Dissertation title:
Embodying Sacred Political Practice: The Resurgence of Culturally-Rooted Birthwork by Midwives and Doulas in Arizona
In the context of innovative maternal health initiatives, organizational shifts, and the expanding Birth Justice Movement in the US and globally, a disproportionate level of traumatic birth experiences still exists in Indigenous, Black, and intersecting Queer and immigrant communities. Meanwhile, decades of dominant narratives in research have historized the medicalization of childbirth while justifying the erasure of Indigenous and Black midwives from their role as community leaders and birth experts. Recent maternal health scholarship has demonstrated the value of continuous perinatal support, which has in turn contributed to the expansion of doula care programs as a strategy for countering birth inequities and making medicalized birth settings representative of communities on the margins. Despite growing interest, there is still limited community-driven research examining the resurgence of cultural birth practices and the political work of urban and local midwives and doulas who sustain and reproduce ancestral and Indigenous knowledge.
In this dissertation, I examine how midwives and doulas of color enact Birth Justice in Arizona. The methods and analysis are deeply reflexive and rooted in decolonizing research paradigms and Indigenous Feminist Theories and Practice. My dissertation is organized as follows: The first paper narrates my methodological journey of obtaining permission from elders in Mexico to conduct the study, following cultural protocol and insights from research collaborators, and applying four key decolonizing research methods: auto-historia teoría, visits, sharing circles, and listening sessions. The second paper presents six thematic findings organized in three pillars: embodying the sacred, knowledge sharing, and accountability of systems; it sheds light on the continued lack of institutional support for midwifery models of care in the state. The third paper examines the implications of this study and traces the implementation of a state-level doula care policy, demonstrating how state bureaucratic processes related to training, credentialing, and reimbursement are successful when birthworkers of color and local doula training organizations are active contributors. Fundamentally, my findings demonstrate that culturally-rooted birthwork is an intentional political practice grounded in the inherent dignity and sovereignty of the birthing people it serves.
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Dissertation Proposal title (August 2023): Birthworker-led advocacy and training in Arizona and beyond: Uplifting the knowledge and practices of community-rooted birthworkers through an Indigenous feminist lens
In this critical study, I center Indigenous epistemologies as an act of decolonization and explore the foundational understanding of childbirth within the realm of medical anthropology. Specifically, I focus on the contemporary manifestation of traumatic childbirth and its deeply interwoven connection with the perpetuation of white settler colonialism and heteropatriarchy. Within this overarching discourse, I highlight the pivotal role played by community-rooted birthworkers in serving as agents of disruption within these prevailing systems of power.
A significant aspect of the analysis revolves around the enduring hierarchies of knowledge and culture that continue to characterize the Westernized biomedical field. This field, which underpins much of the research and practice in modern obstetrics, continues to marginalize the cultural plurality, spirituality, and the rich ancestral heritage that is emblematic of BIPOC communities in the United States. Consequently, individuals whose cultural practices, traditions, intuitive wisdom, and embodied knowledge are imperiled within the biomedical context remain at grave risk of experiencing traumatic birth events or pregnancy-related mortality.
Over centuries, birth companions have played an instrumental role in amplifying the voices of women and all birthing individuals, advocating for their rights and well-being both inside and outside the birthing environment. In this regard, my research strives to discern and elucidate the presence of indigenous feminist principles in contemporary advocacy endeavors and doula training programs in the state of Arizona. These findings will aid in the construction of a culturally-restorative framework, one that can inform and shape birth equity policies and practices.
A deeply personal dimension is inherent in this research, as I, the investigator, am a transterritorial mother of mestiza Mexican heritage, formerly undocumented, and raised along the Tohono O'odham borderlands. This positioning affords me the privilege of engaging in a reflexive research process and fostering the development of my own Indigenous feminist practice. As a scholar and a member of my home communities in Central Mexico, Tucson, and Phoenix, I stand committed to the reclamation and revitalization of indigenous knowledge systems and practices in the realm of childbirth, thereby contributing to the broader discourse on equitable and culturally sensitive perinatal care.
Dissertation committee: Dr. Roseanne Schuster (co-Chair); Dr. Jonathan Maupin (co-Chair); Dr. Rosalynn A. Vega (Member, University of Texas - Rio Grande Valley); Dr. Myla Vicenti Carpio (Member, Arizona State University & University of New Mexico).
