Angela Davis and the Struggle to Make Birth Just
How a philosopher of freedom and structural injustice helps us confront what pregnant women face inside modern systems of care.
Angela Davis, born in 1944 in Birmingham, Alabama, is an American philosopher, abolitionist, and political theorist whose work has reshaped global thinking about justice, power, and human dignity. Trained in philosophy under Herbert Marcuse and long engaged in movements for racial and gender liberation, she has written extensively about how systems create harm even without individual intention. Her insights into institutional bias, structural violence, and the lived experience of marginalized communities resonate strongly with the realities of pregnancy and childbirth. Many pregnant women, especially women of color, experience care within medical systems that are not hostile but are often inattentive, unresponsive, or shaped by pressures they did not create. Davis helps us understand these dynamics and challenges obstetrics to see more clearly the moral landscape in which it operates.
1. The Body as a Site of Power and Resistance
Davis has long argued that the body is shaped by social forces, and that these forces can limit or enable human freedom. Pregnancy makes this dynamic visible. A pregnant woman does not move through the healthcare system with a blank slate. She brings with her a history of how institutions have treated her and her community. Research shows that Black women in the United States report higher levels of dismissal, stereotyping, and disbelief in clinical settings. Davis teaches that these experiences are not random. They are part of broader systems that create patterns of unequal listening. In obstetrics, those patterns affect triage, diagnosis, and response times. Recognizing this reality is not political. It is clinical. It makes care safer.
2. Listening as a Form of Justice
One of Davis’s central ideas is that justice requires listening to those whose voices have historically been ignored. In childbirth, the consequences of not listening can be immediate and severe. Women in labor who say something feels wrong are often correct. When their concerns are minimized, escalation is delayed. Davis helps clinicians see that listening is not a courtesy. It is a moral and clinical obligation. When a woman expresses fear, confusion, or pain, she is offering crucial information. Responding with seriousness and curiosity is part of ethical care. The Human Factor in obstetrics begins with recognizing that listening is a clinical skill.
3. Systems Produce Outcomes, Not Just Individuals
Davis urges us to look beyond isolated actions and examine the systems that shape behavior. Obstetrics often focuses on individual decisions, but many adverse events emerge from structural realities. Staffing shortages, inconsistent handoffs, racialized assumptions about pain, and fragmented communication create conditions where harm becomes more likely. Davis pushes us to understand that these failures are systemic, not personal. This perspective encourages clinicians to advocate for stronger protocols, better training, and more equitable distribution of resources. Responsibility is shared. Improvement must be structural.
4. Reproductive Freedom as a Collective Responsibility
Long before reproductive justice became a widely used term, Davis argued that reproductive freedom must include the conditions that allow women to survive pregnancy safely. For her, autonomy is not only about legal rights. It is about meaningful access to care, respectful treatment, and the ability to make informed decisions. In obstetrics, this means ensuring that every woman has the information she needs to understand her options, the time to ask questions, and the respect to choose. Davis’s perspective reminds us that autonomy is weakened when systems constrain choice through fear, pressure, or limited support. Clinicians must create conditions that make real autonomy possible.
5. The Emotional Weight of Birth in Unjust Systems
Davis writes about how social structures shape feelings of fear, vulnerability, and belonging. These themes appear frequently in the stories of pregnant women who have felt dismissed, misunderstood, or rushed. Fear in labor is not only about pain or uncertainty. It is often about feeling unprotected within a system that may not see one’s full humanity. Davis helps us understand that emotional safety is not separate from clinical safety. When women feel that clinicians are indifferent or skeptical, they may withhold information or avoid asking for help. This can change outcomes. Creating emotional safety is therefore not optional. It is part of competent practice.
6. Collective Care as a Model for Obstetric Teams
Davis often emphasizes community and the need for collective responsibility. Obstetric care also depends on collective functioning. Labor nurses, midwives, obstetricians, anesthesiologists, and pediatric teams must act as one. Yet communication failures are among the leading contributors to preventable harm. Davis’s thinking supports the idea that teamwork is not simply logistics. It is an ethical commitment. Each clinician has a responsibility to ensure that others have the information and support they need. Obstetric units that cultivate shared purpose and mutual respect embody the collective model Davis advocates.
7. Naming Harm as the First Step Toward Change
Davis teaches that institutions cannot transform what they refuse to name. Obstetrics must confront disparities in maternal mortality, high rates of disrespectful care, and the persistent underestimation of women’s concerns during pregnancy. Naming these harms is not an accusation against any individual. It is an act of honesty that makes improvement possible. Davis reminds us that silence protects systems, not people. By acknowledging where obstetric care falls short, clinicians honor the women they serve and take the first steps toward building safer and more humane environments.
Reflection
Angela Davis challenges obstetrics to look closely at how systems shape experience. She teaches that listening is foundational, that autonomy requires supportive structures, and that justice emerges when institutions accept responsibility for the conditions they create. Childbirth is not only a biological event. It is a social encounter filled with meaning, vulnerability, and power. Davis leaves us with a question that resonates deeply in maternity care. When a woman enters a hospital to give birth, does the system amplify her voice or diminish it. The future of obstetrics depends on answering that question with clarity and courage.