NEW

Join HRiC’s Key Stakeholder Advisory Group

HRiC is forming a global network of lawyers, researchers and advocates dedicated to improving maternity care - everywhere. Join us! Human Rights in Childbirth (HRiC) is developing a new strategy to inform our advocacy and strategic direction over the next three...

Terms of Reference: Key Stakeholder Advisory Group (KSAG)

Human Rights in Childbirth (HRiC) is developing a new strategy to inform our advocacy and strategic direction over the next three years. Our goal is to develop a sustainable network of key stakeholders in order to make full use of, and build on, our collective skills...

Forced Sterilisation during Caesarean and Informed Consent – the case of I.V. vs Bolivia

I.V. vs. Bolivia was the first time the Inter-American Court of Human Rights analysed the foundations of the right to informed consent.

Shared Decision Making in Maternity Care

In this article HRiC outlines its opinion on shared decision making and how it relates to human rights, specifically in maternity care.

Report on Rights Violations in Maternity Care During COVID-19

Since the beginning of the COVID-19 pandemic, HRiC has been collecting reports of disproportionate human rights violations in maternity care. The first set of rights violations have been published in a report (available below) and sent to the United Nations. , The...

Contribute to our Second Report on Violations in Maternity Care during COVID-19

Help us document what is happening taken in maternity care services in your country - send us a submission by Friday, 10 July 2020.The COVID pandemic is having an enormous impact on maternity care around the world. Minute by minute, day by day, practices and norms are...

HRiC informs European Parliament Action on Maternity Care during COVID-19

HRiC has been working with a Member of European Parliament to bring light to some of the problems women throughout Europe and the world are facing in maternity care during the COVID-19 pandemic.

Report Rights Violations during COVID-19

Help us document what is happening taken in maternity care services in your country - send us a submission by Friday, 24 April.The COVID pandemic is having an enormous impact on maternity care around the world. Minute by minute, day by day, practices and norms are...

Midwifing Us Through the Epidemic

Now is the time to press our governments and policy makers to support midwifery care in communities as part of policies to address climate change or Green New Deals that are being prepared around the world – to make sure we are well-prepared for the next emergency or pandemic. We ignore midwifery models of care, essential midwifery skills, community and home birth at our peril – future generations will depend on them as part of crisis response.

Communications Volunteer Position

HRiC is seeking a communications volunteer – apply by 30 April 2019!

Standing on our Ancestress’ Shoulders – opening the HRIC US Summit

On May 26, 2016, Human Rights in Childbirth held the second HRiC US Summit in Los Angeles, California.  Activists and legal advocates from the nation’s leading reproductive justice and maternal health consumer advocacy groups convened for one day to share stories and information about the human rights concerns facing their communities as well as their strategies for solving those problems.  The Summit worked through the day to develop the draft for a Consensus Statement on the human rights of birthing people in US maternity care, focusing on calls to action for ensuring that every pregnant person’s rights are respected and upheld in pregnancy, childbirth, and postpartum. (more…)

Feeling safe and Being Safe during Labour and Birth

Human beings, like all mammals, need to feel safe in order to give birth.  Childbirth as a physiological process is powered by hormones, and those hormones are strongly affected by the birthing women’s emotions, which are in turn affected by her perception of whether she is giving birth in a safe environment.  What women need to feel safe will vary from individual to individual, and across cultures as well. Some women will need to feel safe laboring naked; some need to be covered to feel safe. Some feel safe in a space where they can be very quiet and peaceful, some need to be able to move, dance, sing or scream.  Some women will need their mother with them to feel safe, some will need their man. There is no reason why maternity care cannot be constructed in a way that meets each woman’s needs to feel safe during birth. And yet, in many systems around the world, women must sacrifice feeling safe, and even being safe, in order to access the safety that medical backup provides.  Widespread reports of disrespect and abuse, dehumanized, traumatizing treatment, and violations of women’s rights to privacy and dignity show that women are giving birth in environments in which they cannot feel safe, because in fact, they are not safe.

