Document Type

Article

Publication Date

2025

Abstract

Maternal health outcomes in the U.S. are remarkably poor, especially when compared to those in other industrialized countries. For example, our maternal death rate is more than twice that of Canada’s. Women of color in the U.S. suffer maternal morbidity and mortality at rates considerably higher than white women. Indigenous women experience the worst maternal health outcomes of all. Yet, most maternal deaths and injuries are preventable. Furthermore, rates of maternal harm, including death, are lower when midwives and similar birthing attendants are involved. This Article is the first to fully explore the unique skillset of traditional birth attendants (TBAs). TBAs are midwives trained in their Indigenous or other traditional cultures to assist with childbirth. This Article argues that state and local midwifery laws should include recognition of TBAs, as a few state regulations have recently done. It details the maternal health crisis, and it explains the correlations between that crisis and the climate crisis. It also describes the data showing maternal health problems are exacerbated by systemic racism and colonialism. Legally recognizing TBAs disrupts these inequities and improves maternal health. This Article is the first to make these connections and to argue specifically for legal integration of TBAs, rather than midwives more broadly. TBAs operate with deep respect for the interconnectedness of people and of the environment in the birthing process, which is a unique skillset. The environmental justice and reproductive justice movements offer critical insights in this regard, as does the emerging “birthing justice” movement. Those legal movements demonstrate the ways that principles of interconnectedness and empathy can be leveraged for positive legal change. This Article invites legal advocates to build on those foundations, reflected in many existing laws, to cultivate reparative strategies for maternal health. State and local governments can mitigate the maternal health crisis disproportionately experienced by women of color in the U.S. by integrating TBAs into midwifery laws.

Download

SSRN

Share

COinS