#SheThePeople2020: Against Skyrocketing Black Maternal Mortality & Knee-Jerk Praise of White Women



A few days ago, I wrote a somewhat long Twitter thread re: Black maternal health in crisis, #BlackMaternalHealthWeek that just ended April 11th-17th, the seeming rise in awareness from politicians (which, I guess is meant to be a good thing), and A LOT of my thoughts re: #SheThePeople2020 & Elizabeth Warren's comments on the topic.


I focused primarily on Warren because she's the one I've noticed getting the most praise for her ideas on how to address the high rates of Black women (really Black people) dying in childbirth. I found that interesting since most of the candidates have made similar comments, but only hers seemed to garner such"She gets it! She really gets it!" levels of acclaim.


Twitter is a strange place that can sometimes create echo chambers of a few solitary voices, so I wasn't completely sure the impression I came away with was accurate. I've included, though, a few examples of what I was seeing at the time. What follows is the slightly formatted text of my twitter thread on that Thursday after the forum. Disclaimer: I cuss.

I am forever out here scream crying into somebody's face about the fuckshit ass level of care Black birthers receive nationally (especially here in GA) while mofo's wanna go on about being "pro-life." At the same time, I am really not here for this whole Warren "gets it" schtick. I'm gonna have to sit with myself and have a serious convo re: my personal dislike for the wannabe Native vs. prioritizing maternal health. So far, I just feel like she parroted our own talking points back to us at #SheThePeople2020 on Wednesday & is now reaping all of the cookies. Some would call that listening/learning on her part. Maybe. I'll concede that the monetary penalty/reward system she suggested for hospitals may be a good start to fixing these systems. But I also know that capitalistic means of motivating folks to care will only go so far.



I'm more interested in what kinds of radical investment will be made into Black midwife/doula communities. Where is the funding for that kind of education and mass promotion? Where is the training on standards of care for Trans people and their specific OB/gyn needs while pregnant? I'm really just looking for a transformative shift towards self-determination in the methods of care, and availability of such, for Black would-be parents and mothers - instead of the current hospital centered condescension we've been getting.


I want a standard of care that requires doctors, nurses, & pretty much the entire medical industry to step up to midwife/doula levels. I want them measured against our collective jumping stick, not the other way around. Because it's no coincidence that U.S. maternal mortality rates have been increasing for the past 25 years, aka since the mid-80s, immediately following a 25 year concerted push to demonize predominately Black home/holistic birthing practices. How many of us have watched that 1953 All My Babies documentary? Which was not-so-coincidentally produced right here in Georgia (Albany, specifically) where we've got the worst maternal mortality rate in the nation. These things do not just happen in a vacuum.


Georgia Governor*, Brian Kemp's, successful push for this new anti-abortion bill >> while his predecessor consistently undermined the expansion of medicare/medicaid to build out primary care facilities in rural Georgia >> after years of work to vilify the value of independent, predominately rural, birth workers and thereby all but eliminate them >> means that now Black pregnant people, in those areas especially, could be forced to give birth with literally no infrastructure of support in existence. A veritable death sentence. Sanctions on hospitals don't mean shit if you've got no medical infrastructure to begin with. Which is why I'm more than a little leery of the praise Warren seems to be getting based on such a simplistic answer to the question at #SheThePeople2020 yesterday.


There's so much more that's needed. And, I get that overhaul doesn't happen overnight. Change comes in stages. There are numerous organizers putting in work to effect that change and if they see this Warren talk as a step in the right direction then great. But I intend to keep up the pressure re: everything else that's still needed to get the job done because I'd otherwise be left feeling as if I'm feeding into the same kind of savior narrative that helped create institutions like DONA International.


That's a whole other conversation but, suffice it to say, I'm not a huge fan. Mainly because, as I said earlier, things do not just happen in a vacuum. Yes, a doula is not the same thing as a midwife. And, yes, DONA has worked in recent years to diversify their leadership (the current president is a Black woman & two of their membership directors are Black women). And, yes, they are largely filling a void created by the mass elimination of midwives in mainstream medicine. But, I'm also of the opinion that they're part of the tag-teamed "good cop"/"bad cop" narrative that's at the root of such problems.


i.e. A predominately white male medical industry demonized and regulated away Black midwifery. Then, when the job was all but done by the 80's, a predominately white female cohort came along to save the day/clean up the mess. Effectively putting a band-aid over the gaping wound with this "new" thing called a Doula - dating back to a 1969 anthropological paper by Dana Raphael.

