeped in cultural humility. It is a way to decolonize birth - Chanel Pochia- Albert “ The closer we [ black women] get to the institutions that perpetuate harm, the more we ensure harm.” - Jessica Roach Panelists further educated us on patient education, provider education, informed consent, shared decision-making (with patients), thus enhancing the quality of care with dignity and non-discrimination and elevated support for patients patient-provider relationship. Furthermore, three critical questions posed by Dr. Joia Crear-Perry set the tone for a Reproductive Justice framework in patient-centered, clinical, and non-clinical care: What would it look like for women to not only survive pregnancy but to thrive? What would it look like to be a reproductive justice OB/GYN? What do we do when we have a system that polices how black women give birth? Answering the questions above, panelists offered a vision for realized Reproductive-Justice Clinical Practice: Birth Justice, rooted in non-traditional partnerships; patient-centered care; and cultural humility. Non-traditional partnerships consist of anti-racist, reproductive justice-trained birth workers (i.e., doulas, midwives, and OB/GYNs) and lactation consultants. Patient-centered care means taking time to explain procedures and medical care, encouraging Q&A with compassion and empathy, and listening to the patients’ voices. Cultural humility, providing non-judgmental and supportive care based on questions to understand rather than assumptions about patients’ needs which Black women have so often reported when sharing their experiences with their providers. See Lessons Learned Series: Recommendations for Providers

The breakout sessions echoed these recommendations by the opening panel, illuminating structural racism, gender discrimination, and bias black women encounter and identifying solutions that must originate from the voices and lived experiences of black women. In Trauma-Informed Approaches to Interacting with Black Pregnant Mamas, presenters challenged participants to consider how black women experience trauma and be mindful of the use of language and practices that can potentially re-traumatize pregnant and parenting women. The session, Battling Over Birth, explored the framework of traditional research and its roots in the exploitation of disenfranchised people. In contrast, the concept of Research Justice was introduced, which re-centers community voices and shifts control of the narrative, scope, and the priority action steps back into the hands of community members. Dr. Chinyere Oparah and Dr. Sayida Peprah used their research project, Battling Over Birth -- a 5-year process documenting black women’s experiences of childbirth through focus group design real-life example of the feasibility and practicality of Research Justice. In the sessions, Maternal Mortality Review Committees- Experiences from Community Based Organizations and Providers emphasized the need for Maternal Mortality Review Committees (MMRCs) to serve from an anti-racist, health equity lens, trained and racial equity, trauma and reproductive justice. Moreover, the panel emphasized the need for MMRCs to analyze stories instead of our usual mode of storytelling- relying solely on the quantitative data, which can perpetually blame the mother. For this reason, we need community engagement and oversight. Reproductive Justice trained Community birth workers and doulas can be a voice of the community to craft a narrative representation of what is happening in the community to contextualize what numbers say. The additional layer of race(ism) and implications of toxic stress on Black women’s bodies: mental health needs of persons grieving a loss in Mis-Counted the importance of storytelling as a relevant, valuable form of [qualitative] data collection; and how to Communicate Reproductive Justice and Black Maternal Health to Policymakers. Honest Conversation on Bridging Provider/ Patient Interaction and Communication “What would team-based Birth Care look like?” The gist of the open dialogue concluded that there isn’t one discipline that will solve the black maternal health crisis. Instead, a multi-discipline, holistic approach that keeps the patient voice elevated is essential for progress. The final session attended, Criminalizing Black Pregnancy and Parenting, provided evidence of the systemic racism in the Child Welfare system established by federal legislation and perpetuated by state and local policies that have a specific detrimental effect on black pregnant/parenting women.