Saturday, July 9, 2016

Final Blog Post of 2016

Dear Village,
This will be my final post for the year 2016.  I am taking time off from blogging to devote to completing my book, "Birthing While Black; how racism and white privilege kills Black babies."  We are living in very difficult times.  When I watch my TV and see thousands marching in the streets of American cities, I know change is coming.  Whether it be for the better or worse, I do not know.  All I know is that now is the time to add my voice to the conversation.  Now is the time for the publication of my book.  I will not only complete my book, but also write curriculum for my new cultural congruency training for maternal infant health organizations.  I hope to complete both by December and start offering my curriculum in 2017 as well as (hopefully) a book tour.  I am greatly disturbed by what is happening in our country, as are many of you.  This is the contribution to that dialog that is for me to make.  Thank you to those who continue to hear my voice.

Sunday, April 17, 2016

MIDWIFE X

Today I took a dear friend out to lunch and had the misfortune of sitting behind two white female OBs.  I couldn't help but hear them loudly exclaim that they knew exactly what THOSE women needed to do to improve their birth outcomes.   If I hear one more arrogant white person state what we need....I swear I'll explode.  Truth be told what we need is a whole lot fewer arrogant white obstetricians thinking they know what ails us.  What ails us is them.  They are our problem, along with the entire healthcare system they rode in on. This also happened last month when I attended a monthly meeting on infant mortality and listened to blatant indictment of Black women as the cause of Black infant death.  It simply is not so. All across the country I hear this, Black women, Black families, the Black community blamed for Black infant deaths.   Deaths that are entirely preventable.  Deaths that aren't prevented because Black lives don't matter in this country.  Deaths that are caused by systemically racist healthcare and economic systems that fail Black women and Black families. I want to scream at the top of my lungs and I shall.  Our hands are not the hands bloody with these deaths. Listening to those women smugly and arrogantly parcel out advice from high atop their mountain of privilege made me want to come up with my own list of demands that point out the true villains when it come to Black infant mortality.








BLACK WOMEN'S MATERNITY CARE MANIFESTO








Number One: (to Black women)
Whenever you can, wherever you can, opt out of the system.  This system is not intended for you, means you no good, and is largely responsible for your poor outcomes, while blaming you for them.  Get out, however and whenever you can.  Look for alternative ways to get your healthcare.  Look for alternative providers.  Pay for your own care, after all you really do get what you pay for.  The 'free' government run system will keep us and our babies sick and dying. Get out of it if you can.








Number Two: (to Black people)
We are not who they say we are.  They pathologize us, but we are not pathology.  It is not our bodies or our culture that is flawed it their system.  Their flawed system pathologizes us.  Our bodies are strong.  Our minds are strong. Our collective will is strong.  We have survived everything they have brought against us.  We are still here.  We still survive.  Now it is time to thrive.




Number Three: (to white careproviders)
Take your white hands off my Black body.  Until you can see me, hear me, respect me, love me you have no business touching me. Every touch will be an act of violence upon my person.  You do not have permission to touch me until you can see me. Until you can look at me as a real person and not a caricature or a stereotype, you may not touch me. Until you can actually listen to the sound of my voice and hear and respect what I have to say and not dismiss me, you may not touch me. You haven't earned the right.




Number Four: (to white people)
Allieship on our terms.  You are allies when we say so and how.  Otherwise your allieship is not to be trusted. You are not to be trusted.  You do not even know when you are being untrustworthy.  You must depend on our guidance and our say so.  If you are not willing to do this, we have no use of you.                                                                                                                                                                                                                                                                                                                                                                                                                                                  


Number Five: (to the Black community)
Cultivate our own maternity care system.  We must restore our community midwives.  We must invest in midwifery schools and the midwifery arts.  We must train our own to serve our own.  We are the solution to the healthcare crisis that plagues our communities.  Outsiders can only play a limited role, if any in relieving us of this burden of health outcome disparities.  We must do it for ourselves.

