Group pre and postnatal fitness

Okay, so, a disclaimer first:  I’ve always loved aerobics classes.  It comes from having been a dancer for most of my life (I quit when I was around 26 or so).  I love following along with the choreography, I even love the stupid versions of bad Top 40 music (okay, with the exception of aerobicized versions of Celine Dion, to whom my sister and I like to refer as Sea Lion—she’s never good, even all jazzed up at 150 beats per minute).  I just love aerobics classes.  I love them enough that I was compelled to become a group fitness instructor myself back when my first child was about 18 months old.  (I admit I also liked the idea of getting a free gym membership as part of my teaching job, and the accountability of being an instructor—if you’re teaching the class, you kind of have to show up at the gym, no excuses.) 

Working out solo can be great:  there’s something awesome about plugging in the headphones, turning up your iPod, and zoning out while running or lifting weights.  But there’s something particularly inspiring about getting in a room with a group of other people, zoning in, feeding off each other’s energy, and moving together.  I found that group exercise was especially important for me when I was pregnant and caring for a newborn.

Ironically, considering my work now with Fit 4 Two, I didn’t exercise a lot during either of my pregnancies.  I had hyperemesis twice (lucky me!) so most of the time I was just happy to be able to get from my bedroom to the living room, or on a really good day to work and back, without falling over from nausea and exhaustion.  I certainly wasn’t able to keep up my pre-pregnancy exercise routines, which consisted before my first of going to the gym for aerobics and weights, and before my second of running 10k five or six times a week.  Of course that added insult to injury:  not only did I feel terribly sick and disappointed that my pregnancies were so crappy, I also felt shut in and isolated, unable to do the things I loved to do and cut off from people who might have had a clear sense of what I was going through. 

The one activity I was able to join in both cases was prenatal yoga, from early in the second trimester, when the worst of the vomiting had stopped, through to the end.  I only went once a week, but it was a godsend.  It didn’t get rid of my nausea, by any means, but it gave me a sense of calm about it, however temporary.  My usual Gumby-like flexibility plus all the relaxin flowing through my body made the stretching feel awesome, and in both cases I learned amazing visualization, breathing and vocalization techniques that were invaluable in labour.  (I can still hear my second teacher Lillian’s captivating Spanish-accented voice intoning with gently rolling Rs, “Relax your pink rrrrrrrrose!”) 

The other reason I went to prenatal yoga, and then again to postnatal yoga after my kids were born, was because it was a way to meet other pregnant women/moms.  In my first pregnancy, I was young (23) and knew pretty much no one else with kids.  In my second I was less young, but I still didn’t know many people with babies, and in fact we were relatively new in town so I didn’t know many people, period. 

Going to yoga classes was good for me physically and it was also good for me personally.  I didn’t make forever-friends in any of the classes, but I made connections that worked for me at the time, that reduced the sense of isolation that is common for women with new babies, and that gave me a network of people with whom I could commiserate about the ups and downs of pregnancy, birth and the early days of parenting.  Once a week, I got to check in with a group of women whose pregnancies and/or babies interested me, and who expressed both empathy and excitement about mine.  Those weekly 90-minute stretches were invaluable.

I look back at both my pregnancies and wish I’d been able to find more resources like the pre/postnatal yoga I did.  I wish I’d felt well enough to seek out information about other kinds of pre and postnatal fitness classes.  Again, I don’t imagine they would have cured my hyperemesis, but I suspect they might have made it easier to endure, as research has shown without a doubt that exercise can do wonders for relieving many of the discomforts of pregnancy. 

After my first baby was born, I resumed my pre-pregnancy activities quickly—I had an easy birth, and I went back to ballet class 13 days postpartum.  But it wasn’t always fun, and in fact it was downright stressful worrying about whether or not my baby needed to nurse while trying to get through the barre, or hoping that she’d be content in the childminding room at the gym long enough for me to do a full cardio routine.  With my second, and following a c-section, it took longer to get back into fitness, and when I did it tended to be a grim experience where I’d nurse, then race to layer on my winter running gear, bundle the baby into the stroller, and then hope hope hope that I could actually get out for the run before she needed to nurse again or have her diaper changed.  Not exactly baby- or mom-friendly! I restored my muscle tone and my cardiovascular capacity, but at what price?  (And let’s not even discuss the fact that running with the baby in the stroller so early totally ignored Safe Kids Canada’s guidelines for stroller safety.  Yikes.)