The recognition of preventable maternal mortality as a human rights issue was a huge step for women’s sexual and reproductive health and rights.   But when we only recognize the right to survive as important for childbirth, the violation of women’s other human rights is rendered invisible. Women in both the developing and developed world are organizing to speak out about systems of care that dehumanize and traumatize them at their moment of greatest vulnerability. They are demanding recognition of their rights—not only to access healthcare and to survive childbirth, but their rights to autonomy as informed consent and refusal, to privacy, to dignity, to non-violent and non-discriminatory treatment in labor and birth.  The human rights framework takes women beyond asking providers to please give them individualized, non-violent care, but requires the state to enforce women’s human rights as legal rights that must be respected in policy and practice. In some nations, women’s groups have passed laws naming the abuse of women in childbirth as obstetric violence, and brought legal actions that described their experiences in those terms. It is notable that the systems of care in which women are passing laws against obstetric violence are those with some of the world’s highest cesarean section rates, like Central and South America.

The global cesarean section pandemic is, in itself, a form of obstetric violence.  In many cities and nations in both the developed and developing world, women who can access care are churned through cesarean section assembly lines, while women from marginalized communities in the same nation are left to die preventable deaths.  Is this equity? Media reports on the cesarean pandemic often claim that women want all these surgeries. Studies show, that’s not true. Women want a healthy birth, and they want to know that the medical system will meet them at their need, and have surgery available if they need it, but support them in a vaginal birth if they don’t.  Economic studies all over the world connect providers’ financial and time-convenience incentives to the massive increase in surgical deliveries. The money that healthcare systems are wasting on the surgical delivery of healthy babies from healthy women could be directed toward underserved women and closing gaps in women’s reproductive health.

The disrespect and abuse of women in childbirth, and the generation of children being born by surgery, are not soft human rights issues.  The right to respectful, non-violent support in childbirth is not the request for a “positive birth experience.” Framing these issues in terms of “birth experience” runs the risk of trivializing them, and creating a false dichotomy between the “experience” of care, versus health and safety.  The issues that we are talking about here are, in fact, about health and safety, and are a matter of life and death.

As the cesarean section rate passes 50% and approaches 100% in many facilities around the world, the global movement for women’s health and rights needs to ask, when are we going to stand up and say, no more?  Why are we letting this happen to ourselves and our babies? Why are we letting this happen to each other? What would maternity care look like if it recognized not only women’s right to survive childbirth, but the full spectrum of human rights that every woman has, and that she carries into labor and birth?  What would it look like if every woman could feel safe, and be safe, while she brought her baby into the world?

Human Rights in Childbirth founder and executive director Hermine Hayes-Klein gave this speech at Women Deliver 2016, on a panel session titled “Compassionate and People-Centered Care: Why We Need It.”  The session’s subtitle: “Respectful maternity care is a woman’s right, not a luxury. Ensuring that women are not only satisfied with their care but have a positive birth experience can be the catalyst to ensuring they survive and thrive.”

Rooted: Understanding the History of Birth Justice and Growing a Movement

Rooted: Understanding the History of Birth Justice and Growing a Movement

The history of midwifery in Florida is at once inspiring and infuriating. In 1920, there were 4000 midwives. In 2016, there are just over 100 licensed midwives in the state. Where did all the midwives go? As birth workers, we stand on the shoulders of many ancestors whose stories have been neglected and disrespected. The saying goes that when an elder passes, it is like burning down a library. So imagine, for a moment, all the wealth of birthing knowledge that has been lost because no one took the time to sit with and listen to the stories of those thousands of elder midwives.

 

At Southern Birth Justice Network (SBJN), a southern rooted organization based in Florida, we are reclaiming our story, the stories of our grandmidwives and our ancestors, in the name of those yet born. What birth experiences will our daughters have? Our granddaughters? What will birth look like in seven generations? Not an assembly line chopping block of unnecesareans (unnecessary surgical births). We refuse! We resist! We are consciously creating a community of birthworkers, activists and parents to organize, strategize and create the communities we want for our children. Many of us have had traumatic birth experiences, been robbed of our right to breastfeed or the right to parent our children.

Midwifery is and was about survival in the African American community. There are many midwives in our legacy like Lucrecia Perryman, Biddy Mason and Gladys Milton who, through their work as midwives, were able to teach mothering across generations, serving as both a
conduit for the transmission of cultural practice rooted in an African past as well as for innovation in the interest of survival. Our ancestors have paved this path so gracefully, clearing brush and thorns out of our way so that we may see our way forward without blood in our eyes…so that we may walk with less stumbling. There are so many untold stories in our communities, so many sheroes and heroes that remain unsung. The practice of Sankofa, reclaiming our story and carrying our ancestors forward with us, is the responsibility of all of us. The names are too many to call.

