The First Three Steps: How White Perinatal Professionals Can Support BIPOC Birthing People
It is virtually impossible for anyone who was raised in a white colonialist country – like the United States – to come into adulthood without racism in their heart and mind.
This is where implicit bias comes from.
So if you have heard people say things like, “All white people are racist,” that’s what they are referring to.
It’s not using the N-word or going to a KKK rally.
It’s not listening to Black women when they report pain in the hospital and missing a potentially deadly complication as a result.
That is one way implicit bias presents.
The research is ample and conclusive on the impact of racism in health care.
But beyond the research, we need to believe Black people.
White people created racism and white supremacy, so it is up to white people to dismantle it.
So what can white birth professionals do about it?
How can they identify and face the implicit bias in their own heart, and systemic racism within the health care system, so racial disparities can improve?
Heather Thompson and I sat down to discuss the greater issue of whiteness in maternity care and, during that conversation, we discussed this question.
The journey is lifelong, but here are three steps you can take to start.
PS: The entire interview, “Why Racism Matters: Understanding whiteness in maternity care,” is part of the Expert Interview Series available through VBAC Facts Professional Membership.
JK: If you’re a white birth professional what things should you be especially aware of if you are supporting a BIPOC person?
HT: I would say, yeah, go ahead.
JK: Well, I was gonna say, where do you even begin, right?
Step One: Understand Whiteness & White Supremacy Culture
HT: Yeah, with Tema Okun’s paper about whiteness, white supremacy culture I think is a great place to begin. I think it’s a great place to begin for a couple of reasons.
It really does open your eyes to the water you’re swimming in, it makes the fishbowl easier to see.
And that’s one of the steps, is just simply seeing how dominant culture functions.
I actually did an exercise, I think I mentioned this in the workshop you took, where I wrote all those characteristics down on a piece of paper, and I put them in my pocket everyday for several months.
And putting them in my pocket was a reminder about the ways I was participating in a culture that was designed for me. Like, here’s my dominant culture, puttin’ it in my pocket.
And I would take it out at meetings and in various places in my life, and it was amazing how much more I was able to see those characteristics show up.
And then when I was in communities that were less white, I was able to see how they didn’t show up, and the ways that they were not even relevant in some cases. So, that’s one piece.
The other reason I really like starting with a white culture is it gets us right into the juicy part of how hard this is for white people.
You know, it involves a lot of shame and guilt, and sometimes resistance, and fear. It pushes our perfectionistic buttons dramatically.
And I think engaging with white culture is a way to bring up some of those feelings.
Like, what is the top layer of those for you? What does it look like to interrogate, having been part of the dominant culture, and have the culture serve you, you know? That you have privilege from that culture.
And, I don’t love the term, white privilege, ’cause I think it gets misunderstood regularly, but all it means is that there were advantages, systemic advantages for you, that weren’t for people of the non-dominant culture. So I think starting there is a great place.
Step Two: Learn the Real History of Your Country
HT: I also think knowing history, real history, true history, history not written by the victors, is very, very important.
A really critical piece for me, in understanding the role of interrogating where I get my history, was the book, “All the Lies My Textbooks Told Me,” or something like that. And it basically–
JK: I’m writing it down
HT: Yeah, it’s how textbooks are made.
HT: And it is astounding how poorly facts get relayed in that process, and how many layers and moments for bias and stigma there are in the process of that.
And so, the story that gets told is the story about the victors, which tends to be white folks in this country.
You know, we can tell the stories about how Thomas Jefferson’s enslaved wife really loved him. And that might be true, but we haven’t heard that from her, so I’m not sure we should make that assumption, you know.
So there’s a lot of history we don’t even know. How, you know, the race riots in Tulsa. Tulsa, Oklahoma, was a burgeoning Black Wall Street, is my understanding. People with a real sense of wealth. And this country burned it to the ground, killed the vast majority of the folks in that community. And I never learned that in school.
JK: Absolutely not.
HT: You know, I live in the middle of the country where there are Indigenous lands and Native American reservations all in the states around me. I never learned the real history of what happened in the middle of this country.
I mean, I just recently heard that at one point in, I think it was South Dakota, more than 50% of Native American children were not living in their biologic home, with their biologic family. And it was the whole “train the savage out of them” time.
HT: And we have a lot of commentary now about what’s happening at our borders, and I think that we need to really interrogate the history of what’s happened within our borders, by us, to the people who live here. Because the history is really, really important in understanding it.
JK: I’m typing these up so I can add them into our resource list below this.
Step Three: Learn the True History of Obstetrics & Gynecology
HT: Yeah, Britteny Cooper’s book [Eloquent Rage as well as Deirdre Cooper Owens’ book Medical Bondage: Race, Gender, and the Origins of American Gynecology.]
You need to know the history of obstetrics and gynecology, and how much it was built on the bodies of Black slaves, specifically.
Because I think it gives you a sense of what our, where we are now.
JK: Yeah, you know, understanding the history is so important because trust is fundamental in maternity care.
And white people have to understand why particularly Black and Indigenous people will not trust you off the bat.
And it has nothing to do with you personally, it has to do with this whole history that has occurred.
And if you’re not aware of it, you’re going to take it personally. And it’s going to harm the relationship, and you’re not going to be able to provide good care.
And it’s like the person who grew up in a really abusive household, and they’re still dealing with the fallout of that as an adult, and someone says to them, “But that happened 30 years ago. Why are you still upset about it?”
It’s like, there are some things that are just ingrained in your wiring, and ingrained in your heart and your soul, and it doesn’t just disappear. And the history of racism in our country is that to the millionth exponent, you know?
It is so ingrained, it impacted everything, and you can’t say, “Well, slavery happened 200 years ago, it’s over now, what’s the big deal?” It’s so dismissive, it’s so dismissive.
HT: And I think your example of the family trauma is a really good one, ’cause it is trauma, and it is passed down intergenerationally. People do experience it.
And, I mean, it was the 60s before certain communities were even allowed to vote in this country.
So, there are people alive who remember that. So we don’t even need to go that far back in history to remember that folks didn’t even get to participate in our democracy.
We did not even allow them to have a say in what was going on here until pretty recently.
JK: Yeah, I just heard the other day on the radio, it was 1964 when Black women could vote in the United States.
And I just sat there, and I thought, every time I hear a statistic like that, it still hits me fresh, because I think, that was not that long ago.
JK: How can people think that racism is done, is over in this country.
As an internationally recognized consumer advocate and Founder of VBAC Facts®, Jen helps perinatal professionals, and cesarean parents, achieve clarity on vaginal birth after cesarean (VBAC) through her educational courses for parents, online membership for professionals, continuing education trainings, and consulting services. She speaks at conferences across the US, presents Grand Rounds at hospitals, advises on midwifery laws and rules that limit VBAC access, educates legislators and policy makers, and serves as an expert witness and consultant in legal proceedings. She envisions a time when every pregnant person seeking VBAC has access to unbiased information, respectful providers, and community support, so they can plan the birth of their choosing in the setting they desire.