An Open Letter regarding the Division of Access and Equity at MANA

The Division of Access and Equity was convened to address systemic issues impacting midwifery and those seeking midwifery care. The hope was that the Division, by being people of color led and autonomous, could help shift the organization away from its foundation in white supremacy and toward a more equitable culture. Our strategy was that we could make this shift from the inside and that such a shift would make MANA’s mission of uniting all midwives more possible.

And certainly it has been a time of disorientation and discomfort for everyone involved. The kind of discomfort that hearkens back to Bernice Johnson Reagon's speech "Coalition Politics: Turning the Century" presented in 1981 when she said, "There is no where you can go and only be with people who are like you. It's over. Give it up."1

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We had hoped that the Division, as both part of MANA and yet made by and for the outsiders MANA had not yet institutionally welcomed, could turn that disorientation into transformation.

This effort was undertaken at a time when people were finally starting to listen to black and indigenous people about disparities in infant and maternal health, and when the role of racism in creating those disparities was finally taking center stage. Not to mention other issues that surfaced at this time including: the importance of transgender inclusivity (see MANA’s updates to their Core Competencies), and acknowledgment of the intersectional issues that impact reproductive health, including abortion.

For us, turning disorientation into transformation is the essential next step, the key priority. And it requires not just words, but action. It requires clear and deliberate action that demonstrates both that white supremacy is no longer acceptable and that another world is possible. As the Division this is what we tried not only to say, but to be. We are fueled by a commitment to equity in midwifery and to centering the work of people in midwifery who have been historically and structurally at the margins because this is essential to all of us thriving, this is essential to uniting all midwives.

During the “Midwife Debate” one hundred years ago, when midwives were maligned by doctors using such blatantly bigoted language as, “poor, black, immigrants, dirty, illiterate, untrained, ignorant, immoral, drunken, unprincipled, overconfident, superstitious, callous, rough, ‘relics of barbarism,’ and in some cases criminal abortionists,” (Pence Rooks)2 the consequences were not equally shared by all midwives. Midwives who were categorized as “poor,” “black,” “immigrant,” ‘barbarous’ (aka uncivilized) were impacted differently than those who weren’t, for what we hope are obvious reasons.3 We live with the resulting inequities today.

And so we wonder, like Adrienne Maree Brown in Emergent Strategy, “How do we shift from individual, interpersonal, and inter-organizational anger toward viable, generative, sustainable systemic change?”4 This has been a guiding question: how? Our experimental answer has been to act with clear and deliberate action like our Mama’s Day campaign celebrating midwives of color in 2017, interrupting white supremacy in public forums in 2017 and 2018, coaching board members in leadership decisions since 2014, and convening groups of leaders of color at MANA in 2016, 2017 and most recently in 2018 with funding from the Birth Equity Leadership Academy. We have tried to answer this by showing up as the outsiders within.

We are still at the beginning of trying to figure this all out as a movement and as a society. Despite the many who have come before us and tried, manifestation of the world we envision is still on the horizon. MANA has not shifted its power dynamics, as evidenced by the most recent conference where confrontations around race surfaced in multiple forums. Our number one priority as a Division was to take clear and deliberate action demonstrating both that white supremacy is no longer acceptable and that another world is possible. Following the 2018 conference, based on action and lack of action, we believe that this is not a priority shared by the Board.

As a result, our efforts within MANA do not feel viable, generative or sustainable. We have determined that the best place for our work to continue is not as a Division of MANA, but through our own projects and organizations (more details soon). And while such a departure is certainly not new (recall the Midwives of Color Section at MANA who disbanded in 2012)5, each generation adds something to the generations who come before, and so we offer our footsteps and fingerprints and these words to those who come next.

While we don’t yet know what the next iteration of this work will look like, we will make sure that many projects already underway will continue, like supporting the leadership of midwives and student midwives of color, convening national stakeholder groups around equity, conducting trainings and workshops, and generating educational materials.

We each remain, as individuals and members of the various groups and organizations we represent, part of this ecology, in coalition and in relationship. And we will keep trying to figure out how to “intentionally change in ways that grow our capacity to embody the just and liberated worlds we long for.”6


Indra Lusero

Demetra Seriki

Nicole White

Maya Johnson

Delmar Bauta

Jamarah Amani

Jaqxun Darlin

Marinah Valenzuela Farrell

Farah Diaz Tello

1.Bernice Johnson Reagon, “Coalition Politics: Turning the Century,” Home Girls: A Black Feminist Anthology, Kitchen Table Women of Color Press (1983). (Available here).

2.Judith Pence Rooks, Midwifery and Childbirth in America, Temple University Press 1997.

3.If it is not obvious consider reading, Dorothy Roberts, Killing the Black Body, Vintage Books 1997.

4.Adrienne Maree Brown, Emergent Strategy, AK Press 2017.

5.See Keisha La’Nesha Goode, Birthing, Blackness, and the Body: Black Midwives and Experiential Continuities of Institutional Racism, p. 182 (October 2014) (PhD dissertation, City University of New York) (Available here)

6.Brown, supra note 3.