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.

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

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.

 

             

Another Committee? No Thank You

I am fresh returned from another trip.  I had yet another opportunity to hear how yet another organization  has set up yet another taskforce/committee/ad hoc group whose sole purpose is to yet again eliminate disparities within the profession and or within our community.  It all sounded very familiar.  Then I remembered why.  I've been hearing these very same messages from every maternal infant health organization I've been a part of throughout my 20s, 30s, and 40s and now into my 50s.  That is a grand total of 4 decades of listening to someone else's promises of a better day.  That day has never come.  Disparities still exist in all perinatal professions, and perinatal outcomes in the African-American community have actually gotten WORSE over the past 4 decades. 

I'm afraid I'm going to have to decline yet another 'opportunity' to be on someone's super terrific committee designed to pull me and my community our of a socially-bound slump.  There are those of us within communities of color creating real world solutions.  Anyone who wants to be a part of those solutions can come join us- or go form another self-serving committee.  The  help our communities has been promised has never shown.  While clinicians fight their professional practice battles, our women and babies die in greater numbers.  We can't wait for others to prioritize Black lives.  We must raise up an army of perinatal professionals that can care for our long neglected communities.  We must lead these efforts ourselves.  We are the only ones that will save us.  We are our own best hope for ending health inequities.  Learn about the groundbreaking work of Mama Toto Village, Common Sense Childbirth, the International Center For Traditional Childbearing, A More Excellent Way, and of course, Uzazi Village.  These models were created within communities of color, by communities of color, for communities of color and they are popping up all over the county.

On a recent trip, I met with a group that will be starting a national association.  We will decide and set the standards for programs in our communities and certify them- standards that are not exploitative and that truly support the attainment of improved outcomes.  These are the types of efforts that all of us have the opportunity to participate in.  I implore you to do these things in whatever capacity you can where you are, to what extent you can. We need to set the standards, hold the purse strings, give out the grants, offer the jobs, etc.  Outside organizations, institutions and agencies will never hold the answer to healthcare inequities- they are too embedded in the culture of the problem or they are too distracted with their own issues to be invested in ours.  Others may join us, but they may not lead.   Please join me in being a part of the solution. Now is the time for brilliance and innovation. Let us be bold.  Let us be decisive. Let us look inward to our own best selves.  Let us seek the wisdom of the ancestors.  We are our best if not only hope.  If we do not find a way- there will not be a way.

The Village Prenatal

A couple weeks ago, I was in Seattle and spent time with a Native woman who had made a good life for herself.  She had a lovely family and home, a satisfying career and is well respected by her peers. She is a good deal younger than me and very accomplished.  When we were alone together, I asked her a very personal question, one I was dying to hear her answer too.  "Why didn't you get pregnant?" "What set you apart from me and many of your own peers whose life plans were altered by an unplanned pregnancy?"  Despite having married the guy she dated in high school they did not have children until many years into their marriage.  I really wanted to know what made the difference.  I have her permission to share her answer.  She told me, without hesitation, that it was two things: excellent school-based sex education, and a supportive parent willing to have the birth control conversation without freaking out.  Wow.  For the price of those two things, the world gets an accomplished individual who is making a positive difference in the world and in her community. Now, I'm not saying that an unplanned pregnancy ruins you- after all I had TWO kids when I walked across the stage at my high school graduation.  But I spent most of my life catching up from that and only now have the productivity in my fifties that I longed for in my thirties.  I was so entranced by this woman's story that it made me angry.  Angry, that I live/work in two states that will only allow 'abstinence only' education in the public schools.  Angry, that I see young women everyday who have little to no access to the knowledge and the birth control that would give them a fighting chance in life.  Angry, that our state lawmakers have not expanded Medicaid.  Angry, that our society can't wait to condemn unplanned pregnancy, but keeps effective birth control out of reach.  Angry, that we set women up to bear the brunt of consequences from unplanned pregnancies.  Angry, that we can't have simple conversations with our daughters and sons about basic physiologic functions.  Angry, that we don't want women to have abortions, but we don't want them to use birth control either.  Angry, that contraceptives aren't free and available to any and everyone who seeks them. Angry, that an unplanned pregnancy can send a family into a financial and emotional tailspin from which it may take years to recover.  Angry, that we compromise our children's future by keeping them clothed in ignorance as if it were a virtue.

