Paper short abstract:

How do American doulas attempt to help clients achieve reproductive justice by highlighting and mitigating the intersectional precarities around birth? Through ethnography anthropologists can open collaborative conversations with birth workers about the need for reproductive justice in the USA.

Paper long abstract:

Following decades of pathologization of pregnancy and birth and institutional racism within biomedical care in the USA, recent years have seen a small but steadily growing shift amongst marginalized childbearers of color towards embracing alternative and non-medical methods of perinatal care and support, such as the use of a doula. While obstetricians and nurses push to streamline and medicalize the birth process, doulas push back against what they see as unnecessary medical interventions and institutional racism in biomedical care to advocate for their clients and to help childbearers of color achieve reproductive justice. This has been further complicated by COVID-19, as anxieties over infection have reshaped the conceptualization of "good" perinatal care and "essential work" in clinical settings. Using qualitative data gathered during the COVID-19 pandemic in Los Angeles, I will discuss the tensions that erupted between obstetricians, nurses and doulas when doulas were deemed "non-essential workers" in clinical settings. Through this ethnographic data, I highlight how doulas create ideological and moral boundaries around themselves in order to reaffirm their own legitimacy in relation to biomedical birth workers. I argue that it is these boundaries that doulas use in order to help their clients attempt to achieve reproductive justice by highlighting and mitigating the intersectional precarities around birth faced by childbearers of color in US birth spaces. Overall, I demonstrate how ethnographic data can open collaborative conversations with birth workers in order to create space to understand the urgent need for reproductive justice in US perinatal care settings.