I remember wishing at the time that there was a better way, and I’m thrilled to say that thanks to discovering Fit 4 Two, I’ve found that there is.  I know this sounds like an infomercial, but I swear it is not—it’s more, to use an Oprah-ism, me sharing one of my own ‘a-ha!’ moments.  I found out about Fit 4 Two on the advice of a local doula and childbirth educator, who suggested it to me when I mentioned I was interested in combining my interests in childbirth education with my fitness and teaching background.  And as soon as I learned about the company’s values and approaches, I was hooked.  One thing that we stress is the idea of building relationships:  fitness is not just about exercise, it’s about increasing our health in multiple different ways, and that includes building networks of people who can offer friendship, guidance and support.

When I was student-teaching a Stroller Fitness class in Vancouver a couple of weeks ago, I was struck by how frequently during the power walking segments the women would fall into groups of two or three and start chatting about things they were experiencing with their babies.  Sometimes we had to remind them to focus on their walking, but sometimes we also let them be, knowing that the social benefit at that stage of life can have as much value as the physical benefit—knowing, in other words, that fitness is about a lot more than raising your heart rate or strengthening your muscles.  True fitness is holistic, encompassing many different aspects of a person’s life.  (Of course we also knew that it would only be a few more minutes before the chatting would end and we’d get them into another set of more focused activity—they’d paid for an exercise class, and they definitely got one!)

I’m excited to start teaching my own pre and postnatal fitness classes this fall.  I love group fitness, I love teaching, I’m kind of obsessed with all things birth-y, and I can’t wait to provide opportunities for women during a unique time in their lives to find comfort for themselves, to keep their bodies feeling as strong and healthy as possible, to develop the physical confidence and techniques that can lead to a more satisfying labour and birth and an easier postpartum recovery, and to link with other women.  I love the idea of teaching classes where women can get a great workout and, in the postpartum classes, still be able to be with their babies and tend to their needs.  (Big shout out to the women who nursed while doing plie squats at Stroller Bootcamp:  WOW!)  It’s no exaggeration to say that getting involved with Fit 4 Two is for me a real labour of love.  I can’t wait to get started.


Why I love doulas

I had dinner on Friday night at a friend’s place where, entirely by chance, half of the women were trained birth doulas.  I was thrilled.  I love doulas.  So much.  

There is a ton of research showing how beneficial it is for women to have doula support during labour and birth, and yet most women still don’t hire them and, from the sound of it, many prenatal health care providers still aren’t recommending them to their clients.  I don’t feel like I’m exaggerating when I say that this is a terrible situation.  I try not to reduce every situation to my own experience, but then again, I also care about this particular issue because of my own experience, so… 

I had a doula with my first birth.  I first learned about doulas soon after I got pregnant, although I can’t remember where, when or from whom.  At the time, an old friend of my husband’s was in midwifery school, and the plan was for her to attend our birth and act as my doula.  Since she was commuting a long distance for school, she also arranged a back-up doula for us (another friend of hers, who had been a doula for some years by then) just in case she wasn’t able to get to us in time.  In the last few weeks of my pregnancy, both our friend and her back-up came to my house a number of times to talk, to help me write my birth plan, to give me massages, to help me cope as my EDD passed and day after day after day after day I remained pregnant. 

When I was finally in labour, as luck would have it, our friend was busy attending the labour of her sister-in-law, so her back-up came into play.  

13 and a half years later, Lolli still holds a special place in my heart.  When I think about my labour with Clea, her image comes to mind every time.  It’s not that I think she made the birth a good birth—it had its own path and its own energy, and it was just good in and of itself.  But she helped me, a first-time mother, to experience it in the most positive way.

That was no mean feat.  My labour with Clea was induced with Cervidil at 41 weeks 3 days.  There was no medical indication for the induction; I was just done with being pregnant.  Leaving aside the problems with that line of decision making (of which I was not aware at the time and I’m grateful didn’t materialize), inductions tend to stimulate harder contractions.  Many women are not able to manage labour unmedicated after an induction for exactly this reason.  Sure enough, for much of my labour, the contractions were hard and strong, piggy-backing one on top of the other for three or four hours.

