Birth Justice is a values-driven framework—rooted in Black midwifery—with both a vision and a set of operating instructions that reorients maternal health around autonomy, dignity, healing, and human rights in order to ensure that our work stays accountable to the people most affected—particularly Black, Indigenous, immigrant, undocumented, young, and LGBTQIA+ communities—and to the ancestral midwifery traditions that have sustained them. This paper details how the movement’s core principles and values have emerged, how they translate into practice, and what we must do now to embed this future across care, policy, funding, and measurement.
“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
Birth is one of the most profound experiences in a person’s life. However, for many Black, Indigenous, and marginalized communities, pregnancy and childbirth are fraught with systemic barriers, medical racism, and unnecessary risks. The birth justice movement seeks to change this reality, ensuring that all people—regardless of race, gender, income, or background—can birth safely and with dignity.
At the heart of birth justice is the understanding that reproductive and maternal health inequities are not just unfortunate statistics; they are direct consequences of centuries-old systems of oppression and a system-created, manufactured healthcare crisis. By advocating for culturally-reverent, community-driven, and trauma-informed models of care, birth justice activists are working to transform how society supports birthing people and families.
In this Black Paper, we explore the core values of birth justice, key issues affecting birthing people today, and the urgent need for systemic change.
Despite generations of erasure, surveillance, and structural exclusion, Black midwifery has never disappeared—it has adapted, resisted, and endured. Today, we are witnessing a powerful resurgence as a new generation of Black birthworkers, scholars, organizers, and healers reclaim ancestral practices and lead the charge to reimagine maternal health systems through the lens of justice, equity, and liberation.
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. Founded 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.
It has since grown into a national force advancing policy change, training the next generation of Black and Brown midwives and doulas, and articulating the landmark Birth Justice Framework that continues to guide the movement today.
SBJN’s Birth Justice Framework was born from community conversations and organizing efforts in the historically Black community of Overtown, Miami, in Florida. At its core, the framework asserts that when families are empowered, communities are transformed.
At every stage, Black midwives have remained the backbone of this movement—carrying forward ancestral knowledge, sustaining communities, and ensuring that birth justice is rooted in lived experience and cultural wisdom.
Originated from the Southern Birth Justice Network, the Birth Justice Framework is built upon four core principles we hold as central to our work:
These ten guiding values serve as the bedrock for creating meaningful change.
“With these principles as our North Star, we now turn from framework to felt experience—the living cultural practices that make Birth Justice tangible in everyday care.
These values become real through the rituals, stories, language, and community traditions that have sustained our people for generations.”
-By Jamarah Amani
The unique experiences of Black people demand culturally specific solutions. Birth justice is, at its core, a cultural movement, as reflected in our values. Our cultural work is sacred because we, as people, are sacred. Though culture is often suppressed or outlawed through white supremacist policies, birth justice celebrates cultural expression through an African-centered, decolonial lens. The values of birth justice inform our methods of analysis, theories of change, community engagement, and narrative work. Birth justice offers a distinct voice in policy and strategy discussions, embodying this cultural work in its structure and essence.
Altars
Creating a space to honor African culture in all its forms is essential. A cultural altar differs from a spiritual one; it serves as a platform to display our aesthetics in a joyful way, using fabrics, crystals, herbs, ancestral artifacts, or other symbols of cultural and historical significance. The cultural altar embodies culture, which can have multiple meanings. It isn’t inherently religious unless used as such, which is not the case here.
Libation
Libation emphasizes the importance of history and cultural connection, specifically of our Black midwife ancestors and others before us who have provided inspiration and direction.
Concerning libation, we say:
“Libation is a sacred traditional practice invoking the presence of our ancestors, honoring those who came before, and acknowledging the interconnectedness of all.”
Photo by W. Eugene Smith / The LIFE Picture Collection.
Prayer
This is the Black Grannie Midwives Prayer, originated in Mississippi in the 1920s (Source: “Southern Lay Midwives As Ritual Specialties,” written by Molly C. Dougherty). We recite it for two reasons: to be inclusive; and because it reflects our cultural heritage.
Solidarity
As Black cultural workers, we practice deep solidarity with our Indigenous, Caribbean and Latine siblings. With Miami being the birthplace of birth justice, it is crucial to recognize that birth justice was born into a gumbo of many peoples and backgrounds.