Interconception care (care BETWEEN pregnancies) is designed to get you healthy BEFORE you get pregnant and to help you space your pregnancies out.  This is a luxury ideology when you don't have healthcare coverage BETWEEN pregnancies as our current system of Medicaid ensures.  About half of pregnancies are unplanned (either due to a lack of use of contraceptives, or contraceptive failure). It varies from state to state from a little under half to a  little over half, but here about half of pregnancies are covered by Medicaid.   Medicaid does little to nothing to prevent or delay the next pregnancy, since women are promptly dropped from insurance at six weeks postpartum.(Just in time to resume sexual activity.)  It will cover birth control obtained up to that six week mark but not thereafter.   Providers don't help with their contraceptive bullying techniques (bullying women to get the shot or implant because its convenient for the provider- never mind what it does to milk supply or that it is not compatible with her goals or lifestyle). There is little about this system that actually serves women- especially women of color.  It is designed to control and subjugate but not to facilitate health and wellness and informed choice.

I propose a new course.  A way to circumvent an educational system and healthcare system that seeks to keep us uninformed  and ignorant.  Let's educate ourselves about birth and breastfeeding and contraception.  Instead of approaching our births with drugs, fear and ignorance, lets teach ourselves what we need to know.  Let's go door to door, house to house, community to community reclaiming our right to understand how our bodies work.  Let's teach one another rather than depend on those who don't have our best interest or the best interest of our communities at heart.  I propose that we start connecting through 'learning parties' that center around learning about our bodies, pregnancy and birth control. But it isn't just about learning new knowledge, its also about nurturing the pregnant person.  This idea was created by my mentor, Sr. Morningstar.  She calls them Village Prenatals. They bear no resemblance to clinical prenatals and there are no clinical activities.  A pregnant person or persons is simply surrounded by their community in an intimate setting.  A number of activities take place.  First of all there should be good nourishing food and drink.  There should be someone to take the lead.  There should be a comfortable space for the pregnant person or persons to lie down. There may be drumming, singing bowls or other instrumentation. There may be incense or flowers.  The rest of the party should form a circle around the person leading the Village Prenatal and the pregnant person. I have developed a 5 point itinerary that is specific for my community that can be followed or modified to your own needs:

Village Prenatal Template

1.An acknowledgement of past failures or harms.  (Infant and maternal mortality) I like to start with an acknowledgement of past harms or an honoring of lives already lost- I might do this with a pouring libation, a moment of silence or a guided meditation)

2. Replace the fear with knowledge. (Knowledge is power) (the pregnant person is asked to give voice to their concerns first then their joys.  I address those fears with knowledge (this is where teaching occurs) and we stand in agreement in any joys or rejoicing

3. Our bodies are amazing- restore trust in that.  (Understand how your body works) (Next we celebrate the body with some sort of body work; body painting, or a belly or foot massage, or belly casting or necklace beading or waist bead making or some other way to honor the body)

4. We are what we need-sisters supporting sisters. (we can be one another's best support) (the next part allows the group or circle to interact by each gifting their own word of wisdom, or presentation of a gift, or participating in some way to honor the individual who is the focus.)

5. Restore community through conscious healing (focus on our corporate good) (I like to end with a closing circle in which everyone offers parting words or wisdom- they can say what they learned, they can offer a thought to the pregnant person.  It can end with a song, or with dancing or as it began with drumming or other instrumentation. 