Saturday, March 12, 2016

The Colonization of Black Birthing Bodies

I attended a community meeting this past week.  The meeting purpose was to examine causes for infant deaths in our community (which overwhelmingly happen to Black and Brown babies).  Despite the fact that I was surrounded by leading professionals who were knowledgeable about all aspects of maternity and newborn care, the best they could come up with was to blame the victims (the mothers) themselves.  There was no critical examination of the role of systemic racism within policies that kept them locked out of care.  Only criticism of imagined failures of each mother as her case was presented.  When I tried to point out that there may be other factors, there was deafening silence.  I was told later by another party that my words were being dismissed by other participants because they had faith that the system was delivering good care. 
Well I have no such faith.  I have watched Black and Brown women be chewed up and spit out by the system for decades now.  Our current system of maternity care for low resource women is toxic and punitive. Privileged whites have no business judging Black and Brown women's healthcare decision making- they should be seeking to understand why they make the decisions they do.  The paternalism and assumption of rightness is maddening. 
It is self-righteous attitudes like these that keep the system from being accountable to those it allegedly serves.  The 'system' is deemed above reproach.  Black and Brown women are not.  Let's add insult to the injury of the death of a baby by questioning the mothers habits and motives.  This is why we need to focus on system's change.  No one is asking why Black and Brown women are twice as likely to be tested for drug use (when they are not twice as likely to use drugs).  In my state it takes weeks if not months to be added to Medicaid and the mothers languish while they wade through a system sorely in need of an update.  This is yet another example of hatred parading as helpfulness.  The healthcare system is full of such landmines for Black and Brown women.  They too believe the system to be altruistic, at least until they experience it for themselves.
We have got to do better.  We have got to be more intentional about examining how we arrive at certain outcomes. As I travel across the country I see more of the same.  Legions of white providers that have written off their Black and Brown patients as irredeemable, while giving themselves complete immunity for their own implicitness in those terrible outcomes.  While the lone voice of the professional of color is criticized for not bearing the party line.    Where is the hope in this?  How long will our bodies bear the brunt of suffering from white judgment and white indifference?  When will corrupt systems be made whole, so that we are enriched rather diminished by our interactions with them? 
I think it may be- when we create our own.

Monday, March 7, 2016

What We Have Here is a Failure to Communicate

I've given a lot of thought lately to what it means to be connected in a common cause.  I can't give up on allyship, but I have grown increasingly frustrated with it.  The more I do this work, the more work I see that there is to be done.  As I sat at a table with an elderly mother to mother support group leader this past weekend, trying to communicate the concept of systemic racism and the resulting inequities that exists within organizations and institutions, I realized we had no basis for a conversation.  Our common verbiage meant different things. True communication was not taking place.  We didn't even have enough in common to have a conversation.  She looked hurt and so puzzled.  Was I saying they had not done the right thing?  Were not doing the right thing?  That's just it, I said.  What you perceive to be the 'right thing' is grounded in your own ethics and ideology, not ours.  We are not on the same page about anything at all.  What she perceives and what I perceive are worlds apart.  She was very far out from beginning to hear my message.  She was too stunned to have to accept that I did not accept 'her truths' as 'my truths.'I could tell she walked away from our conversation with a heavy heart.  She is at a precarious point.  She could just as easily reject as accept my point of view.  It is difficult to accept that your thinking for so long has been really wrong on something.  When it comes to health disparities, White people will have to accept some culpability right off the bat.  For a) establishing and maintaining corrosive and corruptive systems that harm people of color continuously and b) for failing to recognize them as such.  This fantasy world view must first be shattered.  Its a very difficult and disorienting journey, but one that must be undertaken if any progress is to be made.  If you are a White person and consider yourself an 'ally' but you don't feel as though your world has been shaken to the core or that everything you hold dear has been challenged, then you are not there.   You have not arrived and your usefulness as an ally is truly debatable.   Listen to this account I had with a friend on Facebook:


