Doing birth work from a reproductive justice perspective

This graphic, and many phenomenal others, was made by local artist Megan J. Smith (they/them) of the  Repeal Hyde Art Project .

This graphic, and many phenomenal others, was made by local artist Megan J. Smith (they/them) of the Repeal Hyde Art Project.

I believe that birth work is explicitly political. And in a political atmosphere that is uncertain for most and dangerous for many, I want to be clear about where I stand: at All Bodies Birth, reproductive justice is the foundation of my care and advocacy work. Here’s a bit of an introduction to what reproductive justice in birth work means for me.

What is reproductive justice?

You’ve probably heard of reproductive rights, a phrase that is often used in public discourse to signal to things like access to abortion and birth control and is attached to major victories like Roe v. Wade. But for all its accomplishments, reproductive rights has been a flawed perspective. Instead, I draw attention here to the work and experiences of those fighting long before and left behind by the reproductive rights movement — queer and trans people, people of color, indigenous people, and low-income and poverty-impacted people — and align myself with a framework that prioritizes their voices in the struggle for justice.

The foundational definition of the reproductive justice movement comes from SisterSong Women of Color Reproductive Justice Collective. In the words of SisterSong, reproductive justice is:

the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.

This extends well beyond the legal right to an abortion and focuses on the many interconnected ways that institutions in society shape the opportunities and choices available to people, families, and communities. True reproductive bodily autonomy is the right to parent with dignity, health, and agency — to have access to knowledge, resources, and support to make truly autonomous choices. After all, what good is a right if you cannot access the services that right has provided?

From this perspective, identities are interwoven and so oppressions and privileges are interwoven as well. In the words of Audre Lorde, “There is no such thing as a single-issue struggle because we do not live single-issue lives.” Abortion is tied up with food scarcity, policing/incarceration, housing, migration, healthcare, and so many other issues that we can’t afford to overlook. Reproductive justice is a fundamentally intersectional movement that demands intersectional action.

The differences between reproductive justice and reproductive rights frameworks

As a perspective on the world, reproductive justice differs substantially from reproductive rights. As Loretta Ross puts it, reproductive justice is “a paradigm shift beyond demanding gender equality or attaching abortion rights to a broader reproductive health agenda.” Essentially, the rights perspective has been narrow in scope and leadership, while the justice perspective is more comprehensive and intersectional in scope and is driven by people who are marginalized in multiple ways. You can read more on the differences in this ColorLines article.

How does reproductive justice apply to birth work?

First, doing birth work from a reproductive justice perspective means that we must invest time and energy in understanding the specific consequences of racism in birth and parenting. In the United States, black birthing people* are three to four times more likely to die during or because of childbirth than their white counterparts. In Illinois, the risk is closer to six-fold, and the vast majority of these deaths are entirely preventable. This is the direct and explicit result of racism in health care, and not even wealth, education, or celebrity status protects black birthing people from this stark reality. Make no mistake: this is a public health crisis, and it is largely being ignored. Birth workers have an opportunity to draw attention to these issues and do better for our clients.

Graph created by Alyson Hurt for NPR, using CDC data available  here .

Graph created by Alyson Hurt for NPR, using CDC data available here.

Further, the choices we work so hard to educate white pregnant people about and ensure that they have access to — VBAC, homebirth, waterbirth, breast/chestfeeding, etc. — are so rarely presented to or fully supported for black pregnant people. Increasing numbers of black birthing people are returning to home settings to give birth, yet as long as that choice is made to minimize the racism found in hospital settings, to achieve greater choice in their birthing experience, or to ensure informed consent processes, our reproductive justice goal of making every setting and every choice equally understood, safe, available, and accessible for every birthing person remains unfulfilled. Black birthing people and parents do VBAC, do homebirth, do waterbirth, do breast/chestfeed, and absolutely do deserve to make any of these choices freely and without fear of retaliation. (In fact, some discussions point to homebirth as a way to lower maternal mortality in the United States in general and for people of color specifically.)

Reproductive justice aligns with the fundamental premise of being a doula, which is to hold a judgment-free and knowledge-filled space for pregnant people to make empowered choices about their reproductive and parenthood journeys. As doulas, we strive to understand the unique personal and structural contexts in which every person navigates this path, and to come alongside them with support and guidance as they do. Pretending that reproductive oppressions don’t exist or don’t impact the people, families, and communities we serve is a disservice to our clients and to the importance of birth itself.

black women breastfeed

What does reproductive justice demand of doulas?


We must continually learn from the voices of marginalized people who drive this movement. Start with Reproductive Justice: An Introduction by Loretta Ross and Rickie Solinger if you can find it at your local library or have the means to purchase a copy. The Radical Doula Guide by Miriam Zoila Pérez is also a great primer for applying reproductive justice principles to doula work. There are many free resources available online, too (see “further reading” at the end of this post for some suggestions).


Many, many birth workers are white women practicing in a tradition that has grown from communities of color (learn more about the history of black birth work here and here). This requires that we confront our privilege and do the hard work of understanding our role in systems of privilege and oppression. Doing birth work from a place of privilege comes with the responsibility of checking that privilege continually. (Update: Sabia Wade, The Black Doula, runs workshops on Racism and Privilege in Birth Work across the country, and I highly suggest attending one if you are able!)


  • Show up for the community. If you are local to Boston, give your time to organizations like the Boston Abortion Support Collective, The Network/La Red, or Black and Pink. If you live elsewhere, find your local legitimate abortion clinic (be sure it is NOT a crisis pregnancy center or fake clinic), domestic violence shelter, or other organization directed by people of color and/or LGBTQ+ people and volunteer.

  • Find your contribution. Maybe you can show your support financially (great!), but maybe you can’t; there are plenty of other needs that you might be able to meet. It could be spreading awareness and exposure, making phone calls, hosting an organization’s meeting, or giving someone a ride. Use your skills and resources to move justice forward however you can.

  • Divest from the supremacy of these institutions in your daily life. Confront instances of racism, sexism, homophobia, transphobia, ableism, and other oppressions, especially those perpetuated by people you love. When you receive benefits from, for instance, white supremacy, step back and ask who those benefits come at the expense of and how you can work to redistribute benefits in more just and equitable ways. Layla F. Saad’s Me and White Supremacy Workbook is an excellent tool for reflection.

  • Vote, and protect the right and ability of all people to participate in political life. Do what you can to eradicate any barriers to voting that your neighbors might be facing, like childcare, identification, transportation, or work coverage.

  • Check in with friends and loved ones that are being hit particularly hard by recent political events. Hold space for the queer, trans and gender-nonconforming, racial minority, religious minority, low-income, differently-abled, and otherwise marginalized people in your life without taking ownership or control of their feelings. There is a time to fix things and there is a time to just be with them — justice requires both.

T-shirt by  Purgatory Ltd.

T-shirt by Purgatory Ltd.

Further reading on reproductive justice

*In my original content, I choose to use “birthing people” or “pregnant people” instead of “women” as part of my commitment to affirming birth work. Read more about the importance of language to my work here.