Black Birthing Bill of Rights

Black Birthing Bill of Rights

About The Bill of Rights

At NAABB we believe that all Black women and birthing persons are entitled to respectful, equitable, and high-quality pre and postpartum care.

The Black Birthing Bill of Rights is a resource for every black person that engages in maternity care. We want each black woman and birthing person to know their rights and to have the tools to confidently exercise these rights. The Bill of Rights also serves as guidance for government programs, hospitals, maternity providers and others as they transform their policies, procedures, and practices to meet the needs of Black birthing people.
I have the right to receive free health care.
I have the right to receive care from providers that share my cultural or racial background.
I have the right to receive support from a doula, birth companion, or other professional.
I have the right to choose the family, friends, and support team that are present during my pregnancy, birth, and postpartum care.
I have the right to access an independent perinatal advocate to address any concerns.
I have the right to choose my care providers and change my provider or birth setting at any point.
I have the right to receive care that acknowledges and affirms my strengths.
I have the right to incorporate my faith, traditions, and cultural practices into my care and birthing experience.
I have the right to receive care that is free from racism, discrimination, and obstetric violence.
I have the right to access remedies if I am mistreated, neglected, discriminated against, or violated in any way.
I have the right to make medical decisions for my baby.
I have the right to have uninterrupted time with my baby.
I have the right to healthcare providers who listen to me.
I have the right to receive care from providers who believe me and acknowledge that my experiences are valid.
I have the right to have my humanity recognized and acknowledged.
I have the right to be treated with dignity and respect.
I have the right to make an informed decision about how to nourish my child and to have my choice supported.
I have the right to receive accurate information that will allow me to give informed consent or refusal.
I have the right to be informed of all available options for pain relief prior to labor and birth, and to access the pain relief method I choose.
I have the right to receive individualized postpartum care that supports and nurtures my physical, emotional, and mental well-being.
I have the right to receive holistic mental health care including screenings, referrals, and treatments.
I have the right to decline or say no to medical interventions.
I have the right to receive support in accessing care.
I have the right to have my partner(s) included in my care.
I have the right to care that acknowledges, respects, and honors my queer and or trans identity.
I have the right to care that meets my needs, regardless of my body size, presentation, expression, and ability.
I have the right to have all my rights respected, even within the carceral system.
I have the right to choose how I become pregnant or become a parent, including but not limited to assisted reproductive technology, surrogacy, and adoption.

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I deserve free healthcare

Health care is a human right and it should be free for everyone. Unfortunately, capitalism is a cornerstone of our current healthcare system. As a result, access to care is inequitable - not everyone has the same access to care because of differences in income, wealth, and health insurance status. People may be unable to afford their desired care or have limited options.
All Black birthing people deserve access to free and quality healthcare. Join us in advocating by sharing the Black Birthing Bill of Rights.


Black Birthing Bill of Rights download coming soon!

I see me in my provider

Culturally congruent care matters for Black people. Black providers who have similar cultural experiences may be better able to understand the impacts of racism. This shared lived experience can also serve to build trust between a person and their provider, ultimately improving care. Currently, there is a shortage of Black health care professionals. For example, despite a long history of midwifery in the Black community, less than 2% of the nation's reported 15,000 midwives are Black. We need more midwives, physicians, and health care providers who understand our experiences as Black people.

I am supported

A doula or birth companion is a person trained to provide advice, information, emotional support, and physical comfort to a birthing person during the perinatal period. Doula support has been shown to improve the health outcomes of birthing people by decreasing C-sections and obstetric complications. Doula support also includes ensuring the birthing person has access to resources applicable to their abilities and disabilities. Doulas are an essential part of the perinatal health team and should not be excluded from the birthing room. Doulas should receive equitable and fair compensation for their work.


Find Your Doula

I choose my village

When Black birthing people have the support team of our choice, we experience improved pregnancy and birth outcomes. Support looks different for each person and it is crucial that hospitals and providers respect and validate your support network of choice.
This includes not arbitrarily limiting the number of people who can accompany you for your birth.. Any restrictions that do exist should be for the safety of everyone . Restrictions that separate birthing people from their support personnel, advocates, and loved ones are harmful.
Often, hospital policies do not reflect the vital need for doulas within perinatal care settings. As a direct result, doulas are typically defined as “visitors” within hospitals which puts them at risk of being easily dismissed by hospital staff. Hospital policies should reflect that doulas are not “visitors" in the traditional sense and therefore should not be bound by time visitor policies and limitations that would restrict their ability to remain with the birthing person and/or family.