Last night I hung out with my dear friend Karen. We taught an evening CPR class together and then went out in search of drinks. I was broke (per usual) and all she had on her was her "Apple Pay". We could not find a bar that took Apple Pay so we went to a late night Whole Foods and settled for soup and soda. As we laughed and talked, the conversation turned serious, and Karen (whom I've known and loved for nearly 20 years) began to tell me how she had been challenged by my Facebook page. I know that many of my former white friends have fled my page- some not before telling me how wrong I am. Karen said at first she felt just like those that left, she felt shocked and challenged by the things I was saying, but she didn't leave. She didn't unfriend me. She stayed and continued to listen even when she didn't understand why I was saying the things I was saying. She continued to read everything I posted. She too had grown up impoverished and didn't see how White Priviledge applied to her. And then one day, it happened. After reading someone else's post on the subject- a white person's- she suddenly understood. She said from that point on she began to see the small injustices, and what was worse, she couldn't unsee it. She talked about how disturbing and unsettling this kind of paradigm shift is. For forty plus years, she thought the world was one thing, and then found out it was quite another. As time goes on she notices things on a daily basis. How we all live steeped in this racist ideology that is American culture. She is a nurse, and as I've always contended, surely there's no American institution more corrupt, more morally bankrupt than healthcare. There is plenty for her to see. Karen says the discomfort is tremendous, and worst of all, she doesn't know what to do about it. She says its as though her dreams have been shattered. The world she thought she lived in does not actually exist. She compared it to the plot of The Matrix (a movie I have not seen). She says she is trying to find her way in this new, darker reality. She lives now in this uneven shaky world, surrounded by other white people who still live in the illusion. I can understand the supreme discomfort of this, but I resist expressing sympathy. After all, I never got to be a part of the illusion. I tell her that what she has to do now is tell others. Starting with her children. And her husband. Of course they won't believe her at first (maybe not ever), they'll deny and castigate her. They'll deny that they are racist or can be racist. But she must stand in her truth and speak the truth whatever comes her way. After all, she now knows the truth, and there is no going back from it. (Like after I had my first homebirth, I could never love hospital birth again.) I was so excited to hear that Karen had 'crossed over'. I have a daily onslaught of dealing with folks who think they have, but have only done so theoretically, but never had that 'road to damascus' conversion. They have adopted an intellectual argument, but they are not truly changed. They can talk the talk, but their truest selves peak out from behind the curtain and reveals itself. Those individuals are exhausting and come in no short supply. White people like Karen, who finally at long last 'get it' are few and far between. I know when I am in their presence because they are the only White people who do not drain my energy- and those encounters are rare indeed. I tell her that her discomfort is my salvation. Only when the mass of White people have reached the point where she is at, can we begin to have a national dialog on racial reconcilliation, until that point, there is no common ground for conversation. After all how can someone in the real world share a common vision with someone living in an illusion?



This conversation is everything.  But it cannot be had until you are a puddle on the floor, or balled up in the fetal position with despair.  Only then can you be sure you have seen the light.  Until you as a White person reach this point, you are not helping me, you are using me to help you.  You are siphoning off my valuable time and energy to your own advantage.  Keep learning and listening- to and from other White people until understanding comes to you.  Until then, we are not even speaking the same language.  I know what I am asking takes humility.  White people are used to being right about things and its disorienting to hear about your mistakes from a person of color.  You'll have to get used to that.  You'll have to get used to a great many things in this new world of true equity where your thoughts and ideas take a back seat to others.  It will be odd living in a world where Whiteness is not centered, and the lens through which all reality is viewed, but you will get used to it. When you come out on the other side, you'll find me waiting.  

