The birth justice movement, developed in 2009, is rooted in the ancestral art, science and praxis of Black midwifery and the struggles of marginalized communities to transform sexual and reproductive care into safe, dignified, culturally rooted support across the life course. This project traces those origins, defines the framework and values, and calls us to organize and amplify Black midwifery leadership to build birth justice futures.
“Birth justice is a vision held in the hearts and hands of generations of midwives. It is born from the struggles of childbearing people on the frontlines of surviving and fighting systemic oppression: Black Indigenous, immigrant, undocumented, young, and LGBTQIA peoples.”
— “The Birth of Birth Justice,” Jamarah Amani and Anjali Sardeshmukh, 2019
The term “birth justice” resonates deeply, sparking activism, scholarship, and community movements across the United States and beyond. Today, dozens of birth justice organizations exist nationally, with local initiatives taking root in communities. Books have been published, scholarly articles written, and birth justice curricula taught in universities and health departments. Most importantly, the demand for birth justice echoes across space and place as communities across the US South and the Global South demand change.
Yet, the origins of birth justice—its deep roots in Black midwifery and the social and political movements of the American South—are often overlooked. This piece seeks to uplift that story, tracing the historical lineage of birth justice from the work of Black midwives to the creation of a comprehensive framework by the Southern Birth Justice Network (SBJN).
We invite you into the story of birth justice—to explore its legacy, worldview, and evolving practices. Our goal is to honor the struggles, agency, and dedication of those who birthed the movement—Black midwives.
In doing so, we will offer a working definition for grounding birth justice, honoring its continued evolution, and inviting you into creating birth justice futures while recognizing that the movement continues to evolve. For this grounding, we turn to Black Women Birthing Justice, which defines birth justice as both an aspirational future and a movement against reproductive oppression:
“Birth Justice exists when women and trans folks are empowered during pregnancy, labor, childbirth and postpartum to make healthy decisions for themselves and their babies. Birth Justice is part of a wider movement against reproductive oppression. It aims to dismantle inequalities of race, class, gender and sexuality that lead to negative birth experiences, especially for women of color, low-income women, survivors of violence, immigrant women, queer and trans folks, and women in the Global South.”
— Black Women Birthing Justice
As referenced in this definition, we adopt a global solidarity lens on the birthing crisis in the United States. In the United States, maternal mortality rates are nearly three times higher than in France and Canada, and 14 times higher than in Norway and New Zealand—despite higher spending on maternal and infant care.
What does this reveal about national values and priorities? The burden is universal yet unequal: Black and Indigenous communities face rates 2–4x higher than white populations. These disparities reflect the enduring impacts of colonization, Native genocide, and the African holocaust—and they echo conditions in the Global South.
Birth justice emerges precisely because these outcomes are not inevitable; they are designed—and therefore changeable.
This global picture brings us home to a Southern story: the enduring legacy of Black midwives who built community-centered care long before institutions would.
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The foundation of birth justice is deeply rooted in the lives, labor, and leadership of Black midwives. Midwives—meaning “with woman”—are independent health professionals and experts in healthy pregnancy and physiologic birth who support birthing people and newborns through the childbearing year (and often across the lifespan), helping families and communities build knowledge, health, nutrition, healing, and bodily autonomy.
The foundation of birth justice is deeply rooted in the lives, labor, and leadership of Black midwives. Midwives—meaning “with woman”—are independent health professionals and experts in healthy pregnancy and physiologic birth who support birthing people and newborns through the childbearing year (and often across the lifespan), helping families and communities build knowledge, health, nutrition, healing, and bodily autonomy.
The work of Black midwives in particular—spanning continents, centuries, and generations—formed the earliest model of comprehensive, community-centered healthcare in what is now the United States. From the shores of West Africa to the cotton fields of the South, Black midwives carried more than birthing knowledge—they carried a model of care rooted in autonomy, dignity, spirituality, and survival.