I have an advocate

Perinatal advocates are imperative to helping Black birthing people access the resources and support that they need as they journey through pregnancy, birth, postpartum, and parenting. Perinatal advocates are specially trained to help a birthing person implement their birth plan or achieve their desired health care experiences and outcomes. This may also include doulas, social workers, community health workers, or patient advocates.
Most hospitals have patient advocates who can help people navigate the healthcare system, communicate with healthcare providers, set up appointments, and get financial, legal, or social support. We propose that health care systems specifically offer independent perinatal advocates to support birthing people with health system navigation.

I choose my healthcare

Black birthing people have the right to choose healthcare providers who will provide us with respectful and high quality care. You can change health care providers at any time, for any reason. That includes the right to choose where you give birth - whether in a hospital, in a birth center, or at home - regardless of your insurance status.
Racial discrimination, financial barriers, as well as regional systemic inequities might limit care options. Maternity and perinatal care deserts (areas where there is no or low access to perinatal health care) affect approximately 7 million birthing people in the United States. People should be able to choose their birthing location and change providers if necessary or desired without barriers of any kind.

My care affirms my strengths

Some narratives might frame Black maternal health as only a negative issue, but Black people overall and Black birthing people deserve to be acknowledged as more than statistics. We are full people with a rich culture and heritage, with networks of friends and family who support us, and we’re part of communities that celebrate us. Furthermore, each individual has strengths that they bring to the world. We deserve care that sees beyond any negative narrative and that acknowledges our individual and collective strengths. Excellent health care works with our inherent strengths - such as resilience, resourcefulness, deep community ties, and close family relationships - to promote health and help us thrive. These strengths serve us in life and in birth.

My providers respect my culture and traditions

Pregnancy and birth customs vary across the world and across cultures and families. Birthing people have the right to integrate their customs and traditions into the labor and birth experience. This includes cultural, ethnic, religious, or spiritual practices. Squatting for birth position, burying the placenta and cord, saying a prayer at the time of birth, a special ceremony honoring a Seahorse parent (a non-binary or Trans birthing parent), the cuarentena (a 40 day postpartum recovery process) and postpartum belly binding are just some of the cultural and religious practices that Black birthing people often incorporate into their birth and postpartum experiences. Black birthing people who are part of the Lesbian, Gay, Bisexual, Trans, Queer, Intersex, and Asexual (LGBTQIA+) communities may have traditions such as the use of gender neutral pronouns, gender neutral parental names, or family constellations that involve more than 2 caregivers for the baby.
Maternal and perinatal care providers must create and protect the space for Black birthing people to express their culture, religion, and traditions. This is a normal part of family and birthing. Requests to exercise these practices must be taken seriously and accommodated wherever possible, not wrapped up in red tape or made difficult.

My care is free of racism

You have the right to high-quality care, regardless of your race, ethnicity, or country of origin. Racism may show up in maternity care in a variety of ways, from differential treatment to what we know as obstetric violence. Obstetric violence may include disrespectful attitudes from providers and staff, discrimination, physical and/or sexual abuse, and lack of consent for treatment, among other things.

Racism, discrimination, and obstetric violence adversely affect the care of Black birthing people and thus our outcomes. Unfortunately, it has been a cornerstone of the healthcare system and the specialty of obstetrics. From J. Marion Sims experimenting on enslaved Black women to Black midwives being denigrated and nearly eradicated in the early to mid 1900s, anti-Black racism has been and continues to be a key factor in perinatal health care and adverse health outcomes.

We demand that:

1) Racism, and NOT race, is acknowledged as a risk factor in adverse maternal-infant outcomes for Black birthing people.

2) The needs and desires of Black birthing people are listened to, acknowledged, and prioritized by medical staff.

3) Resources such as the Black Birthing Bill of Rights are implemented in medical spaces to provide guidance and training on respectful and culturally relevant maternity care.

4) Maternity policy changes recognize and address intersectional violence in Black maternity care.

Mistreatment will not go unchecked

Mistreatment, abuse, and neglect should never happen, especially not from someone who is supposed to be a trusted health care provider. Mistreatment during pregnancy, labor, and birth may also be referred to as obstetric violence and should never go unchecked.