Friday, November 27, 2015

The Other Side of Adoption

Yes, I know I'm only the birth mother.  I realize my story is of less interest.  That I am much less important to the adoption story than the heroic and self sacrificing 'others.'  I understand that in the popular narrative, my role is to be 'brave and selfless' and place my baby into the hands of others more capable and competent than myself- and then go away, fade into the background, forever.  But I didn't go away forever.  I found my son, after 31 years of seeking him. just a brief year and a half ago.  Since that time, my life has become a roller-coaster of emotions.  I've long wanted to write about my reunion journey, knowing full well this is not the version of adoption that people will want to hear about.
A week ago, I spent my son's 33rd birthday with him.  I traveled to the city where he lives so that we could have our first official birthday celebration together, since the day of his birth.  He wanted to celebrate with his old and new family members and assembled an assorted crew that included his bio dad and myself, his bio dad's wife and daughter, and his brother, sister-in-law, and nephew.  Tossed together like some exotic mélange of Black and White, young and old, we formed a family of sorts, our commonality being our love for and deep devotion to my new found son.  As we sat in the restaurant he had chosen, and laughed, and joked, and shared stories, another family walked in.  Two White parents and two Black children.  I would not have noticed them, but my son pointed them out to me.  He asked me what I thought about that family.  I told him, they appeared to be a family formed by adoption and I did not think about adoption as I have previously thought.  A few days later, he asked me to expound on that statement.  We talked a good long while about the adoption process from my point of view.  A birth mother's point of view.  A Black birth mother's point of view. 
My own adoption experience has caused me to feel a very deep sense of betrayal.  My son did not have the life I thought adoption would afford him. The entire situation has left me feeling abused, abandoned, and misled.  Don't misunderstand.  Our reunion has been beautiful and wonderful.  I love the man that my son is, and I understand that the life he lived has made him thus, but it was a life I would not have chosen for him (did not choose for him).  Yes, I made the choice to give him up, and in doing so, gave up the rights to influence what kind of life he would have.  Even so, the popular narrative about adoption is a lie.  Birth mothers are only good and noble till they sign over their babies.  Then they immediately transform into drug addicted crack hoes whom their babies are better off without.  In the popular narrative, I'm the stupid, knocked up birth mother.  Having come back into my son's life, I'm not supposed to have an opinion, or feel anything but gratitude for the life he was given.  But I do have an opinion, and I do feel things other than gratitude. 

This journey has been equal parts sadness, joy, regret, and gratitude.  I love my son, with a deep yearning and longing that I lack the vocabulary to even describe.  I have endured his curiosity, his anger, his sorrow, and have now I think earned his love and respect.  When I tell him I love him at the end of our weekly calls, he now says it back.  I know there has been longing and yearning on his part as well.  He and his bio dad live in the same city and  see one another frequently.  My son has become a regular fixture in his bio dad's home. He is well loved by his bio dad's wife and daughter.  We have all tumbled together to become enmeshed in one anthers' lives.  It is good.  It is satisfying.  It is all that I hoped for and more.  But it does not erase the lies that adoption tells.

In this moment, I hate adoption.  I hate all that it stands for.  I hate the lies it tells about me, and I hate the lies it told my son.  I hate the lost years that I will never get back.  I hate the lost memories that will only be told to me in past tense stories.  I hate the lie that I did the right thing.  I don't know that.  I will never know if in fact I 'did the right thing.'  There is only what did occur and what I did do.  But I don't know that it what the RIGHT thing to do, or the BEST thing to do.  I had several choices.  I chose this.  I don't blame anyone else for the choice I made. But there was deceit in it. I bought into the propaganda that adoption would make everything okay.  I will never be okay again.  Along with what I've gained comes its close companion, what I have lost.  Knowing my son now, shows me in vivid detail, all that I have lost.  All that I have gained in no way makes up for what was lost.  I am left to sit here and mourn my losses silently, since all I should be expressing outwardly is my profound gratitude. I am grateful, but I have sorrow to match.
Moving forward is where my hope lies.  I look forward to knowing him, and creating our own memories.  He is my son, I am his mother. We begin there.



Sunday, October 4, 2015

The Reluctant Revolutionary

Just returned from a weekend retreat at a retreat center in central Missouri.  I met with the faculty of the future Uzazi Academie.  We are still in need of a midwife to teach the second and third year courses, but we have the first year covered.  Starting a CPM program is a large vision to hold, but so it a birth center and a prenatal clinic.  There is so much going on all at once.  I may be involved in creating a certification process for midwifery instructors and preceptors.  I am humbled by this work, but it must be done and no one else in my local community has stepped forward to do it.  Our community needs midwives now!  We need birthworkers from within our own communities.  Where are the Black nurses, midwives, doulas?  We need them now, and if they don't exist- we must cultivate our own.  There are marvelous women of color around the country doing great works- but there is so much more to be done.
Our retreat was full of making prayers and calling upon the Ancestors for wisdom.  There were five of us for the entire retreat with three more stopping in to join our circle for just a little while.   We had gatherings around the fire circle, with our facilitator, Sister Morningstar.  We gathered herbs, walked the creek, did journaling, feasted on delicious vegetarian meals, had drumming circles sang\songs, told stories, practice Village Prenatals, brain stormed and just took an opportunity to bond with one another.  We talked about what type of school we wanted to create and what our future students would look like.  We discussed the future of midwifery and where things are headed in the US.  We talked about how this systemic racism has sabotaged communities of color and set them up for failure.   We don't have high infant mortality rates because our bodies don't work, but because the system does not work for us.  We are creating a new system, one that works for communities of color because it comes from communities of color.  The Revolution is Real and we invite others to join us in this work.
We are recruiting women of color who want to become midwives, lactation consultants and community health workers.  A change will come when we create it.  We are creating it now.

