Birth Justice, Community, and Trusting Women of Color: An Interview with Indra Lusero

This past weekend, the following image went viral across various social media platforms:

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Rights Over My Birth (ROMB) info card as featured on the Ancient Song Doula Services Twitter.

In the following interview, you’ll hear from the person behind the necessary and important info card that you may have stumbled upon while scrolling through Twitter, Instagram, or Facebook  recently. Or maybe you happened to be in attendance at the 2018 Decolonize Birth Conference hosted by Ancient Song Doula Services, “an international doula certifying organization founded in the Fall of 2008 in Brooklyn, New York with the goal to offer quality Doula Services to Women of Color and Low Income Families who otherwise would not be able to afford Doula Care and training a workforce of full spectrum doulas to address health inequities within the communities they want to serve”, and picked up an info card for yourself!

Indra Lusero is a staff attorney for the National Advocates for Pregnant Women as well as the founder of the Birth Rights Bar Association. According to the BRBA:

Pregnant and birthing people are being denied a range of fundamental rights normally associated with constitutional personhood, including the right to life, physical liberty, bodily integrity, due process of law, equal protection, and religious liberty, based solely on their pregnancy status.  This denial of fundamental rights extends to midwives and other health professionals who care for pregnant and birthing families.

This legal problem is compounded by a broken maternity care system that spends more and accomplishes less, while maternal mortality is rising, and evidence-based practices are under-utilized.

There is a grave need for knowledgeable lawyers, coordinated strategy, and resources. Currently there is no organization with the capacity to address all of these cases. [They] aim to fill that void.

JESI: What are your experiences with the Birth Work community?

INDRA: My experiences with the birth work community are pretty extensive and varied. From being there as a three year old when my brother was born at home, and then again when my sister was born at home were early introductions to the need for birth workers and the quality of presence of birth workers. My eldest son’s birth, where I was the non-laboring parent, and we had a midwife acting as a doula and we had a family practice doctor as our care provider in the hospital setting was another view, and then my homebirth with community midwives – these were all very defining experiences. And then I was certified as a labor doula and as a doula I’ve experienced a range of birth with birth workers of all sorts from home birth midwives to CNMs and OBs. I got that certification while in law school because I wanted my advocacy to be informed by real hands-on experiences and a real understanding of birth and birth work. It’s been almost 18 years since my eldest was born, and I’ve been really dedicated to this field for at least 13 years so in that time I’ve gotten to know and work with all kinds of birth workers from all walks of life across the globe.

JESI: Has any of your work as a lawyer or birth advocate been inspired by the work of women of color who aren’t a part of the legal profession? Can you discuss, briefly, what you feel the relationship between lawyering and community should look like?

INDRA: Most recently, China Tolliver and Demetra Seriki! But I make it a point to listen to women of color. I think this document was able to happen and able to happen so quickly and efficiently because of a long term investment in amplifying women of color and building relationships of mutual trust. Before I went to law school women of color who aren’t lawyers, many who I knew mainly by their writing, helped me grow and utterly shaped the foundations of my understanding. Audre Lorde, Gloria Anzaldua… I studied theatre so also playwrights like Cherrie Moraga, Suzanne Lori Parks, Adrienne Kennedy, Anna Deveare Smith. Audre Lorde’s essay “Uses of the Erotic the Erotic of Power” is one of the guiding lights of my life. I also inhabit the space between whiteness and of color-ness. I am Latinx but I am maybe one of the most light-skinned Latinx people’s you’ll ever meet! This has been an informative position. I think it has made it easier for me than for most white folks, to de-center my whiteness. And it has also made it more central and important to center women of color. Because I understand that I wouldn’t inhabit this position of privilege if it weren’t for women of color who made strategic choices from positions of invisibility and from positions of marginalization, I feel it’s my duty to honor their legacies and to use this position of power to shift the balance. I have birth workers and healers in my family on my maternal and paternal sides. My paternal great grandmother was a curandera. So I am intimately aware of how her wisdom and expertise was side-lined systematically in her lifetime, and not only her expertise as a healer but also her expertise as someone who understands birth, having done it herself almost ten times. So, I already had this sense purpose and foundation for shifting the balance of power when I became a lawyer.  For me lawyering is another set of tools in the toolbox: often, not the most important tools but some of the more dangerous tools.

JESI: Why do you feel that the ROMB info card is important?
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INDRA: Laws are just human created things. We can create better laws and that starts by having ideas about what is right what is valued. The info card is a way of taking charge of our destiny, it’s a way of saying, we know what we need and we are going to demand that our systems adjust to our understanding of what is right.
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JESI: What advice would you give to a pregnant or birthing person who reads the ROMB info card and feels scared to advocate for themselves?
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INDRA: I would say, I get it. It’s hard. It’s not easy. Parenting isn’t easy either. Parenting is going to challenge you to stretch in ways you don’t think you can, so now is a good time to start stretching. And parenting is also forgiving and you get lots of chances to keep at it, so you can also do a little bit now and try again in an hour, or try again in a day and just do the best you can.
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JESI: What led to the creation of the Birth Rights Bar Association?