 

This is my template and you may modify if for your own use, and it may be used even if there is not a pregnant person being focused upon.  Here is a template for doing a Village Prenatal with a group of teen girls:

1. Acknowledgement of the past: Begin with foot washing.  A bowl is brought forth with water, essential oils, herbs, flowers, and there is a ceremonial washing of feet by the elder women of the younger women

2. Replacing fear with knowledge: As the young women sit in an inner circle and the older women in an outer circle around them, teaching can be shared on menstruation, pregnancy, birth, breastfeeding, motherhood, whatever the selected topic is. 

3. Our bodies are amazing: The girls can be led in creating menstruation bracelets or waist beads or body painting.

4. We are what we need: share songs or drumming together.  Elder women can weave a thread from girl to woman as they share their own stories of initiating menstruation.

5. Restore community: Each elder commits to support a young woman in her journey, to become a source of support and encouragement.  Each young woman commits cultivate self love and trust.

Here is a template for a gathering of pre-pregnant young adult college or career age individuals:

1. Acknowledgement of the past- Participants can write notes to their mothers stating what they are most grateful for about her mothering.

2. Replacing fear with knowledge- The education can be on the topic of "What you need to know about pregnancy and birth"

3. Our bodies are amazing - The group can watch a birth video of a natural homebirth with explanations of what they are seeing

4. We are what we need- There could be a round robin on how what they have learned will shape their birth experiences or how they will support one another

5. Restore community- Participants can make care packages to donate to a women's shelter as their closing activity.

Those are a few ideas off the top of my head for gatherings.  They can be done in homes, churches, clubs, civic groups,  schools, or just a gathering of friends.  The theme is birth, breastfeeding or sexual health.  I am committed to leading five of these over the course of the summer to kick them off in my community.  You must be a woman of color.  Contact me, I'll help you plan it, and then come to your location (in my city) and help execute it. You must be willing to have photos and videos taken to upload on a community page I'm going to create called Village Prenatals so that we can all see and learn from other's examples.  If this resonates with you, you are a woman of color, and you live in the Kansas City area, please contact me in the comments section of this post or by email at sherry@uzazivillage.com

I believe we can change our community by educating and nurturing in this way.  If you think so too, contact me and we'll talk.  I hope you will try this in your own community, whoever and wherever you are.  Let's start a revolution.  

All Hail the Queen

(This story shared with permission.) No, not that Queen!  But mad props to the Duchess of Cambridge for being delivered by Black Midwives! While that historic birth was happening, another was going on right here in Missouri outside the view of cameras and media.  A Black working class  woman, appropriately named, Queen, gave birth to her third child in her own house, UNASSISTED, save one quiet witness- me.  Queen labored all alone in her home, keeping in touch with me by text from the time her water broke at her job on Friday afternoon until I joined her in the wee hours of Saturday morning.  I arrived at her home at 2:30am to find Queen laboring naked in her living room.  Signs of active labor were clear.  She was alone in the house, her other two children were spending the weekend at their father's home. The lights were dim, and smooth mellow jazz blasted from a CD.  A shower curtain covered the carpeted floor.  Pillows and cushions were piled on the floor near the sofa to make a resting place. Bottles of water and juice loitered about the room.
She labored on her feet and on all fours.  She moaned quietly through her contractions which came with efficient regularity.  I sat on her sofa and said nothing and did nothing as she continued her labor just exactly as she had been doing before I arrived.