Last weekend I did my Walk for Black Infant Mortality Awareness.  I walked 10 miles on both Saturday and Sunday from Columbia MO to Jefferson City MO to bring awareness to this issue.  I was accompanied by some amazing women- from across the state of Missouri.  I am building a coalition of women who want to change the way birth is viewed and  'managed'.  'Expectant management' is no longer a viable philosophy for caring for birthing women.  We must throw off patriarchal systems of oppression, that view women as broken and birth as something to be controlled.  The current system of birth is literally killing us.  Black women and babies suffer untold trauma and horror at the hands of the current system.  We cannot continue this way.  We will not continue this way.  The way forward is full of hope.  We have nothing to else to lose since our lives are not held sacrosanct.
How can you help?  Spread the word.  Foward this essay.  Tell women of color you know about our work.  Support the work of Uzazi Village with a donation today.  We are in need of support to keep the work going.  We are in need of workers and interns.  I could really use an executive assistant. Invite me to come speak to your group about Health Disparities in the Black Community or come here  and share your talents with us.  There is so much work to be done and the workers are so few.  Challenge the status quo where you are.  Push for change in your local hospitals and clinics.  Speak truth to power.  Demand a place at the table, and then fearlessly speak your truth.  If we don't speak up, nothing will change.  If we don't begin to make a change, nothing will change.  Women and babies will continue to needlessly die.  The Revolution is here and now.
Donate here: www.uzazivillage.com

Monday, August 10, 2015

Dear White People...

