My favorite picture book when I was three years old was called Where Did I Come From? It was a big cardboard book, with the title question written in large, black letters across the front. Inside, a comically oversized sperm cozied up to a cartoon egg, dressed in heels and with the false eyelashes of a young Dolly Parton. There were more realistic drawings, too — of white women’s bodies at different stages of pregnancy. And then, near the end, was the miracle of birth, complete with a baby’s head crowning. A few years later, when it became available at the local library, my mother rented a birthing documentary for us, too — a 40-minute video of, again, a white woman laboring, legs spread, a very muddled process happening below. I don’t think there was ever a time when I didn’t know about birth. My mother, good second-wave feminist that she was, did not believe in keeping any secrets about bodies or life or death.
In the years since then, I’ve maintained my fascination with birth. But the experience depicted in that picture book — taking place in some other country, where class and blackness appeared not to exist — seems like an incomplete education. The situation for black women giving birth has become grim. By all accounts, this country is in a crisis concerning black maternal health. In the United States, between 700 and 1,200 women die each year from pregnancy or birth complications. This means that women in America are more likely to die in childbirth than women in the rest of the developed world, and black women are three to four times more likely to die than white women. This likelihood appears to be influenced by, but not necessarily connected to, income. In the spring, the Internet, or at least the corner of it that I frequent, was transfixed by the stories that Serena Williams and Beyoncé shared of their birth experiences. Both women spoke of the danger they faced. “It’s like that, even for them,” so many women I knew wrote to one another. For many of us, these two women are avatars of what we believe we could all accomplish if we didn’t have this weight of racism and sexism and classism and wealth disparity around our necks. Even Serena and Beyoncé, with all their beauty and wealth and fame — women whose very careers are built on understanding their own bodies and performing in top physical condition — couldn’t break this ceiling. It was and is chilling.
Traditionally, coverage of black women’s health assumes that the fault lies in us. Our bodies are always going wrong, according to the wider culture. Too fat, too black, too muscular, too sexual, too old, too young. But, of course, in reality, the mortality rate is linked directly to the environments we live in and the care we receive. One of the main causes of this, unsurprisingly, appears to be the stress of living in this racist, sexist society. Kiera Butler, writing in Mother Jones, points to studies conducted over the past twenty years that show that black women who report experiencing “frequent and severe incidents of racism” are more likely to go into premature labor. As Butler writes, “Scientists have known for decades that chronic stress can activate the cascade of hormones that kick-start labor. Everyone experiences stress, of course, but researchers think certain kinds of stress are more insidious than others.”
In September, Senator Kamala Harris introduced the Maternal Care Access and Reducing Emergencies (CARE) Act, a bill that would allocate $40 million in funding to train doctors to avoid making racist medical decisions and set up a program to improve prenatal care as well as reduce pregnancy injuries and complications. This is necessary, but as I thought about it more, I became interested in learning where black women were already responding to the threat, building a resource on their own. We’ve done it before, for nearly every seemingly impossible obstacle put before us. I knew that somewhere, black women were probably already doing the work for themselves.