Birth Justice centers human rights, bodily autonomy, and culturally rooted midwifery to confront systemic issues in maternal care—advancing values like autonomy, community, healing, decolonization, and celebration while demanding access to full-spectrum, trauma-informed care. It calls for ending practices like shackling and medical neglect, expanding Black and Indigenous midwifery, breastfeeding/chestfeeding, and parental rights, and mobilizing investment, policy change, and community action so every birth is safe, dignified, and liberatory.
Birth justice is a vision held in the hearts and hands of generations of midwives. Rooted in Black, Indigenous, immigrant, undocumented, young, and LGBTQIA+ communities, it evolves from reproductive justice and a human rights perspective to support people across the full spectrum of pregnancy, birth, loss, postpartum, and parenting.
Birth justice names the drivers of inequity—white supremacy, racism, colonization, cis-heteropatriarchy, and the medical-industrial complex—and insists that solutions lie in community wisdom and culturally rooted care. We stand on the shoulders of healers, midwives, doulas, and all birthworkers—figures like Mary Francis Hill Coley and Biddy Mason—who cared for their people while resisting oppression and bequeathed a daring legacy of love, skill, and freedom. Furthermore, birth justice is rooted locally but linked globally—our struggle echoes movements for reproductive rights and maternal health equity across the world.
Attempts to eradicate Black and Indigenous midwives, the targeting of abortion providers, criminalization of families seeking care, and the severing of medicine from ancestral healing are strategies of control that strip communities of power. Because health disparities are power disparities, birth justice demands a redistribution of power across healthcare, education, and the carceral state; reparations for harms recognized under international human rights law; and the removal of barriers to full-spectrum reproductive care—including comprehensive sex education, midwifery, doulas, lactation support, gender-affirming care, abortion care, fertility decision-making, and other community-based healing.
As Birth Justice advocates, we believe that:
Birth justice emerges from the struggles of marginalized communities facing systemic oppression. Rooted in reproductive and human rights, it reveals how racism, cis-heteropatriarchy, and the medical-industrial complex drive maternal health inequities. The movement honors ancestral knowledge, midwifery, and community-led care as solutions to these injustices. In birth justice, health inequities and harmful practices are to be treated as human rights violations, requiring immediate change.
Health inequities constitute human rights violations, underscoring the urgency of broad birth justice. The United Nations and others have affirmed that access to comprehensive healthcare is a fundamental right, yet marginalized communities still face myriad systemic barriers.
In 2022, the Center for Reproductive Rights led a U.S. delegation of activists, which included the Southern Birth Justice Network, SisterSong, Ancient Song Doula Services, and other prominent organizations to report human rights violations and represent civil society interests to the UN Committee on the Elimination of Racial Discrimination (CERD).
As part of this delegation, SBJN elevated the lived experiences and systemic challenges faced by Black and Indigenous midwives in the United States, drawing attention to the ways racism, underfunding, and legal restrictions undermine their ability to provide culturally grounded, community-based care, related to achieving the UN’s 2030 Sustainable Development Goals, such as Target 3.1: “by 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.”
SBJN also highlighted the devastating impact of abortion restrictions on reproductive autonomy, particularly for marginalized communities disproportionately affected by the rollback of reproductive rights. Their presence helped to center birth justice within broader conversations about racial equity and human rights, underscoring that the fight for reproductive freedom is a global issue with deeply local roots.
State violence—including police brutality, criminalization, and carceral practices—creates toxic stress that harms pregnant people, babies, and families. The killing of Charleena Lyles, an expectant mother who called police for help during a mental-health crisis and was shot in her home, exemplifies how state systems can endanger, rather than protect, Black families.
Exposure to racist violence—whether direct or vicarious—has been linked to elevated blood pressure and stress during pregnancy, and research connects police violence to adverse outcomes like preterm birth.
Mass incarceration compounds these harms through separation from family, disrupted prenatal care, and the continued use of restraints on pregnant and postpartum people, a practice condemned by major medical bodies. The Black Midwives Model of Care calls providers to counter this harm by advocating policy change, naming police violence as a public-health issue, and strengthening community-based supports.
As a brutal illustration of how birth and health justice directly impact a person’s human rights, in many places today, pregnant people who are being incarcerated are forced to give birth while wearing chains or shackles. This shackling of incarcerated pregnant individuals is a dehumanizing remnant of slavery and a inhumane violation that endures today.