We are on Tequesta and Miccosukee lands, and part of our solidarity work is to always recognize that. We build intentional and meaningful relationships among Black, Brown, and Indigenous families and organizations. These partnerships and community building help to shift inherently racist narratives of competition and division between people of color.
Photo by W. Eugene Smith / The LIFE Picture Collection.
Other Cultural Elements
Beyond libations and altars, we practice blessingways where we wash the feet of pregnant and postpartum mamas using herbs, flowers, and oils. We facilitate guided meditations, honor elders, and organize cultural exchange trips to Africa—just to mention a few other cultural ways of being. These are the roots of birth justice in action. We are movement founders and cultural keepers, not just service providers.
To dive more into how these values translate into
practice through specific struggles and campaigns,
please refer to Birth Justice Key Issues.
SBJN’s work connects directly with other major players in the contemporary movement for birth equity. One of its key collaborators is the National Black Midwives Alliance (NBMA), co-founded by Jamarah Amani and Haguerenesh Tesfa. NBMA is the only national organization led by Black midwives dedicated to creating pathways for Black students and birthworkers, advocating for equitable midwifery policies, and preserving the cultural heritage of Black midwifery.
Among NBMA’s landmark contributions is the establishment of Black Midwives Day—celebrated annually on March 14th and recognized by at least four U.S. states and the federal government as of 2025. This day uplifts the critical legacy and ongoing work of Black midwives, with goals that include:
Another vital part of this ecosystem is Birth Center Equity (BCE). Founded by Leseliey Welch and Nashira Baril, BCE is a national catalyst for community birth center development that invests in Black, Indigenous, people of color-led birth centers to grow and sustain community birth infrastructure. Freestanding birth centers are the only healthcare facilities designed to center the midwifery model of care; and BCE defines community birth centers as freestanding birth centers that provide safe, culturally-reverent midwifery care for all. Research shows birth centers improve health outcomes, enhance the birth experience, reduce inequities, and are cost-effective. However, only 7% of the nation’s 400+ freestanding birth centers are led by Black, Indigenous, people of color.
BCE focuses on four strategic priorities:
Since its inception in 2020, 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. Collectively, BCE network birth centers serve 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.
The Birth Justice Origins project 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. The project documents early midwives, organizers, and community efforts 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.
Contemporary leaders continue to expand this work across geographies and modalities through policy advocacy, curriculum development, mentorship, and clinical practice. Their leadership ensures that the work is rooted in both accountability and cultural wisdom.
These efforts are more urgent than ever. As maternal mortality rates continue to rise—especially for Black and Indigenous birthing people—community-led solutions are proving to be the most effective, culturally attuned, and transformative. Black midwives and birth justice organizers are not waiting for mainstream health systems to change; they are building alternatives grounded in joy, safety, and ancestral knowledge.
This reclamation is not only about birth—it is about returning to a way of life that prioritizes collective care and community survival. The rise of birth justice is not a rebirth; it is a return. Forging the path of future Black midwifery—embodied by the Black Midwives Care Model—lays the cultural and philosophical groundwork for the broader birth justice movement. It’s not just about returning to traditional practices; it’s about reimagining the systems that shape reproductive health, with Black leadership, wisdom, and lived experience at the center. The values embedded in the Model—autonomy, cultural safety, accountability, and collective care—form a direct bridge to the next phase of organizing: the articulation of a shared political vision.
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.
Supporting the work of frontline birth justice organizations is essential to building systems of care that protect reproductive autonomy, honor cultural traditions, and center the needs of those most impacted by injustice.
● 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 .
The Birth Justice movement is bigger than any one organization—it’s a call to all of us. Change happens when people take action, share resources, and move together with purpose. Whether you are a parent, a birthworker, and advocate, or simply someone who believes in justice, your contribution matters. Here are ten ways you can take tangible, measurable steps to strengthen birth justice today:
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.
2. Fund – Support the call to fully fund birth justice, such as by contributing to scholarships for Black and Indigenous midwives or aiming to sponsor at least one midwife-in-training per year. Quick Action:Buy one textbook from the wishlist of a Black,Indigenous, or student of color or contribute $25 to a scholarship fund.
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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