ABSTRACT

How does risk of mortality during childbirth become internalized and embodied in Black communities? While mainstream news articles aim to bring attention to inadequacies in Black maternal healthcare, few ethnographies elucidate the effect that these risk factors have on Black women’s psychosocial health and the support networks they turn to in order to mitigate risk.

My ethnography analyzes the effects of institutional racism on maternal mortality risk factors, specifically toxic stress and grounds Black maternal health in the context of a burgeoning doula movement in Mississippi. Through tracing the psychosocial and emotional support networks of single Black mothers on WIC and working Black mothers, I elucidate several inadequacies in healthcare models of maternal care. I identify the framework of medicalization in pregnancy care that arose in Mississippi in 1920, as a way to dismantle existing Black birth work communities, mitigate infant mortality risk, and subsequently stratified birthing knowledge production. Through an analysis of midwifery and doula work in Mississippi, this article traces the displacement of Black midwives and other nonmedical Black birth workers in Mississippi and the distrust these communities harbor towards hospitals in the present-day.

My article primarily aims to bring equity to Black birth workers modes of knowledge production. It explores intergenerational distrust and fear in the context of Black maternal health in Mississippi. First, I trace the unequal landscape of birthing care for Black women in Mississippi from the development of public health in 1920 to the current locales of clinical care. Next, I emphasize intergenerational trauma as contributing to stress for Black expectant mothers and the need for psychosocial support. Finally, I present findings that recommend integration and standardization of doulas in the healthcare system and centering maternal psychosocial support in communities.