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.