I don't know about you, but these blog posts get more and more difficult to write each time.  The more I travel and talk to people and observe and witness the more clearer it becomes, that those who claim ally-ship are often the same ones maintaining the status quo.  A few days ago I got a call  to inform me that another (white) person had misquoted something I said in one of my presentations.  Yes, I know.  That happens all the time.  You see, when I go and speak somewhere, I know that 75% of dominant culture people hearing my message will reject it. Immediately.  Another 20% will consider it, but decide later, that no, I was wrong after all.  But maybe, just maybe 5%  or so will hear it and receive it and it will change their lives; in gut wrenching, heart rending ways.  But they will be so much better on the other side.  They will begin the process of transformation.  They will see, hear, and understand for the first time ever.  They are the lucky 5%.  The other 95% will say I said things that I did not say.  They will call ME a racist.  They will say I don't like White people. They will say I don't think White people should talk to Black women about breasfeeding or birth.  They will say many things, all of them untrue.  I'm used to being misinterpreted.  I come to town for the Five Percenters.  The few who are ready to receive my message and allow it to change their perspective on how we deliver healthcare and health messages during the perinatal period.  I don't want to make folks angry, but that's the most likely outcome of my telling the truth when people aren't ready for the truth.
White people in this country are often misguided.  Why else would my 'allies' cause me so much grief, pain, and moral agony? They can't even begin to grasp the most simple truths or have the most basic conversations about race.  Rather than face the truth about their own racism, they contort themselves to continue their own delusions.  Nearly all White people do this. Don't believe me?  Find yourself in this list of ally act-ups from just the previous few weeks:
  • A group of white professional women closed rank on a woman of color, effectively locking her out of the profession, (since mentorship is a part of the entry into the profession).  They ignored and marginalized her, making it impossible for her to join their ranks, once they decided she was 'unworthy' yet if they sat in one of my seminars while I talked about diversifying this profession, they would NEVER recognize their own overtly racist act of purposely locking a woman of color out of the profession.  They would cheer my message smugly agreeing that yes, of course the profession needed more women of color without ever giving a thought to the woman they had ostracized. (This by the way, is one of the problems with mentorship- it breeds 'good ol' girl' networks.) It's also why I started a mentorship program because this happens to women of color ALL THE TIME and everyone always thinks they have a good NON RACIST reason for not mentoring this woman of color (but its still racism).
  • A preceptor once asked me if the reason a client gave for not having me at her birth was racism in disguise.  I answered, 'yes.'  It took the preceptor two weeks of mulling it over, to recognize the client's discrimination.  It took my own internal 'bullshit-o-meter' about 2 seconds to figure it out, but to be fair, I've had the lived experience of being Black in America to fine tune it.  Most white preceptors would have never figured it out.  Fortunately this preceptor and I discussed this topic openly and regularly but too many white preceptors NEVER have this conversation with their apprentices of color even when they witness clients abusing them.  Most of the time they think they should get a medal, just for HAVING an intern/mentee/apprentice/student of color.
  • A national organization rolls out a new logo.  They've gathered a 'representative' group of members to approve the new logo and when it is unveiled, it looks every bit as dominant culture as every other logo that preceded it.   There is NOTHING multicultural or representative about it. I do not see me represented in it-anywhere, as usual.
  • I have witnessed several chest thumping events by older white women wishing to be recognized as 'pioneers' 'groundbreakers' or some such thing because of the work they did across the span of their careers.  I am willing to allow for that.  But here is what I won't allow.  Don't say you did it for me, to open doors for me. You did it to open doors for other white women.  Let's be honest, you did not spend your career creating opportunities for women of color.  History just does not support that assertion.  BIPOCS live as oppressed classes in this society and the agents of that oppression are white people.  White women traditionally have responded in great numbers one of two ways, co-agents in that oppression or stunning silence.  Those are the two main responses I see to this day, with rare exception. Oh there's lots of lip service, plenty of sound bites.  But actual working to secure equity when it actually costs you something to do so- very little of that. The work white women have done to secure equality has been equality for themselves.  I have noted their annoyance when young women of color take the spotlight.  I've even seen them be publicly critical and turn the spotlight back on themselves.  They want to be known as mothers of the movement.  But this is a movement they can never claim motherhood to.
  • Please don't ask me to teach you how to "wrap your head", "do your hair that way" or other sacred traditions that I'd prefer not to share outside my intimate circles.
  • Had a client ask for a homebirth to 'escape' the system.  With good reason.  Her baby will probably be taken away and fed into the system that seems to exist to supply white families with Black and Brown babies.  These women and their babies don't stand a chance.  The system is not in place to help them but to further exploit them.  They are mere commodities for the state to dispense with as they see fit.  Woe unto them.
  • While traveling around I have encountered several White individuals who received a grant for starting breastfeeding support groups in the African-American community.  These individuals have little to no ties to the community they want to start a group in and often don't know any qualified African-Americans!  How do I know this?  These people walk right up to me and tell me!  I'm not blaming them for trying to seize an opportunity.  I'm blaming the funders for setting up their grant in a way that allows outsiders to come in impose themselves on communities of color instead of building on the strengths and human resources already at work in those communities.
  • I get calls weekly from folks all over the country.  White folks.  They want to do this or do that for my community.  They always get the same spiel from me.  Who are your partners in the community?  Of course there usually are none because as I'm told on a regular basis, 'there are no Black people doing this or that."  My next question is always the same.  HOW ARE YOU QUALIFIED TO KNOW THAT???  If you are a white person on the outside of the community looking in, how the hell do you know WHAT is going on inside?  You can't tell me there is no one for you to support or partner with because you are not even qualified to go find an answer.  You are just ASSUMING because no one presented themselves to you, that there is no one doing the work.  This is just more White arrogance and privilege at work.  You have NO IDEA was is going on in someone else's community.  Plain and simple.  You are an outsider.  That's WHY you need to partner with an insider.
  • Just came from another professional meeting where I met the newest staff member of the team of a local hospital; another White female, even though the population served is 80% women of color, and even though I spoke up and said that I hoped the position would be filled by a woman of color prior to it being filled.  But of course my saying that was offensive- because everyone they hire is qualified (and White). 
So there you have it.  Nothing changes.  The status quo lives.  Black people die.  White people take offense.  We must somehow manage the moral fortitude to speak the truth and do what is right, even in the face of systemic racism embedded in the healthcare system. We must speak truth to power even when we have very little power ourselves, we must take down Goliaths where ever we find them, whether it be by bringing legal action against unjust monopolies, creating our own organizations, or writing unpopular blogs we must do the thing we think we cannot. And then get up the next day.... and do it again. 
In solidarity




Dear Readers,
I have invited a guest post from someone I consider an ally.  I think it would be good for White people reading this blog to hear a White person's perspective.  This is written by someone I trust and respect and whom I believe understands the appropriate role of an ally.  Dear Reader, I give you the thoughtful musings of Diana Casser-Uhl. 