I had met Queen less than two weeks ago.   She called me asking for an appointment to see because she was referred to me by a city bus driver!  She was clear that she wanted an unassisted home birth.  She showed up at the appointed time and I listened to her story; she had had two hospital births that had left her feeling traumatized and she simply refused to return.  She was knowledgeable about the risks and had breastfed her other two babies.  I sat stunned as I listened to her.  This was the woman I had been waiting for.  I wasn't even sure she existed.  A Black woman from my own community who through her own knowing and knowledge seeking understood and believed that she could birth her baby simply, with ease, in her own home.  I nearly wept with joy.  We have been so beaten down and subjugated in birth that I almost never encounter women from my own community who believe they can birth their babies without medical intervention, guidance, or surveillance.  I was so excited, I almost ruined Queen's birth.  She had not sought out prenatal care.  At first I insisted she see my preceptor midwife, get labs and a sonagram done.  She wanted me to be there for her birth, but at first I didn't know how to do that, except in the context of a midwifery student. She acquiesced.   I was in essence forcing midwifery upon her.  Then I read this Facebook post by my friend Ameena Ali Jones: "Birth workers, please...I beg you....STOP TELLING MOTHERS THAT THEY HAVE TO DO ANYTHING!!!!!!! All she is required to do is Labor and birth...THATS IT!!!"  It was as if she wrote it directly to me.  I took it to heart, repented of my deeply rooted dependence on the birth machine.  Queen was willing to do all that I asked because I was doing the asking but then it hit me from Ameena's post that I was not honoring Queen's wishes for an unassisted birth at all- I was just gently coaxing her into the kind of birth I wanted to do. I had made it about me- about my comfort- the very thing I accuse physicians, and midwives in hospitals of doing all the time to the women of my community.  I apologized to Queen.  I cancelled the appointment with my preceptor.  I told Queen I would be happy to come alongside and witness her birth.  I would not come as a midwife (because I am not one yet) but I would come as a companion and sit beside her as witness to her birth.   Her water broke the next day.

As I sat on the sofa in the tidy little bungalow, Queen labored beautifully.  I had no supplies with me.  I didn't even interject encouragements like, 'you can do it' or 'you're doing great'  She did not need even that.  She did it all on her own.  About 30 minutes after my arrival, she began to bear down.  She was kneeling down with her head resting on the sofa. She stood and began to push.  I moved in closer and took several pictures with my phone.  By the time I moved from the sofa to her side, the baby's head was already out.  I grabbed a nearby towel and gently caught the baby and laid it down between Queen's legs.  She wanted to know if it was a boy or girl, but I told her it was not my place to say.  She scooped her baby up and after five minutes of oohing and ahhhing, she gently unwrapped the towel to reveal the gender.  The baby cooed and later cried all from the safety of her mother's arms. I marveled as Queen never even sat down but began to nurse her baby standing naked in her living room. After 30 minutes her placenta came out, we then burned the cord and tied it with the shoestring Queen provided.  I watched over the baby,  as Queen showered, then tucked them both into bed.

As the sun rose beckoning a new day, I drove home and left Queen with her baby nursing in her arms.  I realized that I want more of this, more dependence on the mother's own knowing and wisdom.  Earlier the previous day I had attended a town hall meeting on maternal mortality.  Talking heads from our state capital were in town to present on current disheartening trends- expert statisticians and epidemiologists who would have believed that the answer to those problems lie in exactly what Queen did NOT do; more medical surveillance, more technological control, more dependence on the cult of expertise.  I began to see things differently on that ride home.  Queen was her own best hope.  Not the state experts, not even me.  Women taking back their births, even from the so called experts is what will save them. Listening to all the experts in the room made it clear: THEY HAVE NO IDEA HOW TO HELP US.  We just die, and they just throw up their hands.  Even worse, they think its our fault we are dying- they don't even see their own culpability.    The answer lies with us, not with them. Self reliance and self management within our own cultural context will save us, not waiting around for dominant others to fix us. Am I saying that unassisted birth will fix health disparities?  No, but I'm no longer willing to rule out that it has a useful role.  Today, all of Queen's female relatives are rethinking everything they think they ever knew about birth... with all my millions of classes I teach, I couldn't work that kind of magic. 

