Critical Summary on Birthing Liberation: How Reproductive Justice Can Set Us Free by Sabia Wade, The Black Doula
- Betel S. Tesfamariam, MA, BA (she/her)
- Feb 5, 2024
- 1 min read
Written by: Betel S. Tesfamariam (she/her)
Sabia Wade (she/they), The Black Doula (@sabiawade) on Instagram, is one of my teachers in the Birthing Advocacy Doula Training (BADT) full-spectrum doula training course. BADT is an organization founded by Sabia Wade. She also founded For the Village, “the only community doula organization centering Black birthing people and their children in San Diego” (xxiii). Wade teaches us about a wholly embodied birthing liberation that begins with healing and liberating ourselves.
Pictured: Sabia Wade
Introduction & Chapter 1: “we must all become liberated individuals” (p. xxvi)
Wade introduces her journey as a full-spectrum doula by describing her work at the Prison Birth Project. Her experience supporting birthing people who were confronted with direct surveillance, authoritative control, and intrusive involvement of the punitive carceral state inform her analysis of the interlocking systems of domination, namely patriarchy, homophobia, transphobia, racism, sexism, ableism, and capitalism. These interlocking systems of domination continue to wreak havoc on the lives and birthing experiences of Black people. Wade explains how statistics in the U.S. on high rates of Black perinatal mortality help identify gaps within the current system and reveal the underlying anti-black logics which began during the legalization of chattel slavery in North America. These same anti-black logics continue to structure the healthcare system today. Wade tells us we must honor that these statistics are reflective of true, real, traumatic occurrences that Black, Indigenous, and people of color (BIPOC) disproportionately experience in healthcare as compared to non-BIPOC people. While there is minimal research in Canada documenting the health disparities in birthing outcomes and perinatal care affecting Black people, based on the lived experiences of Black people in birthing and receiving reproductive healthcare, anti-black racism is as insidious and determines the quality of medical care Black people receive or are denied here, as is the case in the U.S. or Brazil for example.
Chapter 2: “I’m a firm believer in understanding history before moving forward” (p. 20)
Wade emphasizes the importance of understanding the colonial and brutal history of gynecology in America so we have more clarity on how to move forward. They recognize the various efforts in redressing obstetric violence historically perpetuated on Black people at alarmingly disproportionate rates by white or biased hospital staff and medical professionals. She exposes the torture and violence of the medical experiments carried out by J. Marion Sims on enslaved Black women towards the mid-1800s. These enslaved Black women included Lucy, Betsy, and Anarcha. It is important to know that Anarcha was only seventeen years old when Sims performed most of these extremely painful procedures on her. He did not use anesthesia on any of his victims, even after it became available in 1846. These countless instances of brutalization led to Sims being credited as the Father of Gynecology.
The historical analysis presented by Wade in this chapter revolves around the central question, how does an understanding of the history of antiblack colonial violence in gynecology and medical care inform our current knowledge and practices of ethical care, human rights, and liberation within birth spaces?
Wade also provides us readers with the tools to name and process our experiences of discomfort, rage, and grief, so our knowledge and emotions can result in positive action, based on our embodied experience of all that we witness. Throughout the book, she asks us to breathe, move, and pause, encouraging us to pay attention to the sensations in our body and which emotions they stem from, so we can let them dissipate and take steps forward with more clarity.
Chapter 3: “…there is no disconnection available” (p.43)
Wade addresses three main areas: accountability, weathering, and generational trauma. They describe what accountability would look like for well-meaning doula organizations claiming to take steps towards completely overhauling the systematic reasons for statistics like “Black people are three to four times more likely to die from a pregnancy-related cause than white birthing people'' (p. 40). They assert that for organizations to be truly accountable to their stated values, “We would all benefit from those places also highlighting why these statistics are what they are, the work that BIPOC communities have been doing to combat this, how these organizations are planning to change these statistics, how they are holding individuals and organizations accountable, and what the consequences of the continued violence against Black birthing people will be” (p. 41). Connecting the areas of accountability and weathering, I pose two questions central to this chapter: how do we hold well-meaning doula organizations and medical institutions accountable? How do we permanently change the “systems that continue to perpetuate harm with little to no accountability” (p. 50)? For me, this chapter’s takeaway is Wade’s call to create our own standards of accountability, outside and beyond the medical-industrial complex. Using their words, the goal is “to parent our children in ways of abundance versus ways of survival” (p. 41).