I remember sitting on the kitchen floor when I realized it was time to call Lolli.  (My doctor gave me a dose of Cervidil and then sent me home to labour in peace.)  My mum and dad were there, with my husband.  When Lolli arrived I was just drifting into that labour zone where time no longer has any meaning and the whole world kind of disappears.  I remember being on the couch, feeling mildly anxious, when she came in the door sometime around 10 or 11 pm.  The first thing she did was send my mum and dad home (“time for everyone to go now”) and walk around turning off lights and closing curtains.  “It’s night time,” she explained to me, simply.

I have no idea about chronology after that point, what happened when, in what order.  All I know is that Lolli was there.  She ran me a bath and sat quietly beside the tub as I slept between contractions, and she was ready and waiting to pour water over me when each contraction crested.  Out of the tub, at some point, I remember that she took my hands, put her face close to mine and said firmly, “Open your eyes.  Look at me.  Don’t let the contractions swallow you up.  Keep your eyes open and look at me.”  I remember that moment like it was a lifeline, locking eyes, re-centering myself.  I remember her tucking Paul and I into bed at some point, telling us to try to rest—again, “It’s night time.”  And I remember being woken by the “pop” of my water breaking, having no idea what the sound was, and Lolli laughing gently, and explaining to me with a smile what had happened.

Of course, that was the point at which the piggy-back contractions began.  Transition—those last few centimeters of dilation, which most women experience as the most intense part of labour—came soon afterward, and I really went far into the alternate realm that is hard labour.  Lolli wiped the toilet seat lid when I barfed on it, unable to wait till—frankly, not caring if—it was open.  She helped me down the front stairs to the car when it was time to go to the hospital.  She instructed my husband to run the red light at the intersection of 25th and Oak as there was no traffic anywhere in sight, and the backseat of a car is not the best place to manage transition contractions.  

She laughed with the labour and delivery nurses about my choice of music to play at the hospital—a mixed tape (please—this was 1997) that included everything from Duran Duran to The Smiths to the soundtrack to Evita (London cast).  She didn’t laugh at me when I requested an epidural, even though she knew it was way too late for that, and she saved the waiver that I signed during a contraction—my signature drifting up and off the top right hand corner of the page—and gave it to me the next day to tuck into Clea’s baby book. 

She called my mother when I decided, at the last minute, that I wanted her there.  During the pushing stage, I was absolutely focused, totally unaware of anything outside of my own body.  Lolli was conscious for me.  At one point, she poked me in the shoulder hard enough to jar me to reality, just long enough for me to hear her say, “Your doctor is going to cut you.  Your birth plan says you don’t want an episiotomy.”  In that brief moment of clarity, I sat straight up, told my doctor, “Do not cut me.”  And she didn’t.

Lolli helped me nurse Clea right after she was born.  She made sure that the hospital kept us together.  “But,” the nurse said, “we have no free beds in postpartum yet—we’ll take the baby to the nursery until we can find a bed.”  “No,” Lolli told her, “keep them together.”  “But we have no diapers!”  “It doesn’ t matter.  Keep them together.” 

She stayed with me while Paul went home to shower and change.  She stayed until I fell asleep, snuggled up with my newborn.  She came to my house the next day when I was home again, to talk about my labour, to go through it all with me, to make sure Clea was nursing well.  She returned a few days later to check in again.  I remember sitting on the living room couch with her—the couch where I’d been sitting when she first came in the door—and the way she gazed at my baby and put her arm around my shoulders, and just feeling like she was this incredible gift.

I still feel that way now.  I didn’t hire a doula for my second birth, as I didn’t think it was necessary.  I was planning a homebirth, and would have two midwives there; a doula would be redundant, right?  Wrong.  So wrong.  I can’t say that a doula could have prevented the complications that arose or the surgery that resulted.  And our midwife (since the labour/delivery ended up being at the hospital only one midwife was there) was incredibly attentive not only throughout the day, but through the stress-filled, complicated week that led up to it.