Black But Not Like Me

I had a recent conversation with a woman from Tanzania.  Emelda (not her real name) will be working with Uzazi Village.   It is rare that I get to really have a heart to heart with a Black person who is not African-American.  Emelda came to the US for college, married an American and is raising her family here in the US.  She is on faculty at a local university.   I couldn't wait to ask her something I had long wondered.  What is it like to be raised in a place where Blackness is not vilified and demonized?   Where whiteness is not culturally centered?  Where standards of beauty are not eurocentric?  Where Blacks are not first seen as a problem to solve.  Where every cultural reference, however subtle and intricate sends a negative message about about who and what I am?  What would it be like to grow up free of the weight of those lies?  She answered simply, "I can't explain it, but every time I fly home, I feel as though when I step off the plane, I leave a burden behind me."
I have long been curious about the 'burden' that we as African-Americans shoulder.  A burden made more wearisome by the oft heard denial of systemic racism.  Now that I have started the conversation, I am insatiable to know more.  What would it be like not to have every sensory experience that comes to me, not filtered through a racially white lens?  A lens that reflects back only negativity about who and what I am.  Caucasians adamantly deny that they are taught from the crib to distrust and look down upon African-Americans, but the contempt is palpable in this country. 
I'm fresh off a weekend binge of African and African-American themed movies.  I love getting lost in a world where brown skin is the norm, and where I'm not forced to contend with the relentless elevation of all things White.  I long to experience what Emelda spoke of; a laying down of the psychic, soul-felt and weighty stigma of being brown in America.  There is no escape from it here, where being diminished is a constant way of life.  I must constantly do battle in my mind, not to believe what is relentlessly communicated in ways large and small.  I have to help my children do the same.  I must actively reject lies told about me in this culture- that I am bad, unworthy, unintelligent, less than in every way, nor accept the lies told about Whites, that they are good, worthy to be the focus of attention and elevation.  I have to fight back against the almost passive infiltration of my own  internalized oppression.  I have no history because in the schools of my country, my history is ignored while I am taught the history of the White man as Lord and Master of the Universe. I have no mother tongue, nor tribal affiliation. My values, my esthetics, even my linguistics are undermined. 
I have to wonder, who would I be, if I hadn't spent a lifetime listening to overt and subtle messages attesting to my inferiority? This culture is brutal to people of color, diminishing our own sense of self and human potential if we are not constantly rejecting the lie, that white makes right. 
Then for an encore we are told, we are imagining it all, by the very ones from who the smug superiority emanates.  I hope someday I find out, what its like to be Black without the baggage.

Allies Behaving Badly

Examples of behavior I have seen in the last few months from 'allies':

• A group of mostly White women start a Facebook group for Black Breastfeeding Mothers that the white women admin, and never miss an opportunity to promote their agenda of diversifying a specific breastfeeding support group.  I have pointed out that what they are doing constitutes an ethical breach (admining a group for Black women when they are White AND using the site to promote their agenda of diversifying their own group, which may not be consistent with an agenda of supporting African-American breastfeeding mothers.)
• Watched a for profit company try to invade an urban African-American community to make money while framing it as 'economic empowerment' when it was more like 'economic exploitation'
• A woman of color in another city contacted me to inform me she had co-written a grant with an ally, one that required a woman of color in a leadership role.  When the grant was received, she was promptly removed from her position working with the project.  There are now no voices of color on the project, even though the funds are aimed at programs for Black women.
• I have seen countless groups scavenge for funding aimed at programs for Black women, even though these groups have no ties whatsoever to the Black community.  I have watched them scramble to get any Black face they could find on their committees and use these people mercilessly to push their own agendas.
• I have seen Black run community-based organizations and coalitions quietly step aside in writing for these same grants for fear of stepping on the toes of those in power.
• I have seen individuals of color elected to top ranking positions in clearly White organizations, so that those organizations can claim diversity, when all they really have is one lone person of color floundering in a leadership role in which they alone are expected to do the work of making significant change throughout the organization to promote diversity, when these organizations clearly have no desire to change anything, except how the top leader looks.
• I have seen organizations talk the talk, but refuse to walk the walk.
• I have seen all manner of disparities pimping. 
• I have seen so called allies argue down people of color telling them their ideas for what is best for their communities, and instead pushing through their own agendas.
• I have seen small groups of peoples of color struggle as they were torn between meeting the needs of their communities on one hand and please the White purse string holders on the other.
• I have seen 'allies' write grants so that they get paid to recruit VOLUNTEERS of color into birth or breastfeeding work in efforts that are clearly not sustainable.
• I have seen organization claim to want to be anti-racist without a willingness to invest in the hard work of actually becoming anti-racist. 
• I have seen organizations approach communities of color only when they need something from them such as a focus group for a report to legitimize the work they are doing.
• I have seen so-called allies never question their motives, their tactics, their presence in communities of color or call themselves into account for their lack of progress or change in those communities.
• Shamelessly appropriating and cannibalizing Black culture when it suits the need.
• I see people of color sidelined, marginalized, made invisible, disregarded, silenced, and worse for trying to help their own communities through the vehicle of dominant culture organizations holding dominant culture values.  Their opinions are not sought out, nor are they highly regarded within those organizations for the value they bring.  Far from it.
• I have had groups approach me to talk or do a webinar, as a check off for their diversity to do list, without any interest in actually changing the organization.
• "Helping" Black mothers by attacking aspects of Black culture, and inviting them to question the wisdom of their elders in inappropriate ways.
• I have seen program managers brag about the numbers of low level workers of color they have recruited, when those workers don't make a living wage, receive benefits, or even have fulltime hours or job security.  The managers recruiting them of course, take all those economic niceties for granted.
• I have seen many allies expect people of color to change to come be with them, but have seen none willing to change to be culturally appropriate to enter communities of color.
• Allies will volunteer to do work in their own communities, that they must be paid to do in communities of color.
• I am getting scads of invitations to talk for 'Black History Month'
• Allies will scramble like crabs in a bucket to get monies aimed a communities they know nothing about.

