Challenging the Legacy: Pathways to Equitable Maternity Care in Modern America

This chapter explores the deep-seated history of obstetric racism and systemic inequities within the U.S. healthcare system that have led to significant disparities in perinatal and infant health, particularly among communities of color. It traces the evolution of birthing practices from community-based, female-led models to institutionalized, male-dominated systems, emphasizing how economic and social factors rooted in the era of chattel slavery have influenced the contemporary model of care. By examining the history of the medical field, we detail how the professionalization of medicine served not only as a reflection of broader societal changes but also as a mechanism that perpetuated ethnic neglect and malpractice, particularly against Black females. This systemic devaluation of Black lives becomes the persistent and pervasive impact of racism on reproductive justice. In addition, we argue that the resurgence of doulas and midwives is a form of sociopolitical resistance and cultural reclamation, with a focus on how these practitioners are working to address health disparities and advocate for the rights and needs of marginalized birthing individuals. Lastly, we call for a multifaceted approach, incorporating advocacy, allyship, and intervention grounded in critical and intersectionality theories, to dismantle racist practices in healthcare and achieve equitable treatment for all birthing individuals.