While some states have anti-shackling laws, enforcement is inconsistent. Birth justice demands an immediate end to this practice and the implementation of policies that protect the dignity and health of incarcerated pregnant people.
Despite universal agreement based on extensive research that most pregnancy-related deaths are preventable, Black and Indigenous birthing people experience disproportionately high mortality rates due to systemic racism. In 2022, the U.S. maternal mortality rate was 22 deaths per 100,000 live births but skyrocketed to 49.5 for Black individuals. Addressing these inequities requires dismantling white supremacy in healthcare and expanding culturally-reverent care models.
Black midwives provide culturally attuned care that improves birth outcomes. However, institutional barriers limit access. The Black Midwives Care model integrates advocacy, holistic practices, and cultural identity to combat maternal health injustices and improve perinatal outcomes.
Trauma-informed, community-based care is essential for historically marginalized groups. Expanding access to midwives and doulas aligns with birth justice values and ensures that birthworkers provide care that acknowledges and mitigates trauma.
Identity-based representation in midwifery has the potential to improve maternal and perinatal health outcomes by ensuring every birthing person feels seen, affirmed, and understood. Organizations such as the National Black Midwives Alliance (NBMA) and birth justice–focused doula training programs, like those at Southern Birth Justice Network, serve as inspiring pathways for future midwives and doulas of color, promoting culturally respectful care and equitable birthing experiences.
Indigenous-led groups—including the Center for Indigenous Midwifery, the Nich Ixim Midwives Movement of Chiapas, and Maya Midwifery International—play crucial roles in advancing training, advocating for rights, and preserving traditional community-based care, all while honoring ancestral midwifery wisdom and expanding access within Indigenous communities.
Equally significant are networks that center queer and trans midwives and birthing people. The Queer and Trans Midwives Alliance (QTMA) highlights the leadership of LGBTQIA+ providers and actively works to dismantle cis-normative and heteronormative barriers in midwifery education, policies, and care. QTMA and its members, as well as organizations such as Kuluntu Reproductive Justice Center, are shaping a new vision of inclusive, gender-expansive midwifery and birthwork—creating welcoming spaces where queer, trans, and nonbinary people can receive care that truly respects their identities and safeguards their dignity throughout their reproductive and sexual health journeys.
Together, these movements are charting futures for birth care providers that are more equitable, inclusive, and rooted in justice. Vital to birth justice, we must remain committed to building a midwife and doula workforce that reflects the communities it serves and ensuring that every birthing person— regardless of race, culture, gender identity, or sexuality—receives compassionate, respectful, and excellent care.
The family regulation system disproportionately harms Black and Indigenous parents. The case of Syesha Mercado’s fight to regain custody of her children exemplifies state interference in parental rights, revealing systemic biases that criminalize marginalized families. Birth justice demands the protection of parental rights and an end to racially biased family separation policies and practices like involuntary drug testing.
The right to parent is directly connected to how we understand fertility and the full range of reproductive care. Birth justice teaches us that this care is part of a whole spectrum—from planning a pregnancy to postpartum healing—and should be rooted in bodily autonomy, cultural tradition, and community care, not controlled by the medical system. Studies confirm that community-based models—like Black midwifery and ancestral healing traditions—lead to better outcomes, more respect, and more trust for families.
When we center Black midwives, we uplift care that respects people before pregnancy, between pregnancies, and through abortion, miscarriage, birth, and postpartum. Reproductive justice reminds us that people deserve the power to decide if, when, and how to become parents.
Institutional biases limit access to Vaginal Birth After Caesarean (VBAC), despite strong success rates of 60-80%. The outdated belief of “Once a C-section, always a C-section” disregards medical advancements and patient autonomy. Expanding VBAC access is essential for birth justice and respectful maternity care.
Breastfeeding/chestfeeding is a human right, yet systemic barriers persist. Birth justice calls for workplace protections, public education, and comprehensive lactation support to ensure equitable access. Initiatives like Black Breastfeeding Week highlight the importance of culturally-reverent lactation support and the right to feed without discrimination.
Midwifery care is holistic, healing, and humanistic. It has a rich herstory and legacy in communities of color.
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