Imagining Collective Healing: Birth Work as Community Transformation

his past September, whistleblower Dawn Wooten (LPN) shared stories of nonconsensual hysterectomies, doctors withholding treatment information from patients, and reproductive violence in ICE detention centers. These revelations renewed personal and political discussions of reproductive autonomy. While this surprised some, others recognized a familiar reality. For many immigrants, Black, Brown, and Indigenous folks, people with disabilities, and queer and trans folks, the experience of being abused, misled, and ignored is commonplace within reproductive healthcare. However, midwifery care can be a key intervention. Latinx midwives, doulas, and birthworkers in the SF Bay Area recognize the historical and contemporary ways that reproductive autonomy has been stolen and locate the possibility for change within their own practices and communities.

Birth has the power to set the foundation for a world that is more loving, empowered, and collaborative. Latinx midwives, doulas, and birthworkers in the Bay Area intervene in reproductive oppression by bringing decolonial and educational healing to their communities. They work against colonial hierarchies of disempowerment where pregnant and birthing people are alienated from their own knowledge and power by providing tools for the community to care for itself and to build communication and collaboration skills. Through these empowered and autonomous experiences, parterx build a new world in which people who birth, babies, families, and communities can care and be cared for more fully. 

In order to learn more about the transformative work of Latinx midwives, doulas, and birthworkers, I interviewed eight care providers in my own community. In the East Bay, there is a strong network of practitioners who incorporate the autonomous, spiritual, and relationship- and community-based approaches that differ from standard medical care. Here, I highlight key perspectives from three queer Latinx practitioners: Sara, a nurse-midwife, Andrea, a home birth midwife, and Angela, a birthworker and herbalist.

A Note on Language

I use “birthworkers,” “parterx,” and “midwives, doulas, and birthworkers” interchangeably. Midwives are reproductive healthcare providers who focus on the medical aspects of labor and delivery, prenatal, and postpartum care, such as monitoring heartbeats and the baby’s position and growth. Doulas are non-medical guides who support those who are giving birth, their partners, new babies, and community members. Partera means midwife in Spanish, a term that comes from the word partear, “to deliver,” and carries with it the history of Indigenous herbalism, spirituality, and healing practices. I use the X to signify the gender diversity of practitioners both in general and in reference to those I interviewed. Midwives, doulas, parterx, and birthworkers all serve as knowledgeable experts and as emotional and spiritual supports. Their roles converge in their social-emotional and spiritual care, in the way they share knowledge, and in their framing of birth.

A Historical Legacy of Reproductive Oppression

Reproductive healthcare is a site of state regulation imposed upon marginalized peoples and individual bodies. Historically and currently, Black, Latinx, and Indigenous people of color, those who are undocumented, and queer folks have been consistently denied access to healthcare, reproductive autonomy, and healthy births. Forced sterilization is one stark way the state has historically controlled reproduction. During the early 20th century, it is estimated that roughly one-third of all mothers in Puerto Rico aged 20-49 were sterilized, many of them coercively or unknowingly.[2] This tactic, used to control Puerto Rican reproduction, was mirrored in California during the same time, where patients of Mexican origin were sterilized at a rate disproportionate to their share of the state population.[3] It is the same tactic that is currently being deployed against people in ICE detention centers.

Sterilization is not the only site for reproductive violence through medical treatment – Black and Indigenous, undocumented, and queer and trans folks experience reproductive oppression during pregnancy, birth, and postpartum times. Among hospital births, people of color are not as safe as their white counterparts. Studies from the CDC and the National Institute of Health report that Black, Latinx, and Indigenous people have significantly higher rates of infant and parental mortality than white people.[4] In response, parterx work to provide loving, empowering, and collaborative care. Birth is a high-stakes context where harm can occur, but also where healing can take place. Through their decolonial and educational care, parterx work against the trauma of reproductive oppression and help build a new world where families and babies of color can come into the world safely — and where they can thrive.

The Transformative Potential of Birth Work

Latinx midwives, doulas, and birthworkers in the Bay Area believe that midwifery care and empowered births have the ability to shift how people think about their own power and how communities care for each other. Many parterx share stories of witnessing transformational births, as well as their own experiences of growth and empowerment through birth work. Sara, a queer Mestix nurse midwife who works in a high-volume Oakland hospital, recalled that they were in high school when they first sensed the transformational power of midwifery:

My pull towards birth was strong...Like, “I have to change the system.” And midwives are the architects, engineers, and the construction workers of building a new future in which people experience body autonomy. I really believed that midwives had that level of power… I thought, “this is the ultimate orchestrator of body autonomy!”[5]

Sara’s construction analogy indicates how midwifery can intervene in the medical industrial complex to build powerful, transformative alternatives. Birth can become a powerful tool of decolonization when folks who are birthing can feel safe and find power from within their body and from their community (instead of relying on disempowering institutional structures).