INDRA: In a way it was the flip-side of the “rights over my birth” info card that led to the creation of the Birth Rights Bar Association. It was trying to answer the question – what do we do when these rights are violated? In trying to answer that question I was shocked by the lack of response. I was shocked by lawyers’ lack of understanding of birth even in cases where they were the ones trying to uphold these rights. I was shocked by the lack of lawyers willing to take these cases. And shocked by the law’s inability to address the harms we were seeing. But there was a loose association of advocates who were trying to address violations of these rights, and it seemed clear that we needed more, more lawyers, more capacity, more understanding. So, that’s what led to the creation of the Birth Rights Bar Association.

JESI: What are you particular areas of interest with respect to birth rights and reproductive justice?

INDRA: Love is a big thing that fuels me in this work. I love midwives. Community based midwives in particular.  I just think it’s beautiful what they do and how. I also love birthing people. I think what they do is beautiful too. But even more broadly, I am very interested in embodied experiences, the way ideas are put into practice in specific ways in specific bodies. Reproductive justice is so much about having a body. And I love that. There are so many variations in embodied experience and I think reproductive justice is about making it possible for every BODY to have a full life.

JESI: What are your thoughts on racial disparities and maternal health?

INDRA: Racial disparities are a predictable effect of the system. You can’t build something on a foundation of racism without racism getting woven into it, and the health care delivery system in the US is, in many many ways, built on a foundation of racism. Racial disparities is what racism wants. So, to get a different outcome we have to do something (a lot of things) differently.

JESI: Which of the eight bullet points on the ROMB do you feel are the most stigmatized or misunderstood and why?

INDRA: I don’t know if it’s the most stigmatized. They are all contested rights. They are all things that we have to fight for. But, the one I am most worried about at the moment is the right to breastfeed. I am seeing breastfeeding too easily minimized and dismissed in the child welfare setting, in hospitals when related to substances use (cannabis in particular), and by providers who don’t understand it’s value.

JESI: You’ve written extensively on the topic of home birth midwifery. What are your thoughts, generally, on the topic of home births/pregnancies completely or partially removed from the medical model? “Unassisted” pregnancies and births?

INDRA: I think we need and will always have a full range of birth options. One of the things that the US maternity care system shows us is that even when everything points to institutional birth, there will still be people who opt out. There are so many barriers to opting out that the fact some small percentage of people still do says a lot about that drive in humans. I think it is part of a healthy ecology of birth to have some people who forge their own path. And I think having a range of options other than that is part of a health ecology too. In an ecology of birth options that is more healthy than the one we have I think that there will be more options in between unassisted birth and fully medicalized/institutionalized birth. Right now the real dis-ease in our system is the lack of a range of options in the middle. Which could include community births from home to birth center, and with a range of providers from traditional birth attendants, to formally trained birth attendants of varying levels with no to low interventions, and only as needed with increasing interventions and increasing specialization.

JESI: You’ve also written extensively on the topic of VBAC bans. Can you briefly discuss why you feel this is an important issue?

INDRA: The thing that gets me riled up about VBAC bans is that people who put the bans in place seem to forget that what it actually means then, practically speaking, is that people are not welcome to have a physiologic experience in that facility, they can’t just be, they can’t just do what their bodies are doing. It’s like telling people they can’t come to your hospital and breathe without using a breathing machine – when they haven’t been diagnosed with a breathing condition! And then there is the human rights angle – by doing that, you are creating a situation where people will be forced to have surgery, that they don’t need or want – but it’s a particularly insidious type of force. There is no one person forcing you, there is no bad-guy pointing a gun at you, it is being forced by a faceless, nameless entity and I find that particularly dangerous. It makes it easier to get away with. It makes it harder to combat.

Indra Wood Lusero, JD, Staff Attorney, is a reproductive justice attorney and entrepreneur who founded Elephant Circle and the Birth Rights Bar Association to advocate for policy change that supports families and physiologic well-being.  Indra’s publications include “Challenging Hospital VBAC Bans Through Tort Liability” and “Making the Midwife Impossible: How the Structure of Maternity Care Harms the Practice of Home Birth Midwifery.” As a genderqueer Latinx parent Indra is committed to creating a world where all worlds fit.

Birth Rights Bar Association | Rights are implicated in the context of childbirth across several areas of the law, including:

  • constitutional law
  • regulatory law
  • antitrust
  • torts
  • international human rights
  • civil rights

We build the capacity of our members to respond to these issues through continuing legal education, networking, research, and writing. In addition, we keep and track data, and identify trends and opportunities  for strategic action.

National Advocates for Pregnant Women | National Advocates for Pregnant Women (NAPW) is a non-profit organization that works to secure the human and civil rights, health and welfare of all people, focusing particularly on pregnant and parenting women, and those who are most likely to be targeted for state control and punishment – low income women, women of color, and drug-using women.

Ancient Song Doula Services | Ancient Song Doula Services mission is to offer all pregnant and parenting individuals  regardless of their socio-economic standing quality Doula Care, provide resources young mothers to make healthy choices in their lives, and advocacy to address health inequities within marginalized communities.  Ancient Song is committed to addressing implicit bias and racism within healthcare system by providing evidence -based education in birth and reproductive justice, advocacy & training, and direct doula services to all regardless of their socioeconomic standing.