I could go on, but I think you get my point.  All of this amounts to the same thing.  Folks that are supposed to be helping us are instead helping themselves and preying off us.  Feasting on our slowing decaying and disparity-ridden bones.  Health inequities = Social and Economic and Healthcare and Reproductive Injustice  A system such as this could have only evolved in a supremely racist and oppressive society.  An entire class of educated and employable folks make their living feeding off the poor and peoples of color and call it social benefit.  How did we come to this?  More importantly how do we get out of it?  I have an upcoming webinar on February 17, 2015 with Preclarus Press called, "With Friends Like These… 10 Steps to Creating Mutually Beneficial Relationships with Persons and Organizations of Color".  Stay tuned and keep listening.  I'm hoping that allies will want to do better, once they know better.

For my brothers and sisters toiling in the trenches, starting in February, I will offer a monthly conference call that you can join.  Watch my Facebook page for details.  We will problem-solve with one another on how to exist and manifest effectiveness and excellence in racist and oppressive organizations and or systems.  The calls will be limited in numbers of callers, so it will be on a first come, first served basis.  That way we can address one another's issues in greater depth. We will create our own brain trust and self help group to address issues commonly encountered by people of color working in the birth and breastfeeding fields.  If this describes you, please join us.

The Way Forward

Yesterday, I had lunch with a former nursing student of mine.  We met at a local pizza joint and she told me all about her new position at my old hospital.  I loved our visit and am grateful that I often connect with former students who are constantly moving forward in their career trajectories.  This visit felt very deja vu' as she spoke about the highs and lows of working in a teaching hospital.  I know all too well the agonies and ecstasies of working in such a facility and tried to advise her as best I could.  The facility had recently become "Baby Friendly" (that means it is certified by a national body as having policies in place that promote breastfeeding).  But while the practice policies have changed dramatically, the underlying soul sickness of the place remains. 

My 'relationship' with this hospital spans my entire life cycle.  In fact I could say that my story is inextricably entwined with this facility.  I was born across the street from the current hospital at its predecessor, General Hospital N. 2.  Even the name speaks to its legacy of racism.  In my mother's day, Whites were cared for at General Hospital N. 1 and Blacks at N.2.  By the time I was born, both facilities had merged and it was informally simply called, General Hospital. It was within its ancient corridors that I would get my first glimpses of White people, who did not exist in my day to day life.  Little girls my size, except for their pale skin and curious twin braids trailing down their backs.    In 1976, the old General Hospital closed its doors for the last time, and a new upstart hospital, bright and shiny new was built by the city.  It was named for Harry S. Truman, the former US President, from Missouri.  My first major interaction with this new hospital was, when I went there to give birth to my first child. 