But I could have used a doula.  I could have really used someone who was there only for me—not for my baby, just for me.  Who had nothing more invested in the scenario than to support and help me.  Who wasn’t watching monitors or checking dilation or recommending any procedures, but who would have been watching my face and hearing my voice, doing laps around the hospital with me and my husband, or maybe urging me to stop doing laps, stop trying so hard to make things happen and instead just look me in the eye and help me experience each moment for the moment it was.  Who knows what a doula might have been able to help me do? 

Doulas are indispensable.  Hospital birth, home birth, birth centre, midwife, doctor…doesn’t matter.  Hire a doula.  If I could do my second birth over, that’s the first thing I would do differently.  I can’t say with any certainty it would have made a difference to the progression or outcome, but I am pretty sure it would have made a difference to me

Hire a doula.

Resisting erasure

This post by Courtroom Mama makes me want to stand up and cheer.   It confronts a common tendency to counter natural birth advocacy with the claim that any critique of mainstream birth practice is automatically a self-righteous judgment and denigration of the women who move through that system.  This line of argument declares natural birth advocacy irrelevant—or worse, anti-feminist—by claiming that those who work to expose the problems in the mainstream system are actually working to limit women’s birth choices.

Courtroom Mama takes on an issue that has great personal relevance for me.  My own advocacy work really started after having my second baby by c-section, when I realized that the current system makes it virtually impossible for women to know whether or not they are receiving appropriate maternity and birth care.  Unnecessary interventions are so common—in both medical and midwifery models of care—and misinformation and fear are so ingrained as the basis on which both health care providers and the women they serve make decisions that I’ve begun to wonder if “informed choice” in prenatal and birth care can ever be more than a pipe dream.

Part of my struggle to come to terms with my c-section has been acknowledging that no matter how educated an individual woman is (I knew a lot) or how skillful and trustworthy her providers are (my midwives, and the OBs on call at the hospital the day Annika was delivered, were awesome), the system sucks.   Although unassisted birth is not for me, I can understand why some women choose to move as far away from formal prenatal and birth care as possible, to try their damndest to get outside of a fundamentally broken system.  Because however risky birthing unassisted might seem to many of us, the fact remains that the mainstream system is just as risky in its own unique ways.

And it’s this denial of risky-ness in the mainstream that has been at the heart of my struggle.  It’s the fact that if you walk into a hospital in labour you are all too likely to come out with unnecessary stitches, or to be treated like an object instead of a subject at the moment when you are most vulnerable, and then to face a world that denies not only your right to complain but to even acknowledge that you’ve been treated like crap. 

It seems that the mere acknowledgment that it is normal for women to be treated poorly during pregnancy and birth—to be treated with disrespect, to have their bodies manipulated unnecessarily as a result of, frankly, bad science—is so threatening that there is a veritable cottage industry dedicated to erasing our complaints. 

One of the most powerful forms of erasure is to flip the argument and claim that women who speak out against mainstream practice are just self-righteous whiners with nothing better to do than try to make other women feel bad about their birth experiences.  There’s no doubt that there are a lot of self-righteous whiners out there.  However, the world of natural birth advocacy certainly doesn’t have the market cornered on that.  Moreover, as Courtroom Mama puts it so succinctly, “just because someone is ambivalent about their birth experience,” it does not mean she thinks “that everyone MUST give birth in a certain way. This is horseshit.”

So, let’s put the name-calling aside where it belongs and focus on the more important issue here:  that women are speaking out of turn,  and that telling us to shut up, for whatever reason, just isn’t going to work anymore, especially if it’s because it makes you have to think about your own experiences from a critical perspective.  That is not self-righteousness; that is unapologetic analysis allowed to make whatever impact it makes as individuals digest and apply it. 

Ultimately, as Courtroom Mama explains, advocacy in this context is not about telling anyone what to do.  There are political implications when women choose medicalized births.  Those choices shore up a system that does as much harm as good.  But would I ever deny a woman the right to choose that kind of birth?  Absolutely not.  Yet I will still critique it.  Why?  Because the only way to make change is to take the risk of questioning the status quo.  Those questions might hurt sometimes.  Believe me, I’ve been on the receiving end of the hurtful questioning, so I do understand.  And at the same time, the questioning must continue because I don’t believe women really do get to make choices unless we actually have options, and the only way to actually have options is to be sure that we have good information from trustworthy sources.   Right now, when it comes to pregnancy and birth, most of us just don’t.  And those of us who think we do (or in my case, thought we did) can’t even really be sure because the whole system—the research designs, the funding bodies that control the research, the peers who review it, the journals that publish it, the providers who put it into practice—is so completely twisted and separated from what should be fundamental, which is giving all women appropriate and safe care. I wish it were different, but wishing won’t make it so—questioning might.