Unfortunately, Black birthing people are at a higher risk of experiencing obstetric violence due to interpersonal, institutional, and systemic anti-Black racism. Black LGBTQIA+ birthing people, due to their race, gender, and sexuality identities, are also more likely to be mistreated, further marginalized, and often in greater need of advocacy and systems of restorative justice to uproot obstetric violence. There must be a system of accountability where people can report mistreatment and feel confident that the person who harmed them will be held accountable. We propose that Black birthing people have access to a variety of tools to remedy obstetric violence. Restorative justice is a mechanism by which the person who has caused harm (in this case a health care provider) meets with the person that was harmed, they cooperatively discuss how to remedy the harm, and practices and policies are instituted to transform care and prevent future harm. The process is facilitated by a trained mediator. This model has been utilized successfully in health care to address poor outcomes and medical mistakes. It does not replace or diminish the ability to utilize other routes to demand justice (including litigation as deemed necessary by the harmed person). Though a useful tool, restorative justice is often underutilized in instances of obstetric violence against Black bodies. However, it can be healing, and it can lead to improved care by changing harmful policies and practices.

I determine what is right for my baby

Decision-making in the newborn period is a great privilege and responsibility for parents and caregivers. Decisions around care for the newborn such as Vitamin K injections, erythromycin gel, circumcision and formula supplementation are often straightforward but they can sometimes be contentious as well. Birthing people may encounter tension if their decisions don’t fall in line with the expectations of the medical providers. We affirm that Black birthing people have the right to make medical decisions for their infants. They have the right to decline interventions without CPS getting involved. CPS involvement can initiate a cycle of policing and family separation, and causes more harm than good. Ultimately, decision making power lies in the parents'/families hands and it is the responsibility of health care providers to ensure all necessary information is provided to the parent/family to make decisions that feel best for them and their infant. We know that rejecting or declining care is associated with higher rates of mistreatment in the childbearing process. During the newborn period, there are even reports of medical providers calling child protective services when parents have declined specific aspects of care.

View the Black Birthing Bill of Rights pdf for more on this right

My baby, my time

Birthing parents, caregivers, and babies have a physiological need to be together during the moments, hours, and days following birth. This time together promotes bonding and significantly improves outcomes for the birthing person and newborn. Although birth centers and home birth attendants tend to respect the parent-baby dyad by keeping them together after birth, separating the birthing parent and their child is a common practice in hospitals. Uninterrupted skin-to-skin contact in the first hour after birth, known as the golden hour, is associated with many benefits for the birthing person and the baby, including higher rates of parental satisfaction and confidence, exclusive breastfeeding and chestfeeding, a longer duration of breastfeeding, and higher levels of blood sugar for the newborn. It is also associated with lower rates of parental anxiety after birth. Instituting quiet hours where a birthing parent and caregiver(s) is undisturbed, given time to rest and be with family can support this special bonding process. We demand delaying unnecessary and routine non-emergent tasks (such as paperwork and labs) by hospital staff to protect this sacred time. Offering uninterrupted time with the baby is a key component of respectful and compassionate perinatal care for Black birthing people.

Listen to me

We have heard too many stories of Black birthing people who suffered negative outcomes and harm because their provider did not listen to them. Their requests for help were ignored and their pain was not taken seriously. Decades of evidence show that Black people are often undertreated for pain and other conditions because of racism ingrained into the healthcare system. Black birthing people need and deserve to have their complaints, concerns, and desires listened to and accommodated. Health care providers must act on, investigate, and rule out any complications.

Believe Me

Black birthing people have the right to be believed. Too often, health care providers dismiss our concerns, our knowledge of our bodies, and our expertise in our own lives. Our lived experience is valid. Community wisdom is valid. If you think something is wrong, your provider should partner with you to get to a place where the issue is resolved or managed. You’re the authority of your experience and your body. Your provider is there to assist you in your understanding of what’s going on and any treatments that should be available to you.

Recognize my humanity

For too long, white supremacist capitalist culture has denied and disregarded the humanity of people of African descent. Black people are whole human beings with whole lives. We are worthy of respect, dignity, and good treatment. The needs of Black birthing people must never be assumed. Providers should be quick to ask questions to further inquire about needs and ready to actively listen to the responses of their patients. In practice, this method helps to center whole person care, incorporate other aspects of people’s lives in their care (i.e. disabilities, family responsibilities, other identities, etc.) and Black birthing people’s right to autonomy over their individual care. Acknowledging the humanity and the intersecting identities of Black birthing people is a critical step in dismantling a maternity system that was never designed to help us thrive. We seek to create a responsive perinatal care system that meets our needs and recognizes Black perinatal health as a human rights and reproductive justice issue.