I was and am a voracious reader, and I had read everything I could get my hands on about pregnancy and childbirth.  The year was 1978.  I was fifteen- a sophomore in high school.  The natural birth movement was in full swing.  I was fascinated by my own pregnancy and began immediately to amend my orientation toward healthy behaviors. I was fascinated by books I found in the library on homebirth and natural birth.  I somehow intuitively knew that these books were onto something.  Some very deep and veracious knowledge that I had never heard spoken, but as soon as I saw it on the page, knew that it was so.   I also knew that that birth experience was out of my reach.  I knew I would get the 'typical' Truman birth.  I was however committed to a natural birth.  I knew I would not take their drugs.  When the time came, to push my baby out, after a hefty labor of Lamaze style focused breathing, the resident offered to give my 'something for pain' which I declined.  He shoved a large needle into my vagina anyway, numbing me with what I would later come to discover was a puedendal block (an early precursor to the epidural).  I remember my anger at being ignored.  I had worked very hard for my natural birth.  I had endured a Pitocin enhanced labor (that I didn't know they had given me until decades later when I read my old chart), with techniques I had taught myself.  I was left to largely labor alone and then when it was time to push, had my desires completely disregarded.  I was invisible to them.  They neither saw me nor heard me.  I was merely a revenue producing commodity.  It didn't matter in the least that I spent months teaching and preparing myself for my birth.  In the end I was given over to these people for their purposes, their agenda, their learning.  I was completely at their mercy, except there was no mercy to be found in them.  There was nothing I could do as a young Black girl to make myself visible to them. 

When I returned to Truman, some twenty years later as a brand new graduate, labor and delivery nurse, I brought that experience with me, and saw my new patients through that girl's eyes.  Nothing had changed, nothing.  The population of largely Black and Latino women were simply fodder for the mostly White and male resident's learning.  I'd sit in the nurses station and listen to the White nurses talk about 'those' people and judge them by their own imperial standards even though they knew nothing about the world the patients had come from and would quickly return to with their babes in arms.  The doctors and nurses were completely ignorant of that world.  They only passed it in a quick blur as they sped through it in their shiny cars enroute to more prosperous lands.  They learned on  our Black and Brown bodies, learning to despise the very ones they owed their learning to, and quickly went on the their 'real' jobs after residency caring for Nice White Ladies.  White ladies who would reap all the benefits of their doctors having learned to sew up a nice tidy episiotomy after fucking it up on several Black women first.

All these memories came flooding back to me as I sat and lunched with my former student, now a nurse on the very unit that had caused me such sickness of soul. My experiences on that unit, first as a birthing women, and later as a nurse are exactly the reason Uzazi Village was born.   I had been back there recently as a doula with a client during a three day long induction.  I could testify to the policy changes that had put a spit shine on the appearance of the care. The residents had been taught to say all the right things. The nurses sickly sweet.  But upon closer inspection, I could still see the unseemly underbelly of racism, intolerance, white privilege, and discrimination that ruled the culture.  The underlying assumptions were the same.  "Do what we tell you to do and don't ask too many questions.  If you do, we'll label you 'noncompliant' and punish you and your baby."  And they have so many ways to punish. 

It's easy to see that moving to evidence-based care won't change outcomes either.  This is the very essence of a white-washed tomb.  It is the underlying systemic racism that is woven into the fabric of healthcare institutions that must be cut out like the cancer that it is.  Evidence-based care is a clean white bandage over a gaping pus-filled wound that continues to seep.  Change the bandage as many times as you want- that does not fix the problem.  I am more convinced than ever that my path is true.  We must build systems of care for our own.  We will never find the health and vitality and wholeness we seek in the reflection of someone to whom we are at best, invisible, and at worst despised.