My favorite part of Courtroom Mama’s post is where she writes, “there is an ideal way to give birth, but not a right procedure. The right way is the way that leaves the mother feeling at peace with the birth. If she’s at peace with her elective cesarean or her epidural or her water birth, that is the right way. If she’s left feeling disempowered, scared, unsure, this is the wrong way.”  Indeed, this is the crux of my argument, and the sentiment that motivates my work.  Women deserve to feel at peace with their birth experiences, and confident about their birth choices.  When I question common birth practices, it’s not to make anyone feel bad—there is already more than enough sadness and pain going around in this context.  Rather, it’s to make that peace and confidence possible for more women, to insist that regular women—not only doctors and midwives—have the right to be part of conversations about birth, to say what we like or don’t like, what works or doesn’t work, and to be heard, whether or not people like what we have to say.

When will my body go back to normal?

I don’t know what the statistics are on this, but I wouldn’t be surprised if one of the top concerns most women have going into pregnancy is about weight:  Will I gain too much?  Will I be able to lose it all when the pregnancy is done?   Will my body ever go back to normal?

I’ve devoted a lot of time to helping my fitness clients establish positive goals.  While I accept that many people exercise in order to lose weight—and that there are many people who do fit the medical criteria indicating a need for weight loss, and that they come to me because I know how to help them achieve that goal—I encourage my clients to think about the ways in which physical activity can build their bodies, rather than whittle them away. 

I can’t think of a more important context for this approach than in working with pregnant and postpartum women. 

I understand from both a personal and an intellectual perspective how hard it is to fight against the cultural grain that compels women during pregnancy and breastfeeding, when they are single-handedly creating and sustaining a whole other human life (or lives, in the case of multiple births), to try to remain as small as possible.   Like many other women, I struggled with body image issues while pregnant and postpartum.  Tragically, body image issues were part of what killed my nursing relationship with my first child after only 4 months.  And with my second baby, body image issues were a lot of what motivated me to go out and run 10 kilometres barely 7 weeks after my c-section, while pushing my baby in a jogging stroller—not something I would ever recommend to a client.

Still, while I agonized over ever again being able to fit into non-maternity pants, and grudgingly bought bras in sizes I thought were reserved only for porn stars and people addicted to cosmetic surgery, I tried to remind myself that weight gain in pregnancy is not only normal, but necessary.   And while some women lose all of their ‘baby weight’ within weeks of birth, there is no moral failure involved for those (like me) who don’t.  

Yet it’s hard not to get obsessive about body image while pregnant.  Everyone has an opinion about your size, and somehow all social graces that normally prohibit unsolicited commentary disappear.  Suddenly, everyone and their brother will tell you whether you are too big or too small, and compare you with their mother/aunt/sister/friend/cousin who gained a ton of weight/didn’t gain enough weight/barely looked pregnant/everyone thought was carrying twins because she was SO HUGE, etc.  

When I was about 14 weeks along with my second baby, I went for a manicure.  I’d spent months on my couch with debilitating nausea, and on the first day when I felt even remotely capable of leaving the house, my husband tried to cheer me up with a gift certificate to the salon. As I sat having my nails painted, the manicurist started trying to sell me electronic “firming treatments” intended to slim “problem areas.”  I explained that I wasn’t interested in trying to lose weight—I was pregnant.  But she didn’t miss a beat:  “Oh,” she exclaimed, “then you’ll really want to know about this for after the baby!”  And she wasn’t stopped when I tried to explain, politely, that no, actually, I didn’t want to know.  The sales pitch continued.  Needless to say, she never got to do my nails again.