What stood out to me about Wade’s discussion on the connections between weathering and generational trauma was how weathering causes “the heightened rate of Black infant mortality” (p. 50). A study titled “Does Breastfeeding Reduce the Risk of Sudden Infant Death Syndrome?” which was published in March, 2009, further elucidated this critical disparity and “indicated that body feeding during infancy decreased the risk of [sudden infant death syndrome] SIDS by approximately half” (p. 51) and another study published in 2014 showed that even body feeding for a short period like 2 months makes the same difference. This is a big deal! Wade also details the existing obstacles that Black birthing people who want to bodyfeed face in the lactation world: “racism, lack of inclusion, accessibility, the commercialization and commodification of lactation, an absence of culturally humble care, and generational trauma” (p. 52). By leaving us with efforts like lactivism, Wade demonstrates how important lactation educators and organizations have been in improving the conditions of lactation today.
Chapter 4: “Collective liberation requires us to decenter ourselves and push forward with the mission of equity for all” (p. 80)
Wade explains how reproductive justice can be understood as what it would take to fix our healthcare system. She provides historical context on the advent of reproductive justice as a political framework and intersectional racial justice movement. Reproductive justice was introduced in the U.S. during the 1990s by Loretta Ross and the Women of African Descent for Reproductive Justice in response to second-wave feminism in the 1960s to 1980s due to their primary focus on legal protections for non-BIPOC middle-class cis women. Loretta Ross and the Women of African Descent for Reproductive Justice brought attention to systemic and structural barriers faced by Black birthing people and fellow birthing people of color to accessing adequate sex education, safe housing, contraception, and quality health care. They acknowledged that raising awareness for the most vulnerable and historically marginalized people would result in positive outcomes and improvements for all.
Wade then defines and describes the 4 pillars of reproductive justice: analyze power systems, address intersecting oppressions, center the most marginalized, and join together across issues and identities. She points out how “systems are communities of people” and non-BIPOC birth professions, who are closer to power, are responsible for understanding that their decisions and actions have life or death consequences for Black birthing people (p. 71). Wade further explains how joining across issues and identities becomes crucial to building power in numbers, developing a similar outlook on intersecting issues, pooling resources, and maintaining consistency (p. 86). An important recent example Wade highlights is the movement-building efforts and solidarity demonstrated in 2020 for the movement for Black lives, among non-BIPOC and BIPOC communities alike.
Chapter 5: “Moving through trauma will take effort, focus, and intention” (p. 121)
Wade defines trauma as “an event or change that someone personally registers as too much, too fast, too soon” (p. 92). Although we are not always responsible for the trauma we experience, Wade explains that for our own sake, and for the sake of the communities and spaces we show up in, it is our personal responsibility to find the tools and sources of support to heal ourselves. While she acknowledges the difficulty and at times even unfairness of this task, she deems this responsibility necessary for collective liberation. Wade shares how her experiences in birth work, interacting with both BIPOC and non-BIPOC folks, made her realize how racism is a source of trauma. She defines the four trauma responses, flight, flight, freeze, and fawn, and also defines the different forms of racism that exist. She offers rest and play as crucial contributing factors to healing and invites us to explore various self-reflective questions; one question that stood out to me, in particular, was, “What would it be like to give yourself full permission to heal?” (p. 95). Her prompts and questions accompany a helpful analysis of generational trauma, as well as the biological systems inside us responsible for both our trauma responses and our capacity to rest and digest. Wade is asking us to not only simply think about the ways trauma shows up in our personal lives and relationships but to also feel into our reflections physically—so healing takes place on a somatic, embodied, or physical level.