This project has been particularly inspired by the life and legacy of Biddy Mason, a Black woman born into chattel slavery in 1818, who rose to become a midwife, community health leader and activist for economic justice in Los Angeles. After gaining her freedom, Mason established herself as a community-revered midwife, contributing significantly to her community’s health and wellness.
Midwifery traditions brought through the Middle Passage were not merely medical techniques—they were ways of life. African midwives, often elder women revered in their communities, practiced holistic care that addressed not just the physical act of childbirth but the emotional, spiritual, and social well-being of the birthing person and their family. Upon arrival in the Americas, these practices evolved in response to the trauma of enslavement, systemic violence, and racism, but their core remained intact: care was personal, culturally grounded, and centered on collective wellness.
Black midwives became vital community health leaders during slavery and well into the 20th century. They provided far more than birth assistance. They tended to illness, guided the dying, cared for elders, and supported children—often serving entire families across generations. Midwifery was often a multigenerational vocation, with knowledge passed down through apprenticeship, oral tradition, and spiritual guidance. For many, midwifery was not a profession but a way of being—a sacred calling, an embodied art and science, and a socially vital role.
In this way, Black midwives were early advocates for what we now call social determinants of health—addressing housing, food access, sanitation, spiritual care, and social support long before public health institutions acknowledged these as drivers of well-being. They navigated birth not just as a clinical event, but as a deeply human experience tied to family, faith, land, and liberation. As community organizers and wellness practitioners, they provided a model of care that treated health as collective, not individual.
Sociologist Patricia Hill Collins describes the reproductive labor of Black women as motherwork—a form of care that is inherently political and ensures the survival of both family and community in the face of oppression. Historian Laura Wilkie underscores this framing, writing that “midwifery was the motherwork of creating Black mothers.” In both of these lenses, midwifery is not just about attending birth, but about restoring wholeness and affirming life in systems that seek to devalue it.
At the height of their practice, Black midwives attended nearly 90% of births in the rural South and about half of all births across the United States. They held critical roles not only in Black communities but, paradoxically, in white households as well, where their skill and expertise were respected even as their humanity was denied. Despite being marginalized and dehumanized, these Black midwives were highly respected within their communities, and some worked closely with white physicians.
Yet the rise of medical institutions, colonial frameworks, and professionalized obstetrics began to challenge this holistic model of care. By the late 19th and early 20th centuries, racist, sexist, and classist ideologies labeled midwives as uneducated and dangerous. Medical campaigns—backed by white male physicians and public health authorities—sought to eliminate midwifery under the guise of “modernizing” birth. In 1857, the American Medical Association issued a statement that midwives should be outlawed in part because of their abortion practices. They took out ads in papers to denigrate midwives with racist messaging that said they were immoral, unsafe, dirty, ignorant and that women should trust doctors instead.
One pivotal moment came with the Sheppard-Towner Act of 1921, a federal maternal and infant health law that introduced funding for maternal care and midwifery supervision. While it appeared to offer much-needed investment in maternal health, it also imposed licensing and training requirements that were inaccessible to many Black midwives, effectively sidelining them from practice. Training programs were often housed in segregated institutions or outright excluded Black students. As a result, the Sheppard-Towner Act contributed to the medical establishment’s consolidation of power, replacing trusted community-based care with hospital-centric, physician-controlled models that often failed to serve Black families equitably or safely.
Nurse Midwife (Maude Callen), Birth of Baby, South Carolina, W. Eugene Smith | Mia
Figures like Marie Laveau of New Orleans, Maude Callen of South Carolina and legacies of grand midwives like them—known as midwives, spiritual leaders, and community pillars—embodied the powerful intersection of healing, resistance, and cultural preservation.
Their practices were infused with spiritual resilience supporting the entire reproductive continuum across life stages—including fertility, contraception, miscarriage, and postpartum. Sacred objects like Florida Water—a spiritual cologne often used in Afro-Caribbean and Black Southern rituals—were common tools in a midwife’s kit, used to cleanse spaces, protect birthing people, and maintain connection to the ancestors. Altars, ancestor tables, and other ritual items helped maintain cultural continuity and affirmed Black birthing as sacred. These practices, passed down through generations, continue to thrive in many Black households today.