The transformative potential of birth work also extends to the way communities take care of each other. Birth is a high-potency context where relationships inevitably shift — someone becomes a parent or loses a baby, babies come into the world, people care or are cared for in new ways. Andrea, a queer Chicana home birth midwife, argued:

Birth is a political act, and when people have positive birth experiences it affects their whole life and the temperament of the child and their beliefs about themselves. [Parents] leave with a knowing that affects their parenting forever. The way they advocate for the baby, not resonating with abusive relationships anymore, learning to set boundaries with people around them. I feel like it really helps end generational trauma.[6]

Andrea spoke of the way skills found and developed during pregnancy and birth can stay with a family into their future. In this way, birth has the potential to set the foundation for the way families interact with each other and how kids grow into the world.

Angela, an Indigenous Chicana birthworker and herbalist, argued that the way people care for each other in birth contexts can impact the way communities care for each other in general. They explain that birth can change “the way that we show up for one another, the way that we do our own work, what we see as important, how we respect our bodies, how we respect what other people say about our bodies, how we want to be treated. It’s paradigm shifting.”[7] Even further, Angela illustrated how birth opens up the possibility for transformation on a broad community scale.

[Birth] clears people’s vision for what can be possible in this world if they can actually see somebody and support somebody through birth. If you can see this transformation happening right in front of your eyes, you can believe that any transformation can happen in this world… Birth is transformational, it’s healing, it brings people together, it brings communities together.[8]

Angela’s vision is powerful. They convey how impactful birth work can be, and what is possible when people give birth or support their loved ones through pregnancy or birth. Sara, Andrea, and Angela have provided the context for what I have identified as the two primary methods of transformation: decolonization and education. Next, I will explore the educational tools parterx use to help families build self- and collective reliance, bringing decolonial transformation to communities as a whole.

Decolonizing the Future of Birthwork

Colonization often functions through disconnecting folks from the knowledge they need to take care of themselves, forcing them to be reliant on the oppressive settler state. Thus, midwives, doulas, and birthworkers seek to transform their communities through education. Andrea framed this task as one that is based in communication.[9] They seek to answer questions such as, “What information does my community need?” “How do I make this information more accessible?” and “How do I share what I know while maintaining a power dynamic that is collaborative and equal?” Asking questions in this way allows parterx to support their communities without replicating the harm of the medical industrial complex. When they allow the community to identify their own needs and share knowledge in an accessible and collaborative way, parterx help to build community knowledge and empowerment.

In order for information-sharing to be truly collaborative, Andrea makes sure that the way they communicate with their clients is non-hierarchical and trusting. Andrea explained their relationship-based model as one that focuses on “the connection we have with our clients – we’re giving loving care as a peer. We’re experts on natural childbirth and we’re sharing that knowledge with our clients in a loving way, a respectful way. We’re all about clients having autonomy.”[10]

Midwives, doulas, and birthworkers know that birth can heal the wounds of colonization, medicalization, and intergenerational trauma. Their work critiques colonial efforts to control all aspects of reproductive health for Black and brown people and aims to restore autonomy, sacredness, and knowledge to communities. Families can then grow their network of support, expanding beyond the relationships between care providers and clients to offer space for communities as a whole to engage in decolonization. Angela explained birth work as an integral aspect of the way communities relate to and care for each other.

Our mission is to bring people back to birth ceremony. For people to understand the sacredness of life. We’ve always had this practice available to us, it was just taken from us by colonialism, medicalization, all of that has made birth this scary thing… [Our mission is] for us to work with historically oppressed groups of people in recognizing the sacredness of our lives so that we can protect one another.[11]

Angela’s way of thinking brings love and sacredness into the conversation and expands the reach of this positivity into a wider circle of care, setting the foundation for broad community transformation.

Imagining an Empowered Future

What is so magical about the way parterx think about bodies, babies, communication, and healing is their vast capacity for imagination and for visioning alternative ways of being. By helping those who are pregnant and birthing find power in themselves, connections with their babies and families, and support from their communities, parterx help to build tools of trust, communication, autonomy, and self-love.

Parterx see and acknowledge the trauma that comes from disempowering institutions, relationships, and experiences, and they imagine how that trauma can be healed and how to move forward differently. Bay Area Latinx midwives, doulas, and birthworkers remind us that we have the resources we need among our communities. They remind us that our bodies and spirits are sacred and that our ancestors are with us. They remind us to move, breathe, share, and connect. They remind us of the generosity of boundaries and the power of ceremony and that we can keep ourselves and each other safe. They remind us that together, we are powerful.