Raphael is, to me, a clear example of the ethical issues within anthropology. She coined the term Doula based on a Greek etymology, but not until at least 15 years later did she admit that most of the practices she advocated actually came from her study of birthing techniques by women of color. On such "noble" foundations lie the roots of DONA International and, by extension, the doula industry as a whole. Namely, white men demonizing and destroying; followed by white women rebuilding, rebranding, and monetizing. Capitalism at work.


I know. I'm a cynic and I'm largely off track from my original topic re: what's needed to better this maternal mortality health crisis we're in, especially for Black parents. It's maybe worth pointing out here that the political arena (especially the stage upon which Presidential candidates stand) is never going to be completely clean or without smeared reputations, given the nature of U.S. imperialism. I am aware of this. That's just the job they're applying for. Hence, my strong dislike for certain other candidates like Kamala Harris, Joe Biden, & O'Rourke as well. Really, I just want Stacey Abrams to enter the race and rap this up, though I'm not fooled into thinking her hands are completely clean either.


At any rate, there is a deeper discussion to be had re: tempering one's expectation that any politician will ever meet the needs, or do the job, of the organizers in our communities. Politicians are going to be politicians. It is the responsibility of organizers to help shift public opinions and narratives such that those politicians have no choice but to shift their talking points (and actions) in kind. We've seen some of that shifting verbiage in the form of many of these typically centrist and/or progressive-lite candidates doing exactly what I accuse Warren of: parroting our talking points back to us. And, in so much as it's a first step in the direction of what any organizer should be working towards, that means the past few days and weeks of talking-head-politicians have been a success. But, I'm more interested in the second step which requires that we see corresponding action.


It is a slippery slope of false logic to argue that the only way to get such action is by voting based on the words and hoping for the rest after they're in office. And, I think it's a hill that we're sometimes more willing to die on in service to white womanhood and false notions of innocence, fragility, and/or greater trustworthiness. I remember a time when Elizabeth Warren was a beacon of fiery outrage over corruption within the healthcare and banking establishment during the early run up to the 2016 elections - until she thought she might get a VP nod from Hillary Clinton - and then she quickly backtracked on it all for a handful of photo ops. In the years since then, numerous of her competitors have made similar leveraged concessions based on what they felt could offer them better positioning. Which tells me that Warren is no worse a candidate than any of those others. But, she's also no better.


And, it leaves me to wonder if the somewhat knee-jerk tendency to handle Warren with a softer touch and a more forgiving memory than those others stems from some unconscious motivation. A point which I would hope we'd all investigate for ourselves.



On the topic of Black maternal mortality and this budding narrative of Elizabeth Warren as the person with the answers, for the record, I again want to reiterate that her penalty/reward system for failing hospitals is not a bad one. I'm also not advising that folks abandon the use of doulas or the term in daily life. Black people know how to subvert a thing to our benefit like no other. We've been doing it as a survival tactic for the past 400 years on this continent alone (See also: My newish book club, Hoo-Doula/Voo-Doula). But I would like to see greater awareness, engagement, promotion, and investment in Black centered orgs - as primary focus - rather than as an afterthought to funding hospitals and legislative bodies who will never truly have our best interests at heart. See, I do know how to get back on brand with my general apathy for Warren's suggestions when I need to! Anyway, to list some of those Black centered orgs, I'm thinking of:


The National Black Midwives Alliance,


The National Association to Advance Black Birth (formerly ICTC),


The National Black Doulas Association,


The Black Mamas Matter Alliance, &


The National Women of Color Reproductive Justice Collective - SisterSong.


While I didn't tag them in my original thread, I've included them here for the same reason I didn't say much last week during #BlackMaternalHealthWeek (April 11th-17th). I'm not a direct organizer in this field, though it's one of my biggest areas of interest and research. That fact leaves me not always sure of the best way to advocate without falsely presenting myself as an "expert" and I wouldn't want to misconstrue my personal opinions as something any of their orgs necessarily agrees with. They may fuck really hard with DONA. They may think Warren's comments on Wednesday were perfect. Or, maybe not. But, I'm learning that my fear of speaking up won't protect me from making mistakes or learning or self-correcting. It may, however, stop me from sharing vital info that could help others to get onboard with this wave of change.


So, yeah. I think I'll end here. Be sure to engage with those orgs I mentioned in whatever ways they're looking for support. That's the biggest takeaway I hope folks gain from all of this!

© 2018, Constance Sherese Collier-Mercado.

Atlanta * The Bronx * Chicago