I met Sherry Payne for the first time in 2013, at the USLCA conference. I had submitted my thesis a week prior and had final exams still ahead of me before I was to graduate with my Master of Public Health in behavioral science and health promotion. I had given and was still to give presentations at several conferences that spring, and I was looking for a job. I had reasons to be exhausted, and didn’t attend many presentations at USLCA in favor of rest and preparation for my finals. Having studied about social determinants of health as a primary and recurring theme in my coursework, Sherry’s session, entitled “Chocolate Milk Café” caught my interest. I had just spent the last 2 years learning about health disparities and I wanted to hear about how I should help women of color improve breastfeeding rates in their communities.


What I got, though, couldn’t have been further from my expectations. I heard words like “my community doesn’t want you to come give us breastfeeding support.” Um, what? Is my IBCLC credential not enough for women who look like you? I had studied up on “cultural competence” so I was ready to be tolerant! I was totally okay with black people and I certainly wasn’t a racist. I knew all too well what racists were and I wasn’t that!


“If you’re working with a woman of color, and you want her to come to my breastfeeding support group, sure, give her a ride if she needs one. Then wait for her in the car. Don’t come in.” Again, I was shocked. Why shouldn’t I go in there? I had no problem with black people!


It didn’t even occur to me that maybe, black women had a problem with me, with my authoritative claims that I could help them be successful. “Black women don’t want your white hands and eyes on their breasts,” someone in the room said, and others – clearly others who knew something I didn’t – robustly agreed. But wait? Isn’t that racism? I shifted uncomfortably in my chair and let the more courageous, more erudite (older) white women in the audience carry the conversation. I knew in my gut that anything I might say would be … wrong.


“The black women I see at the clinic where I work don’t really want to breastfeed, anyway. “


Energies were high in that room, and every point being made seemed valid. We can’t make someone want to comply with our care plans, right? I knew enough to understand that there were determinants beyond the clinical setting that influenced the decision to breastfeed – family members, community organizations, workplaces, society in general makes it difficult to breastfeed. I also knew that, of those who managed to breastfeed anyway, most were white and Asian women.


            Sherry calmly but firmly fired question after question to the group. Her message was to advise us that we can’t possibly know what it’s like for these women, because our experiences were so foundationally different. How can a woman of color in a community that does not support breastfeeding possibly breastfeed for an entire year? When her mother, grandmother, and all of her aunties – all of whom live nearby and are very involved in the upbringing of the family babies – didn’t breastfeed and have no interest in re-learning how to take care of babies, when they already know very well thank you how to handle a bottle-fed baby?


            I wasn’t feeling it. I was the first woman in my family to successfully breastfeed in 3 generations. And by “successful,” I mean my babies got nothing but my milk for 6+ months, from my breasts even though I went back to work in an unsupportive (but thought they were supportive – the worst kind!) 10-12 weeks postpartum. I breastfed through two pregnancies, I tandem nursed. My babies refused bottles so I stayed up all night nursing them when they reverse cycled. I suffered discrimination in my workplace. My mother and grandmother didn’t understand why I breastfed, hasn’t I turned out just fine? Breastfeeding seemed so much harder, and I was bringing that on myself. I had no sisters, cousins, co-workers, or friends who valued breastfeeding and mothering at the breast the way I did. I had terrible healthcare. My partner questioned my choices, felt alienated from our families and our friends, and supported my breastfeeding under what felt to him like sheer duress, all that only because I wanted to leave our workplace and he was adamant about my staying in it. I wasn’t a stay-at-home wife of a wealthy man in Lactopia. And yet, I was a breastfeeding superstar against every barrier I knew of. I wasn’t buying that a mother could only be successful in an environment that fostered success, because I had been successful in what I thought was the very same environment Sherry was describing.