Respect Me

Disrespect, abuse, and discrimination within the health care system all play a significant role in contributing to adverse maternal, perinatal, and infant health outcomes and in influencing how Black birthing people experience care. Providing respectful maternity care demands that the health care provider acknowledge the power dynamics inherent in the provider-patient relationship, relinquish power, and affirm the rights and autonomy of the birthing person. Furthermore, we maintain that respectful care is the minimum requirement, and to this end, providers should also strive to incorporate compassion and kindness in all treatment and interactions.

I choose how to nourish my child

As a parent responsible for the care of your child, you have the right to decide how to nourish them. In our current system, people are often coerced into an infant feeding decision. Or they may not receive support to sustain their preferred method of nourishing their infant. Perinatal care providers must provide comprehensive information on infant feeding so that parents can make an informed decision, as well as the resources and support necessary to put that decision into action. Pediatric care providers can also support breastfeeding/chestfeeding, provide information on infant feeding, and make referrals based on a parent's needs and choices. Health care systems can help Black birthing people make an informed decision on infant feeding by ensuring that nurses are trained on infant feeding options, providing access to lactation professionals, and making referrals outside of the hospital or care system as needed.

To learn more about infant feeding options, visit:

I am informed

Autonomy in health care decision-making is a crucial hallmark of person-centered care. Maternity care is no exception. Receiving adequate information on the benefits, risks, and alternatives of an intervention is a critical prerequisite for informed decision-making in maternal health care. Informed decision-making includes the right to consent as well as the right to refuse without being penalized for your refusal. At NAABB, we want Black birthing people to be empowered to make decisions regarding interventions and treatment options that honor their preferences and values in light of the risks, benefits, and expected outcomes. Medical treatment should empower individuals to feel that they are able to make decisions about what happens to their body. To make empowered medical decisions, information in a format understood clearly by the birthing person must be made readily accessible. Information should be available in different formats including plain language, with visual or audio aids for people=and other relevant formats.

View the Black Birthing Bill of Rights pdf to learn more

My pain matters

You have the right to have your pain treated. Even recent studies have shown that medical students and doctors believe that Black people feel less pain than white people do. This belief is entirely inaccurate and derives from racist tropes, stereotypes, myths, and biases. Your pain matters and should be appropriately treated. Ideally, you should be informed of all your pain relief options before labor, craft a pain management plan with your support team, and have unfettered access to the pain relief method of your choice.

For Providers:

I am held

Once you’ve given birth, early and individualized postpartum care is critical. Over two-thirds of maternal deaths occur in the postpartum period, up to a year after giving birth. Early postpartum care is critical to quickly addressing any clinical complications that may arise. The American College of Obstetricians and Gynecologists (ACOG) recommends that all birthing people have their first postpartum follow-up within three weeks of giving birth. The timeline might be sooner depending on your unique needs.

My mental health matters

Your mental health matters. Evidence shows that Black birthing people experience mental health conditions at higher rates than their white counterparts. This is especially true for postpartum depression and anxiety. The intersecting experiences of racism, classism, sexism, and widespread health inequities likely exacerbate mental health conditions and contribute to lack of access. People might not seek mental health care because of mistrust in the mental health system, which is also rooted in white supremacy. Black people have tended to rely on faith, spirituality, self-care, exercise, and family and friends for mental health support - all positive ways of addressing mental health challenges. Many are now adding therapy to the list of ways they achieve and maintain their ideal mental and emotional wellbeing. At the systems level, there is greater attention to Black maternal mental health and advocates are calling for holistic, culturally responsive mental health care for Black birthing people. It is imperative that perinatal care includes mental health screenings, provides space for traditional mental health practices, and offers additional resources and referrals when necessary.

I have the right to say no

People seeking care have the right to have their personal health and medical decisions respected. This includes the right to opt-out of or decline medical interventions without fear of retaliation or mistreatment. Advocating for yourself in a clinical care setting may not be easy, but it is possible. It might require asking questions, being direct about saying no, and engaging a trusted person to advocate on your behalf. People who decline care might be seen as someone who is difficult, or “non-compliant,” in the healthcare system. Health care providers must take the time to listen to their client’s concerns, be open to a dialogue, and work with the person to find the best solution. Providers must respect when someone’s decision is no.

