The Politics of the Black Womb: How Education and Power Reinforce the U.S. Black Maternal Health Crisis

This study investigates the alarming maternal mortality rates among Black women in the U.S. today first by exploring the historical exploitation of Black maternal bodies during enslavement and with the rise of professionalized gynecology. It challenges the narrative that attributes these outcomes to individual choices or supposedly inherent biological factors, arguing instead that the devaluing of Black women’s well-being and authoritative knowledge have been constructed along with the United States itself. To advance a constructive response, the paper analyzes curriculum competencies for obstetric and midwifery healthcare providers, surveys of Black women's birthing experiences in the previous 20 years, and interviews with midwives to explore how conceptions of care are formally and informally conveyed through medical training with implications for how power is exercised in provider-patient relations in obstetric and midwifery care. Preliminary findings indicate that midwifery does contribute to reducing health risks for Black birthing individuals by distributing power in ways that increase feelings of autonomy and practices of communication, collaboration, and shared decision-making among practitioner, birthing person, and family supporters. Additionally, in neighboring and peer countries that have integrated midwifery services, including normalized postpartum care, there has been a clear reduction in maternal mortality. The work therefore ultimately concludes that effective, long-lasting solutions to the maternal health crisis exist with increasing support by relevant experts, however, they fundamentally challenge the norms and deeply entrenched incentive structures of the contemporary U.S. healthcare system. We know how to address power imbalances in the birthing process and how to empower critical insights that would counteract the structural subjugation of Black women in obstetric healthcare. We need the commitment and political will to translate the lessons of past and present midwifery into healthcare that prioritizes and translates into well-being for all.