But avoiding the rude manicurist didn’t solve my problem because there were more people around every corner waiting to put in their two cents regarding the size of my pregnant body.  And their judgments varied widely.  On one single day, when I was about 7.5 months along, one person declared that I was “HUGE—all baby!” while another –less than an hour later—clucked, “You’re so small!  Are you sure your dates are right?!”   There’s only so much of this crazy-making commentary a person can take.  By 8 months, and after a note on alluding to the hypnotic appearance of my pregnant décolletage (I defy anyone to find maternity wear that is both appropriate for teaching and won’t make you melt while lecturing in an 85-degree classroom—something had to give, and by that point there was no question that I was going to choose comfort over modesty), I was ready to bar the door and just stay home rather than deal with any more of it.

It’s tempting to comment on pregnant bodies.  They’re awesome, and for a lot of us they’re unusual, and when the body is a friend’s or a relative’s, it’s intriguing to see how someone we know so well can change so much in such a short time.   I’m not saying that all comments should be verboten.  But it might be worth thinking about how a seemingly innocuous comment about the size of a belly might also be a judgment of the degree to which a pregnant body conforms to or challenges the dominant culture of thinness.   

It is similarly worth asking why we expect women’s bodies to bear no lasting markers of pregnancy, one of life’s most major events.   When will my body go back to normal?  Never.  Because you’ll never have not been pregnant again.  I wish it were more acceptable to abandon the old normal in favour of the new.  I wish that women’s default would not be to ‘get back to normal,’ but instead to find a new balance, new strengths, and new possibilities.   This does not, by any means, mean welcoming maternity jeans permanently into your post-pregnancy wardrobe.  But it does mean that if you’re still wearing them when your baby is 3 months old, it’s not the end of the world.  New mothers have better things to do with their time than worry about the size of their pants.  And they can have more fulfilling, effective workouts if they can focus their minds on something more productive than shrinking.

When I teach fitness, I try to never talk about weight or shape.  I figure that everyone is already thinking about these things anyway; what if we try a different approach? 

Go with me on this radical idea.  What if, instead of focusing on pounds and inches and lumps and bumps, we talk about strength and power, and feeling capable of meeting life’s physical challenges?  What if we recognize weight gain during pregnancy as a normal and sensible adaptation to new physical demands?  What if we accept that some women’s bodies need more fat stores than others in order to support lactation?  What if we stop cajoling women to have some lovey-dovey, Pollyanna-ish sense of self-acceptance and instead validate that they live in a culture that is hostile to all fat—but maternal fat in particular—and that fighting against it is really, really hard?  What if we take active steps to help women understand that their bodies are as individual as the rest of them—just as no two people think alike, no two people look alike, and no two bodies respond in exactly the same way to pregnancy and nursing–and they need to learn individualized responses to their bodies’ new needs?  What if we talk about building stamina for labour, and preparing physically for the sleep-deprivation and marathon nursing sessions that are par for the course during the postpartum phase?  What if we stop trying to convince women—pregnant, postpartum, and otherwise—to disappear?  What if? 

I don’t think women would stop exercising.  In fact, I think a lot of women who otherwise wouldn’t exercise might start.  Because it would become an activity that helps them feel valuable, powerful and good, instead of something focused on reduction, depletion, and annihilation. 

 I have been scale-free since 2005.  I remained scale-free throughout my second pregnancy the following year (with the support of my midwives), so I actually don’t know how much weight I gained or how long it took to lose it, or whether I have actually lost it all.  I know that by my daughter’s first birthday, most of my pre-baby clothes fit again.   Some still don’t.  Because not only do we gain weight when pregnant, our body shape changes.   That can be hard to accept.  It was (is) definitely hard for me.  But it’s reality, and it’s not all bad.  I’m stronger than I was before Annika was born, and I’ve come through major surgery, nursed for 2.5 years, earned a third academic degree, gotten several new jobs, and done a million other things that make me a different person from who I was before she was conceived.  So my sundresses I bought at Old Navy in 2004 don’t fit anymore.  Big deal.  They’re probably out of style now anyway. 