            Sherry shared about Uzazi Village, a community center in the urban core that provided perinatal health services and support to families in the neighborhood. She acknowledged that those of us in the room were obviously there because we wanted to be part of a solution, but kept driving home the point: we, ourselves – the white women in the room – were NOT the solution. I hadn’t learned yet about the white savior narrative, wherein learned white people descended upon a needy community of people of color to save and fix them – but this was what Sherry was teaching us about. Our job isn’t to go to Uzazi Village and provide breastfeeding support, it’s to take an active role in the development and mentorship of women of color so they can provide breastfeeding support in their communities. Our job isn’t to tell the story of the marginalized, it’s to get out of the way and let them tell their own story – and, when invited, to amplify their messages, to let women of color stand up on my shoulders.


            My shoulders.


            It was at that moment, over an hour into Sherry’s presentation, that the light bulb turned on. I thought some more about how similar my own breastfeeding experiences and efforts at early mothering had been to the circumstances Sherry described in the community she served. Why did I overcome? What was different about me? It wasn’t because I’m a better person, or a stronger person. It wasn’t because I was more motivated or because I wanted to work harder. It wasn’t because I loved my babies more than black women loved theirs.


            It was – and continues to be – because I was raised to question authority and to exercise my own. My own authority. At every turn – home, school, in jobs I held, in day-to-day interactions I had with people I knew and didn’t know – I was encouraged to believe in myself. That I could accomplish anything I set out to accomplish. The world was my oyster, carpe diem. I received this message loud and clear, unequivocally, every day.


            Mothers don’t pull their purses and their children closer when I approach from the opposite direction on the sidewalk. Drivers don’t lock their doors when they enter my neighborhood and see me on the corner, waiting to cross the street. I’ll tell you what else doesn’t happen to me. Just yesterday, I picked up my keys to the apartment where I will live while I’m in school and my family is at our home 250 miles away. There were several emails and posted signs in the leasing office stating that I’d have to show photo ID to receive my keys. My ID was never requested. The black couple receiving their keys were asked for theirs by not one, but two employees at the complex.


            I live in a different world because I am white. Someone recently commented on Facebook, about a political figure who has no concept of privilege, “he was born on third base and thinks he hit a triple.” I didn’t earn the relative ease with which I pass through my life, I was born into it.


           I didn’t learn too much about how I could provide breastfeeding support to black women that day at USLCA, but I left Sherry’s session with an unrelenting discomfort. I donated to Uzazi Village that week, to support a cause I believed in with means I had. I was confused that the knowledge and skills I had acquired as an IBCLC and a public health professional weren’t worth what I thought they might be. I struggled for awhile with whether there was any place for me at all in the fight against racial and ethnic health disparities. It would be a few more months before I’d realize that the disparities are caused by systems, not individuals, and eliminating those disparities would take a systemic effort.


I’d love to tell you that from that moment on, I’ve been a perfect ally, a white woman who waves my Magic Wand of Privilege and makes things better for women of color every day while I scale tall buildings in a single bound and mother my three children and get a doctorate and … no. More often than not, I still feel helpless and lost about what I can do, what I should do. More often than not, I still feel ashamed and confused about the biases and prejudices I’ve permitted – and sometimes continue to permit in my own thinking and behavior. I get frustrated that certain ZIP Codes, even one less than 10 miles from my own, harbor awful, awful health disparities, but I raise my own family in the ZIP Code where we have a better shot, and I wonder if I an implicit or complicit supporter of the structures that created those disparities – the structures that make it possible for me and my white family to make a life in a town where black and brown families have to work twice as hard to get half as far. I listen to and do what I can to amplify the voices of my black and brown friends, peers, and colleagues. I listen carefully. I listen to every word and, when my knee-jerk reaction is to say “but that isn’t about race …” I stay quiet and I keep listening because it’s not my job to tell black people in America what their experience has been or how they should do things differently so they can be just like me. Their world is different from mine, and my job is to bear witness, to believe what they say, and, maybe by my words or maybe by my example, to challenge the systems that make our worlds so different.