Portrait of Marie Laveau.
The growing dominance of the medical-industrial complex also coincided with horrific abuses. Gynecologist J. Marion Sims, often called the “father of modern gynecology,” experimented on enslaved Black women—including young girls like Anarcha, Betsey, and Lucy—without anesthesia or consent. These violations were not isolated incidents but part of a broader pattern of eugenics, forced sterilization, and medical experimentation that disproportionately targeted Black women and reinforced the idea that their reproduction needed to be controlled rather than supported.
Despite these violent efforts to erase them, Black midwives persisted as healers, educators, and cultural stewards. They organized informally, trained others in secret, and continued to serve their communities even as the state sought to discredit them.
Their survival is an act of defiance; their legacy is the heartbeat of the birth justice movement.
This modern reclamation is not simply about reviving midwifery—it is about restoring it to its rightful place as a culturally-rooted, community-driven model of care that affirms Black life. It is also about building new systems that reflect our values: autonomy, dignity, wholeness, and interdependence.
At the center of this reclamation is the Southern Birth Justice Network (SBJN), a Black-led organization that emerged in the U.S. South to address maternal health inequities through a reproductive justice lens. Led by Jamarah Amani—a midwife, community organizer, and national birth justice leader—SBJN began in 2008 as “Mobile Midwife,” a small grassroots effort to deliver midwifery care to marginalized communities.
The resurgence of Black midwifery and the growing momentum of the birth justice movement are testaments to the enduring strength and vision of Black women, birthworkers, and community healers.
As certified nurse-midwife Dr. Michelle Drew powerfully reminds us in Birthing Justice: Black Women, Pregnancy, and Childbirth:
“In reclaiming the midwife, we reaffirm our right
to self-determine our reproductive futures.”
— Dr. Michelle Drew
Honoring Black midwives—past, present, and future—is not just an act of remembrance; it is a political and spiritual commitment to reproductive freedom and collective healing. The leadership of Black midwives must be recognized, codified, and resourced as vital to advancing birth justice. Their work continues to shape a vision where every birthing person experiences care grounded in dignity, autonomy, and justice.
Birth justice is about building a future where every individual experiences birth with justice, joy, and autonomy. It means investing in community-led solutions th at center equity, dignity, and liberation prioritizing culturally rooted, holistic care models that honor midwifery and reproductive autonomy. For Black and Indigenous communities, midwives have long been guardians of birth, preserving culture and safeguarding families. The Birth Justice movement seeks to restore that legacy by advocating for policies, education, and care systems that truly support families and communities.
To realize this vision, we must also dismantle the white supremacist and capitalist structures that drive reproductive oppression, such as the culture of birth in the U.S. that prioritizes pro ts over community-centered care. Perinatal mortality rates amplify these deeply rooted injustices, hindering access to healthcare, safety, and freedom. The systematic targeting and erasure of midwives have been central to these harms, undervaluing life-saving services and stripping communities of vital care networks and autonomy.
● Organizations like the Southern Birth Justice Network (SBJN) are leading the charge for a more just and liberated reproductive future. Through advocacy, education, and direct support, SBJN centers Black, Brown and Indigenous midwives, birthworkers, and families. At the 2022 UN CERD review, SBJN elevated the global urgency of addressing systemic racism, abortion restrictions, and the criminalization of Black and Indigenous midwifery as interconnected reproductive injustices.
● The National Black Midwives Alliance (NBMA) is key to expanding Black midwifery nationwide. Through leadership development, policy advocacy, and campaigns like Black Midwives Day, NBMA works to ensure that Black midwifery is recognized, resourced, and respected as essential to reproductive justice.