For Providers:

I am not alone

Black birthing people can face financial and physical challenges to accessing perinatal health care. While health insurance reform has expanded health care coverage for most Americans, care remains costly for some. Co-pays, deductibles, and out-of-pocket expenses might make regular and timely health care inaccessible for those with the most need. Furthermore, services like doulas and home birth may not be covered by health care insurance, limiting options in care. Beyond financial access to preferred care, some people live in maternity care deserts - areas where there are not enough perinatal providers to meet the demand. They may have to travel hours to see a care provider, which requires access to transportation and may include time off of work or away from familial responsibilities. Black people are more likely to experience systemic barriers to accessing care due to racial inequity. NAABB calls for an end to inequitable access to care. Fortunately, there are a number of interventions that can help. For example, some providers take a holistic approach to care to help their clients address the social, environmental, and economic barriers to complete wellness. Providers and health care systems may not be able to solve all social justice problems, but they can provide connections to helpful resources.

My partner is included

Partners, spouses, and co-parents are an important part of the pregnancy and birthing experience and have the right to be included throughout. Too often, partners are forgotten or marginalized while the focus is on the birthing person or newborn, but they have a critical role to play. Partners and co-parents can be an amazing source of support throughout the perinatal period. Supportive partners may help the birthing person achieve their ideal birthing outcomes - for example, through financial and emotional support, advocating with them in the clinical setting, and identifying warning signs and symptoms that need attention postpartum. We demand that care providers challenge the trope of disengaged fathers, in particular, and the bias that results from this harmful stereotype. We demand that same-sex, queer, and trans partners be honored, respected and included in maternal and perinatal care. Partners and co-parents, regardless of their identities, must be included in perinatal care wherever possible.

My queer and trans identities are acknowledged and respected

Every person has the right to health care that acknowledges and respects their full identity, including gender and sexuality. Black people across the gender and sexuality spectrums become pregnant and give birth. They deserve perinatal care that affirms their identities while meeting their needs. Generally, health care providers are trained to engage with clients from a cisgendered, heteronormative approach - tailoring maternal and perinatal care to cisgender women (people assigned female at birth) in heterosexual relationships. We challenge providers to reject assumptions about gender and sexuality and instead engage in an open dialogue with their clients about care that honors their identity.

My body is honored

You have the right to care that meets your needs, regardless of your body size, presentation, expression, and ability. For example, disabled, fat, intersex, and neurodivergent folks should be respected and honored. Health care educational institutions should prioritize teaching learners about the intersections between and how to challenge and reject fatphobia, ableism, cissexism, heterosexism and white supremacy in their work. The onus is on health care institutions to provide universally accessible spaces and on health care providers to advocate for and provide accommodations as needed so that all individuals are honored throughout their care. Every body, every size, every person, and every individual intersectionality deserves compassionate care free from racism, judgment, and disrespect. We reject ableist norms, cishet norms, fatphobia, and “snap-back culture”!

All of my rights are respected, no matter what

Individuals within the carceral system have the right to have all of their birthing rights respected. Birthing people who are in prison or jail must be afforded all of their rights, including the right to prenatal care, childbirth education, a birthing plan, and early and individualized postpartum care. Shackling during labor and birth is dehumanizing, demeaning, and unnecessary. Medical experts oppose restraints during childbirth, citing potential dangers and interference with the birthing process, but it continues to be widely practiced across the country. Fortunately, states and the federal government are slowly moving towards ending shackling and the restraining of birthing people, but more advocacy is needed to ensure the humane treatment of incarcerated pregnant and birthing people. At NAABB, we hold mass incarceration as a reproductive justice issue. The over-policing and excessive punishment of Black people by the carceral system is driven by racism. We want to move towards a world where incarceration is not an approach to justice.

Learn more about the carceral system and birthing people:

I choose how to become a parent

Reproductive justice is a framework invented by Black women that asserts everyone’s rights to have a child, to not have a child, parent children in safe and healthy environments, and maintain bodily autonomy. While much attention is given to contraception, abortion, and maternal health, less attention has been given to the right to have a child. People have the right to choose how they become pregnant and the right to access the resources they need to exercise their choice. Some studies have found that Black people are more likely to experience infertility than white people, experience more delays in accessing fertility treatment, and have lower success rates after undergoing treatment. Health care practitioners could help by raising the topic of fertility with their clients as part of general care and referring them to appropriate resources in a timely manner.

Assisted reproductive technologies such as in vitro fertilization, intrauterine insemination, and surrogacy are costly and may not be covered by health insurance. We call for affordable and accessible reproductive technologies for Black people who desire to become pregnant, give birth, or form their family. This includes adoption as a means of family building.