About
The documentary feature film “Born for This” (to be released in 2023) and its associated podcast series (in production in 2023) is a labor of love, created entirely by a team of women who are passionate about maternal healthcare and birth justice.
Summary of the issues portrayed in the film
By now, the failings of our nation’s maternal healthcare system and its disparate impacts on women of color are widely known,¹ but the solutions are still elusive. In part, this is because there is not one system, but two fundamentally different ones, with an extreme imbalance of power and resources: the industrialized medical system of hospitals, and the world of out-of-hospital birth.² While both systems ostensibly provide the same services to pregnant people, their world views, along with their motivations, methods, and importantly and centrally in Born for This – how those systems are experienced by those who access them – could not be more different.³ Whereas hospitals and those involved in the industrial system often approach birth as a medical event requiring close management and frequent intervention, the midwifery model of care practiced in birth centers and homes approaches birth as a natural process, aiming to intervene as little as possible.
To an outsider, these distinctions may not be obvious. Hospitals, catching on to their customers’ interest in a ‘birth center-like’ experience, have in recent years opened their own ‘birth centers’ staffed with nurse-midwives and equipped with birth pools and yoga balls alongside IV drips and fetal monitors.⁴ After causing incalculable harm from decades of rising intervention rates, many hospitals have also implemented policies and practices aimed at reducing those rates.⁵ And yet, the experiences of medical racism, coercive practices, obstetric violence, deaths, harm, and trauma persist.⁶
Meanwhile, outside the hospitals and in many communities, Black women have taken matters into their own hands. Midwives and doulas practice care that is individualized and centered around the needs of their clients as whole people living and birthing from within families and communities, and birth centers, organizations, and collectives have sprung up to meet the needs of those communities. These support systems provide examples worthy of study and attention, as well as cause for hope.⁷ In the San Francisco Bay Area, California, in particular, Highland Hospital’s BElovedBIRTH Black Centering program has demonstrated that the system can change to better support Black birthing people, while outside of the region’s hospitals, midwives and doulas provide excellent care in homes and birth centers. Additionally in this region, efforts are underway to better integrate the systems and to provide better continuity of care.⁸
By sharing one unique family story within this microcosm, Born for This asks, “what kind of birth experiences are possible when Black birthing people and their families have the support they deserve?” The immersive story gives audiences an intimate look at processes hidden to almost everyone except for those who experience them, and an opportunity to witness promising models for solving our nation’s maternal health crisis.
In Castro Valley, California, we follow Janeé and Josh Washington and their providers as the determined couple plans and hopes for a home birth. The young couple were friends in high school, and after the pandemic hit, they reconnected at church and felt a spark that they believe was ordained by God. Often silly and teasing one another, their relationship remains strong through the unexpected ups and downs of the pregnancy. Each week we see their wise, loving, and no-nonsense midwife Lisa Davis (NuBirth Midwifery), one of just a few Black community midwives in the region, as she educates and supports Janeé and Josh in planning for their birth. Lisa is assisted by Bria Bailey, a student midwife and doula who represents a movement of young Black women who are answering the call to serve their communities as birth workers. Like many promising Black medical students, Bria became disillusioned while studying neonatology and training to work within the system. As a mentee and witness, she brings her wisdom and experience to Janeé and Josh and is a steadfast presence in their appointments. The couple is also supported by their doula Davon Crawford, herself a mother of four and student midwife with vast personal and professional experience and passion for the work. This team bands together around the couple, educating them and caring for them as Janeé’s belly grows.
filmed in Oakland, California
The importance of looking at a story from California
The birth justice movement was largely born in Oakland, California, in the living room of Born for This advisor Linda Jones;⁹ and UCSF, with its California Preterm Birth Initiative¹⁰ and an ongoing public awareness campaign, is a center for research on maternal health issues. California is the only U.S. state that has successfully reversed the trend of rising maternal deaths, and hence the rest of the nation is looking to our state for answers and solutions.¹¹ Though the overall number of deaths has decreased, the racial disparity persists, making the state an ongoing center for research and experimentation.
In 2019, California became the first state to pass legislation requiring implicit bias training and additional data collection by hospital-based providers,¹² and then in 2023 implemented Medicare reimbursement for doula services, so the next few years will be a particularly interesting time to examine and document this story in and from California, and Born for This will become an important tool for dialogue amongst a variety of stakeholders in California and beyond.
¹ Hoyert DL. Maternal mortality rates in the United States, 2020. NCHS Health E-Stats. 2022. link
² Vedam S, Stoll K, MacDorman M, Declercq E, Cramer R, et al. (2018) Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PLOS ONE 13(2): e0192523. link
³ Birth Settings in America: Outcomes, Quality, Access, and Choice. Washington (DC): National Academies Press (US); 2020 Feb 6. 2, Maternal and Newborn Care in the United States. link
⁴ Woo VG, Milstein A, Platchek T. Hospital-Affiliated Outpatient Birth Centers: A Possible Model for Helping to Achieve the Triple Aim in Obstetrics. JAMA. 2016;316(14):1441–1442. link
⁵ Rosenstein MG, Chang S, Sakowski C, et al. Hospital Quality Improvement Interventions, Statewide Policy Initiatives, and Rates of Cesarean Delivery for Nulliparous, Term, Singleton, Vertex Births in California. JAMA. 2021;325(16):1631–1639. link
⁶ Vedam, S., Stoll, K., Taiwo, T.K. et al. The Giving Voice to Mothers study: inequity and mistreatment during pregnancy and childbirth in the United States. Reprod Health 16, 77 (2019). link
⁷ Ellmann, Nora. “Community-Based Doulas and Midwives: Key to Addressing the U.S. Maternal Health Crisis,” Center for American Progress, April 2020. link
⁸ “Midwives and Obstetricians Train Together to Improve Care,” UCSF, March 2018. link
⁹ Black Women Birthing Justice “Herstory,” accessed October 17, 2022. link
¹⁰ California Preterm Birth Initiative at UCSF, accessed October 17, 2022. link
¹¹ “A shocking number of U.S. women still die of childbirth. California is doing something about that.” By Michael Ollove, The Washington Post. November 4, 2018. link
¹² “California Legislature Approves Bill to Reduce Maternal Mortality Rate for Black Women,” by Jade Hindmon, KPBS, September 12, 2019. link
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