Many in our community have lost an important connection with motherhood and parenting because we have lost the connection to midwives. Becoming a mother/parent is more than a biological event. Midwives understand the importance of education, health, nutrition, healing and autonomy over one’s own body. This was incredibly important in the post-slavery era for a people who had been enslaved and had little autonomy over their bodies, health or children. In post-slavery America, there were many barriers to accessing to medical care and also there was significant distrust of doctors and the medical establishment. Physicians such as J. Marion Sims used Black bodies for experimentation, in the name of medical advancement and often to the detriment of his patients such as Anarcha who was subjected to 30 surgeries with no anesthesia. So, midwives did a lot of health care in general, beyond caring for pregnant, birthing and postpartum patients. Midwives represented a safe place that literally held the community’s future in their hands.

In the early twentieth century, the American Medical Association (AMA) (led primarily by white, wealthy male doctors) launched racist and sexist attacks on Black midwives specifically, seeking to discredit and regulate midwifery as part of the movement toward medicalization of birth. As a result of these attacks, in many states, it became a requirement to hold a nursing degree in order to practice midwifery, posing a significant barrier to access and autonomy. Conversely, this increase in state regulation and destruction of the role of midwives coincides with disparate rates of maternal and infant mortality and other health issues in the African American community.

Without our midwives at the center of the community, we have lost access to a channel for transmitting our cultural knowledge, tools and values about health that are rooted in our African and other indigenous traditions. For example, we know that it has often been the midwives throughout history, who have facilitated the release of unwanted pregnancies through spiritual, herbal and manual practices. Part of the early AMA agenda was to make all abortion illegal. They accused midwives of performing abortions and began a campaign to drive them out of business.

Suppression of reproductive choice and midwifery go hand in hand, and are both aimed at restricting people’s right to choose when, where, how and with whom to have our babies. In the same vein, our movement for justice – reproductive justice and birth justice – must be intertwined and cooperative. The Birth Justice framework attempts to unite these perspectives. The focus of Birth Justice is to increase the range of pregnancy and birth options available and accessible for all, meaning pregnant people have full access to quality and compassionate reproductive health care options, from termination to homebirth. We must work together to expand reproductive choice. We must collectively guard against co-optation of our movements. The anti-abortion billboards across the South, blaming Black women for the deaths of Black babies send a dangerous message that we do not have autonomy over our bodies or our choices. These same attitudes persist in hospitals where pregnant people are coerced, threatened and even forced into having invasive procedures, including c-sections. We must build a cohesive agenda for all of our reproductive freedoms.

It is important to center education, access and support for marginalized pregnant, birthing and parenting people in our movements. For SBJN, this includes young people of color, incarcerated people (and those under correctional supervision), LGBT andimmigrants/undocumented families. Folks in these communities often have the least access to quality care and birth options but the greatest need. This is still largely seen as a white women issue of privacy and bodily autonomy based on the models of organizing used for abortion access. While midwifery and doula care continue to be portrayed as boutique health care options for wealthy, educated, white families, the reality is many birthworkers (especially birthworkers of color) are boots to the ground giving to the communities that need them with little or no compensation.

It doesn’t matter that the United States is among the wealthiest nations when my people, Black people (whose backs this nation is built on) are dying at rates that mirror the Global South. As we grow this movement, we need global solidarity for Birth Justice. We need bettereducational options to create more access for midwives of color. We need models ofsustainability for birthworkers in health disparate communities. Whether you squat to release a pregnancy or squat to birth your baby, midwifery care can be life saving and life affirming. We need more advocacy for access to these models of full spectrum healthcare.

Jamarah Amani

Mother and Midwife

Jamarah Amani is a mother, midwife and community organizer based in Florida. She believes in the power of birth and in sharing stories of legacy, survival and triumph as a mechanism for healing. Her mission is to do her part to build a movement for Birth Justice locally, nationally and globally. For more info about Birth Justice, please visit www.southernbirthjustice.org.