Chapter 6: “…we make more change collectively than we do individually” (p. 41)
Wade explains how structures like capitalism and antiblack racism create the conditions that push historically marginalized Black people into unhealthy environments. She discusses the importance of recognizing how Black people who experience structural inequities cannot simultaneously be the victims and causes of their circumstances or structural positions. For Wade, once we acknowledge that healthy communities result in healthy parents, which then lead to healthy children, we can begin to identify the unmet needs in unhealthy communities and find ways to meet them.
Through a reproductive justice lens, Wade describes the necessary building blocks of healthy communities. These blocks include patient-led and patient-centered accessible healthcare based on a transparent accountability system, accessible education with resources that support different learning styles and needs, adequate employment and paid job-training opportunities to alleviate economic hardship. These conditions would necessitate the overhaul of the dominant and violent capitalist system, as well as the creation of safe, healthy, and clean physical environments
Chapter 7: “The individual leads to the collective” (p. 152)
Wade emphasizes the importance of individual healing for collective liberation. They explain how the system of capitalism, which privileges productivity, competition, and polarity, has led to us creating hierarchical systems based on the values of differences. These hierarchical systems, or interlocking systems of domination, are based on differences in race, ethnicity, sexual orientation, ability, or class for example. Wade centers personal work in collective liberation because hurt people hurt people, which creates “an endless cycle of harm” (p. 151). Meanwhile, ongoing healing develops more self-awareness and empathy to work towards collective liberation. Wade aptly writes “Our current ideologies and systems of oppression were created, and anything that has been created can be dismantled” (p. 153). They invite us to envision what collective liberation could look and feel like; they acknowledge how we will likely experience feelings of excitement, hope, and desire while also likely experiencing some resistance, discomfort, or doubt. Wade explains that non-BIPOC people will need to give up their privilege and be willing to share their material resources. The resistance to change we may all experience at some level shows up in our bodies as uncomfortable or negative sensations. Wade highlights the need to understand our nervous systems and be self-aware so we can open more spaces of possibility in our bodies and lives for change(e.g. breath work, rest, or movement). They also discuss how the labor and responsibility of creating alternative structures of care, resisting state-sanctioned antiblack violence, and being able to survive have historically fallen on the shoulders of BIPOC people. We are always being expected to not only survive unfathomable violence and grief, but also make the world better for everyone. She asserts that non-BIPOC people are responsible for collective liberation, with the leadership and support of BIPOC people.
Chapter 8: “It is time to return to birth in order to build the future of birth” (p. 193)
Wade explains the importance of returning to birth, as “a process of trusting in our knowledge of our own bodies, our own experience, and our own practices” (p. 189). She makes it clear that returning to birth is a community effort, arising from a collective commitment to accountability, safety, and the lives born into the future. The collective effort required to create new standards of care all boils down to our commitment to personal trauma healing. Wade introduces a new framework to open possibilities for achieving collective liberation—birth neoterism. They invite us to become birth neoterists, people who are “forward focused and dedicated to innovation and sustainability for creating a pathway to a new reality for birth” (p. 191). Birth neoterism is based on an understanding that reproductive justice is key to achieving collective liberation. Along with a useful resource list of various birth organizations doing reproductive justice work, Wade offers a series of reflective prompts that concludes the final chapter. One question that stood out to me was, “How does it feel to dream and create the future?” (p. 193). I want to end my critical summary by underlining how Wade not only asks us to envision what collective liberation would look and feel like, but also calls on us to be creative and bold in how we carry out the work personally and collectively to reach collective liberation.
Reference
Wade, S. (2023). Birthing Liberation: How Reproductive Justice Can Set Us Free. Chicago Review Press Incorporated.
Betel S. Tesfamariam (she/her)
Multidisciplinary researcher, educator, co-creator of @remediesofloveherbals, creative, & full-spectrum doula in training with BADT
MA, Gender, Feminist, & Women’s Studies
BA, Environmental Justice & Africana/Black Studies
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