Birth justice is the movement to ensure that all people—especially Black, Indigenous, and marginalized communities—have the right to safe, respectful, and culturally-reverent care during pregnancy, birth, and postpartum. In the United States, maternal health inequities are among the worst in the world, with Black and Indigenous birthing people dying at two to four times the rate of their white counterparts. This isn’t due to biology—it’s the result of systemic racism in healthcare, lack of access to midwives and birth centers, and medical neglect.

Birth justice is about more than healthcare—it’s about human rights, bodily autonomy, and ensuring that every person has the power to make their own choices about their birth experience. It means investing in solutions that work: midwives, doulas, and community birth centers that provide safer, more holistic, and culturally-reverent care.

The birth justice movement is deeply rooted in the traditions of Black midwives and indigenous healers who have provided safe, community-centered care for generations. Before hospitals dominated maternal health, midwives were the primary caregivers for pregnant people, particularly in Black and Indigenous communities. However, white supremacy and medical policies systematically displaced midwives, replacing traditional birthing knowledge with hospital-centered, physician-controlled care. This shift led to worse birth outcomes for marginalized communities and reinforced inequities in perinatal health.

Birth justice reclaims these ancestral traditions while addressing the modern-day realities of medical racism and systemic inequities in reproductive care. It is a movement built on the wisdom of those who came before us, forging a better future for all birthing people.

From menarche (first period) to menopause, reproductive health is an ongoing journey—but in the U.S., many people face systemic neglect and stigma. When young people experience their first period, schools often fail to provide education or products, and stigma makes seeking help difficult. Nearly 1 in 4 students experience period poverty (NPR). Poor menstrual health worsens inequities, harming overall well-being, from digestion to cardiovascular health.

Holistic approaches to menarche and menopause encourage decolonizing harmful beliefs, reclaiming the cultural and spiritual significance of menstruation, and embracing liberated embodiment. Policies should support menstrual liberation through education, nutrition, and access to resources.

Menopause, too, is both a personal and political issue—“not just a moment, but a movement” (The Black Girl’s Guide to Surviving Menopause). Black women are three times more likely to experience adverse effects such as premature menopause, hot flashes, hysterectomy, infertility, fibroids, and hormonal issues. These disparities reflect differences in opportunity, stress, quality of care, and access to healthcare, as explained by Dr. Camara Phyllis Jones (AMA).

Addressing menstrual and menopausal health is therefore a matter of human rights. Advocating for comprehensive care across the life course—especially for Black women and transfolk disproportionately impacted—is essential to achieving reproductive justice and overall wellness.

Midwives and doulas both play important roles in birth justice. 

Midwives—literally “with woman” are licensed health professionals who can deliver babies, monitor fetal development, prescribe medications (for Certified Nurse-Midwives, or CNMs), and provide prenatal, labor, and postpartum care. They help families and communities build knowledge, health, nutrition, healing, and bodily autonomy.

Doulas, however, provide non-medical support, offering emotional support, physical comfort techniques such as massage and breathing, guidance in creating a birth plan, and support for the birthing person’s partner or family. 

Both midwives and doulas assist with full-spectrum care during pregnancy, labor, and postpartum, while advocating for the birthing person, educating parents, and offering continuity.

Racism significantly drives maternal mortality rates among Black and Indigenous birthing people. For over a century, Black and Indigenous midwives and healers have been erased and criminalized, leading to major health disparities. Supporting midwifery, doulas, and community-based care is therefore a matter of racial justice.

Birth justice calls for full access to reproductive options—from abortion to homebirth—as part of the human right to health. It connects to the fight for reparations under international human rights law, recognizing the need to restore resources, sovereignty, and culturally-reverent care to our communities, from the US South to the Global South.

Historically, Black and Indigenous midwives worked together, through shared heritage, knowledge and resisting oppression; today, that solidarity extends globally to indigenous peoples everywhere. Practical solutions exist—such as expanding access to midwifery, doulas, lactation support, abortion providers, gender-affirming care, and traditional healing practices.

At the 2022 UN CERD review, Black and Indigenous midwives, doulas, and reproductive health leaders testified to how U.S. policies rooted in white supremacy restrict bodily autonomy and violate reproductive rights. The call to action is urgent: we must listen to impacted communities, dismantle harmful policies, and invest in a strong, sustainable, culturally-reverent midwifery workforce to save lives and restore justice.