Mothers and birthing people grow familiar with other’s opinions on their bodies long before a child is born. Black mamas face this from all sides—our inner circles offer unsolicited opinions, and the larger world offers damning statistics. Neither of these prioritizes Black birthing people’s desires for pregnancy or birth. And as others’ opinions overshadow their voices and concerns, it’s easy to feel dehumanized and unable to make decisions.
Bodily autonomy, or the right to make decisions about your own body, life, and future without coercion or violence, is rarely called out directly in discussions on pregnancy and birth. Still, even without direct mention, it’s easy to see how patterns of ignoring and silencing Black women’s concerns in birth and postpartum suppress efforts to improve reproductive health outcomes. The downplay of our concerns also minimizes our opportunities to tell our stories, and the impacts of this limit control of our bodies and create additional vulnerabilities during birth.
“I often joke about motherhood being the world’s worst best-kept secret,” says Brenda Kola, director and co-founder of Orbit, the UK-based mother and womanhood platform. She notes that the silence around birth, pregnancy, and motherhood impacts our ability to advocate for ourselves. “Too often, we don’t share our experiences in fear of being judged—then the next woman walks into motherhood completely blindsided by the reality of it.”
When she gave birth to her daughter Capella-Rose in 2020, she learned the importance of bodily autonomy and having your concerns respected firsthand. “My labor and delivery were traumatic, not only because my daughter could have died but because of the way my rights were constantly violated; I had no voice,” says Kola.
The risks Black women face during pregnancy and postpartum regularly appear in the news cycle. Reminders that Black women are three to four times more likely to die giving birth follow us to each appointment. At times, it seems others discuss our risk while denying our humanity. It is rare that we center Black perspectives of pregnancy and birth when giving care. But this disparities-first coverage rarely connects Western maternal health and wellness to a widespread reduced autonomy for African-descended individuals. Often, we miss the opportunity to see global patterns and explore the complex tapestry of factors that shape maternal health disparities worldwide.
Like many, Kola was aware of the racial disparities in pregnancy and birth for Black women. As noted, she lives in the UK, where outcomes for Black women can be as bad as the U.S. MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) published a report that found Black women in the UK are four times more likely to experience maternal death. Birthrights inquiry, a year-long investigation into racial injustice in maternity services there, found lack of physical and psychological safety, being ignored and disbelieved, racism by caregivers, dehumanization, lack of choice, consent, and coercion, structural barriers, and workforce representation and culture.”
In this spirit, Kola and her best friend and Orbit co-founder Shanice Tomlinson shared their birthing stories but didn’t anticipate the video where they did so would take off as quickly with a global audience. Nearly 1,500 individuals from all over the world shared stories of mistreatment during labor. “Some comments were from women who didn’t even know they had experienced assault or being mistreated during labor.”
“During my first experience of pregnancy and labor, “I put my trust into the health care professionals and didn’t push and ask as many questions as I should’ve,” says Tomlinson, reflecting on giving birth to her daughter Milan in 2020. “I trusted their processes and things they said had to or needed to be done.” She realized provider preferences and expectations could shape birth experiences.
In the United States, racial health disparities are met with calls for more Black medical professionals. Research shows “racial concordance” or providers and patients having the same race, improves outcomes. But Kola’s story shows we need more than a color shift—we need a culture shift. She had a Black midwife team, but her provider downplayed her concerns, namely, through cultural customs and expectations to respect elders and not question them, which conflicted with her needs as a patient. The result was a denial of her autonomy.
She recalls hearing comments like “My daughter didn’t need gas and air, so you don’t need it” and “My daughter had three children, and she managed the pain well.”
“As a patient, I am allowed to question why certain things are being done. I am allowed to ask what is going on with my care,” Tomlinson says. But she felt silenced. “They see themselves as my ‘aunty’ and not a service provider.”
Maternal health disparities are widely discussed, but solutions and perspectives humanizing Black mothers and birthing people are rare. Public instances, like Jackie Walters, star of Bravo’s Married to Medicine, making disparaging comments about Black women in medical care demonstrate this. Kola was disappointed to see birthing experiences invalidated in the comment section, saying it demonstrates why many are silent on their traumas. She points to Walters and these comments about Black women who “cry wolf” as evidence that the issues surrounding Black maternal health are multifaceted.
Many believe the issue is a birth culture that prioritizes medical preferences over patient consent. Like other advocates, Kola emphasizes the importance of birthing rights education before labor.
Tomlinson says many mothers are “suffering in silence,” unaware of the frequency of their experience. She wants them to experience the validation of hearing they’re not alone. Thankfully, it’s not hopeless. Advocates believe in giving Black people an opportunity to share their birth stories to increase autonomy. Black researchers and medical professionals lead the way in using Black birth stories as a tool toward autonomy—and challenging exclusively negative portrayals. Resources like the Irth app amplify the perspectives of patients and loved ones. Organizations like Sistersong, Black Mamas Matter Alliance, and other reproductive justice oriented groups hold more space for these discussions. The National Association to Advance Black Birth wrote The Black Birthing Bill of Rights.
But for these efforts to be successful, Black birthing people must take up more space and share their stories. The Orbit founders say the conversations they hold for mothers to share anecdotes about pregnancy, birth, and motherhood is part of a larger strategy to challenge the culture of silence and secrecy that leaves many unprepared for the reality of motherhood.
There’s much work to be done to give Black mothers and birthing people the reproductive experiences they deserve. But the shifts start with reclaiming voice, autonomy, and information. Orbit has connected with over 5000 women, ran over 40 live audio rooms, partnered with organizations, and built a community to get closer to this mission.
“Change can’t happen if we are silent. Change can only happen when we make noise and be disruptive,” Tomlinson says about what they do at Orbit. “We push the boundaries and talk about absolutely everything, including the things society tells you are taboo in womanhood and motherhood.”