● Birth Center Equity (BCE) strengthens community-based birth care by securing capital for Black, Indigenous, people of color-led birth centers. Through investment, business and leadership development, narrative change, and collective power-building, BCE supports sustainable access to safe, culturally-reverent midwifery care, including freestanding birth centers, which are proven to improve health outcomes, enhance the birth experience, and reduce inequities as a cost e7ective solution. BCE has garnered over $10M to support its network of Black, Indigenous, people of color-led birth centers, expanded from 14 to 58 centers (20 established and 38 in development across 26 states and Puerto Rico), serving tens of thousands of families annually with high quality, midwifery-led care. In September 2025, BCE launched Beloved Birth 50 by 50, with the audacious goal: By 2050, 50% of babies in the U.S. will be born with the care of midwives. Achieving this goal requires nationwide collaboration to transform birth culture and make the U.S. a leader in safe, equitable birth care.
● Lastly, this initiative, the Birth Justice Origins Project (BJOP), bolsters the e7orts of the movement; BJOP is a research and narrative initiative designed to preserve the legacy of Black midwifery and ensure that the Birth Justice movement is not disconnected from its historical roots. Created to resist the erasure of Black leadership in reproductive justice, the Origins Project documents early midwives, organizers, and community e7orts that laid the groundwork for the current movement, showing how birth justice is not a trend but a continuation of centuries of care, struggle, and resistance.
Together, these organizations call for deep systemic change. They remind us that birth justice is not a luxury—it is urgent and essential. To realize this vision, we must fun, amplify, and follow the leadership of Black, Indigenous, birthworkers of color. Join the global movement to build a future where every family can thrive and every birth is honored .
1. Invest – Give $25/month or more to a frontline birth justice organization like SBJN, NBMA, BCE, or your local community birth center to help build long term power and infrastructure. Quick Action: Set up a $5–$10 monthly donation today and add a calendar reminder to revisit in 90 days.
3. Amplify – Share 5 stories per year from the Birth Justice Origins Project with your networks to uplift intergenerational wisdom. Quick Action: Share the Birth Justice Bill of Rights with someone in your life and post one quote or stat to your social feed today.
4. Educate – Host a community, health system, or organizational screening, teach-in, or book circle with at least 10 participants to spread birth justice history and knowledge about the bene ts of midwifery care. Quick Action: Invite 3 friends to a 45-minute virtual read-along; send the calendar link and one of these black papers as a primer.
5. Advocate – Contact your state and federal representatives at least 3 times per year to demand policies that expand midwifery access and protect reproductve autonomy. Quick Action: Call one legislator this week and tell two friends about it, sharing a template based on what you said.
6. Shift Resources – If you work in philanthropy, direct at least 10% of your reproductive health or equity portfolio to Black, Indigenous, people of color-led midwifery and birth center organizations. Quick Action: Add one midwifery org to your next grants docket and schedule a 20-minute intro call.
7. Organize – Join or start a local community or organizational birth justice working group, ensuring at least 50% of participants are directly impacted community members. Quick Action: Join the National Black Midwives Alliance as an ally member and invite two colleagues or neighbors to do the same.
8. Honor – On Black Midwives Day (April 8th), donate, host a story- sharing event, or amplify onine. Set a working group or organizational goal of 100 posts or $10,000 raised annually. Quick Action: Record a 30-second thank-you video for a midwife or doula and schedule it to post on April 8.
9. Celebrate – During National Birth Center Week (September 14–20), visit a birth center, uplift its story, or host an event sharing the power and potential of midwifery care and birth centers with 10 or more people in your community. Quick Action: Write a 3- sentence testimonial about your local birth center and share it with a photo.
10. Pledge – Sign the Beloved Birth 50 by 50 Pledge and join the Beloved Birth Giving Circle to ensure that by 2050, 50% of U.S. babies (across birth settings) come into the world with the care of midwives, and invie at least 5 friends or colleagues to sign too. Quick Action: Text the pledge link to your group chat with one sentence on why you signed.
Midwifery care is holistic, healing, and humanistic. It has a rich herstory and legacy in communities of color.
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