So, I ask myself frequently how I’ll respond to women who come to my pre- and postnatal fitness classes with the intention of a) limiting their weight gain during pregnancy, and b) shedding the pounds afterward.  There’s nothing inherently wrong with either goal, and in fact there can be value in both.  Moreover, I don’t want to add another layer of judgment to their lives, as if the goals that motivate them to get moving are somehow wrong or inappropriate.  I do, however, hope to help my pre- and postnatal clients to expand or perhaps refocus their goals.  I want to help women understand the physiological changes they are going through, how to make the most of the unique time in life that is the childbearing year, and to find joy in the challenge of moving their pregnant and postpartum bodies.  By working with them to make fitness a regular part of their lives, I want to help women feel proud of the bodies they have earned, and enriched by the experience of using those bodies to create and then sustain new life.

A Crisis in the Crib

As a pre and postnatal fitness specialist and a student childbirth educator, I am building my resume as a birth professional, and I am building it on top of my background as a PhD-level historian who specializes in the social, political, economic and cultural legacies of slavery and segregation in the 20th– and 21st-century United States.  Most people think my two professional personas are entirely unrelated.  I know otherwise, and I rarely see the links illustrated so clearly as in Tonya Lewis Lee’s documentary, A Crisis in the Crib.

Lee focuses on health disparities in Shelby County, Tennessee, the county that is home to the great city of Memphis. She outlines the health challenges that African American parents in the county face, and the ways in which they and their children suffer from widespread, systemic inequality. Poverty and stress contribute in major ways to African American women across the nation—of varying levels of education, including those with college degrees—giving birth at far higher rates to pre-term and low birth weight babies, a proportion of whom die within their first year as a result.  

The documentary follows a group of students who work together as preconception peer educators to try and instigate a grassroots effort to improve outcomes for black mothers and children.  It highlights commentary by a range of prominent health researchers and clinicians who identify the problems they see and suggest solutions, all of which centre on the point that black babies do not have to be born small or die young.  Although it has become normal over 400 years for African Americans to be less healthy than white Americans, it does not have to continue to be that way.

In a recent talk I gave on reproductive justice for people of colour in the United States, I quoted the following statistics:  In the United States today, the maternal mortality rate for black women is 3.4 times higher than for white women.  Black babies are 2.3 times more likely than white to die during birth, and 1.8 times more likely to die from SIDS.  Black women are 2.5 times more likely to receive late prenatal care or no prenatal care at all.

These statistics are sobering on many levels, but not least of all when we think about the deep injustice of allowing the children of women who quite literally gave birth to the nation to die untimely deaths.  If not for black women’s reproductive labour, the United States as we know it today would not exist. 

Black women’s reproduction has been a political issue since the 17th century, when the early American colonists defined slavery as a hereditary condition passed through the mother.  In other words, no matter what the father’s identity—a slave of African descent, a white European indentured servant or worker, or a white planter or master—enslaved mothers gave birth to enslaved children, thus building the enslaved population one baby at a time.  Black women as mothers were therefore the keystone in the system of slavery, the system that enabled American economic, political and cultural growth and development.  To say that the United States was built in the wombs of black women is no exaggeration. 

Nearly 300 years of slavery, and the formal and informal systems of segregation that followed in the century and a half since, have left a specific mark on the lives of black women, leaving them vulnerable to all measure of abuse.  This is especially clear when we look at the issue of reproduction. As slaves, African American women were compelled to create property for their masters, to understand the painful truth that on a legal level, the children they birthed were not their own.  As free people in the twentieth century, they have been roundly condemned for having babies at all, caricatured in the later decades as “welfare queens” and irresponsible single mothers, and/or victimized by campaigns that forced sterilization without consent and tied government economic support to compulsory contraception. Talk about being damned if you do and damned if you don’t.

African American women have resisted this abuse and victimization since the moment it began, but they have fought against a government and a society with little empathy and a seemingly inexhaustible willingness to continue sacrificing their health and wellbeing for economic gain.  The reasons why are complex, but to put it very simply, American society has evolved into a place where there is an often unspoken acceptance of the notion that black women and children just don’t matter very much. 

In so-called “post-racial” 2010, African American babies are paying the price for a society in which racism is so deeply entrenched that we often don’t see it at all.  Ironically, despite their original national significance and their basic humanity, which should be but is not enough to guarantee them at least minimal protection and care, black children are more likely to be born less healthy and die early.  No matter how responsible an individual mother may be, or how privileged, mothers who are black bear children whose lives are at risk for reasons that are entirely preventable but which racism precludes most of us from seeing or taking seriously.

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