In this episode of Public Health Matters, Christina Madison, PharmD, FCCP, AAHIVP, the Public Health Pharmacist, discusses efforts to advocate for reproductive justice and maternal health among Black women with Regina Davis Moss, PhD, MPH, MCHES, president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda and author of “Black Women’s Reproductive Health and Sexuality: A Holistic Public Health Approach™.”
Madison and Davis Moss discuss what is meant by reproductive justice and the importance of fighting to keep the rights of mothers and pregnant individuals intact, especially as women’s rights face areas of erosion across the country. Davis Moss explains how reproductive justice stretches beyond access to abortion, and encompasses a broader range of issues affecting Black women, including maternal health, economic stability, and racial justice.
Christina Madison: Hello everyone, and welcome to another episode of Public Health Matters. I am your host, Dr. Christina Madison, also known as the Public Health Pharmacist. I’m very excited to bring another extraordinary guest to the table, Dr Regina Davis Moss. I am such a fan. I want to say, when I got a chance to meet you in person, it was such a pleasure, and I feel like the universe wanted us to meet, and we had such a lovely time connecting at the round table discussion. I found out all these new terms that I didn’t know about, like reproductive justice, and what does that mean, and how we can really strive to protect maternal rights. Given our current climate and our times of uncertainty, I thought it would be wonderful to have you on to talk a little bit about your journey and how you started doing this work, and then also about your book, which is something that I really wanted to chat about as well. So, Dr. Davis Moss, if you could tell us just a small snippet of your current role, and then how’d you get there?
Regina Davis Moss: Well, first of all, let me just say thanks for having me. Yes, we met, and then we met over this weekend, and then we just kept running into each other at different events, which meant we definitely it was just a matter of time. I’m sure that our paths have crossed probably before that time, and we just hadn’t known each other because we both care about the same things and are trying to champion the same issues. I’m president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda and the In Our Own Voice Action Fund, which is our 501c4 sister organization, that basically means that we can, when we’re doing that policy advocacy work that we do from day to day, we can push a little bit harder in terms of centering candidates that commit to championing reproductive justice, but also in times like we just had an election, helping to lift up those candidates, as well as standing in solidarity with other organizations that are doing this work.
I said a term called reproductive justice, and I never like to assume people know what that is. It was founded 30 years ago by 12 Black women who attended a conference, and the conference was very much like this time. They were looking at things like our health care system. There were a lot of women in the room, a lot of white feminists, to be exact, who really kept bringing the conversation back to reproductive rights. There were 12 black women at this conference—only 12—who looked around at each other—some knew one another, but some of them did not—and say, “You know what, this is not right.” How do we have a conversation about health care, and not really center reproductive health care holistically, but to only talk about in a concept of having access to abortion.
Key Takeaways
1. Reproductive Justice is More Than Abortion: Moss emphasizes that reproductive justice encompasses a broader range of issues than just abortion access. It includes the right to decide when and how to expand families, to raise those families in safe and sustainable environments, and to have control over sexual expression. This includes addressing issues like maternal health, economic stability, and racial justice.
2. Black Women’s Voices are Central: The episode highlights the importance of centering Black women’s voices and experiences in the reproductive justice movement. Moss emphasizes that Black women have unique perspectives and needs when it comes to reproductive health and well-being.
3. Reproductive Justice Requires a Multi-faceted Approach: Moss suggests that achieving reproductive justice requires a multi-faceted approach that addresses systemic barriers and social inequities. This includes advocating for policies that support economic security, affordable housing, quality healthcare, and racial justice.
If you remember, around 30 years ago, there were a lot of things happening to Black women. We were talking about things like HIV-AIDS and STIs and infant mortality and teen pregnancy. If you were seeking public support in terms of public assistance, there were requirements like you had to take long-acting contraception. We were not just concerned about not getting pregnant; we wanted to get pregnant, and we also wanted to talk about the other things that impact our decisions when we decide whether, if we find ourselves faced with that question about, this is an untended pregnancy, there’s a lot of things we have to ask ourselves. We wanted to talk about things that have to do with, can I keep my job? Can I stay in school? Is this going to increase my risk for maternal mortality or is this going to be a risk to my infant? And a lot of other questions. We said, if you’re going to have this conversation, we need to make sure it’s a broader, more expansive conversation, like our neighborhoods. What happens after we have these children? Our children are subject to over-policing. Our sons, our daughters are in schools, and they are being subject to disciplinary practices… there’s a bias there. They’re pushed. A lot of times, what our daughters cannot get away with are lot of things their white classmates can get away with. It was really these 12 women that stood together in intentional solidarity and said, “We want to make sure that this conversation just doesn’t stop with abortion rights.” Which we just saw most recently, that is what it was centered around, and we were out there saying the same thing.
Reproductive justice, in short, is the right to decide when and how we expand our families—if we want families—the right to raise those families in safe and sustainable environments, and the right to sexual expression. Because, like I talked about, if we want to have children, but we believe that your sexual expression and however you do express yourself sexually, whether that be through your gender identity, your sexual orientation, that should not be associated with your womb, right? A lot of the conversation we have are very womb-centric and very much focused on whether you should or should not reproduce, and they’re not—your sexuality is a continuum. So that’s what I do in a short way, but I will tell you what I love most about my job is that I do that 24/7, and I focus only on Black women, girls, and gender expansive people. I do that 24/7, I do that every year. Obviously there was a lot of conversation about this in this current election cycle, but I’m working on that, I’ll be working on it next year, and I’ll be working on it until we get to our longer-term vision, which is the right, honestly, to have access to the resources and the opportunities that we need to be able to thrive. But also, to have the social and economic and political power so that we ultimately have liberation.
Madison: Yeah, and I know you’ve been in this role since 2023, and there was just, with the Dobbs decision, and a lot of different moving parts, as far as the policy side, right? I think, when we talk about justice, we think, okay, there’s got to be something in there around equity, but ultimately, it’s choice, which is what you were describing. Sometimes, we don’t have a choice because the choice was made for us, because, unfortunately, a lot of these very draconian policies are made by folks that don’t have wombs, let’s be honest. As someone who is very close to this—I’ve had two children, both times I had complications. The second time, after the birth of my youngest child, I had birth-related complications and a birth-related trauma and was denied care. I’m very open about that, and the fact that even as a health care professional, even with someone with the doctorate, I still face the same challenges that other Black women do. Actually, if you look at the statistics, and I know you know this very well, education isn’t even a factor. It doesn’t matter if you are highly educated or not. When you walk into that ER, if you walk into that provider’s office, all they see is a Black woman. They don’t see anything else. So, you’re still treated, unfortunately, because modern obstetrician and gynecology is based off of experimentation and torture of enslaved women from Dr. Sims and internalized structural racism within our health care system.
Davis Moss: Yeah, I mean, you said it. I hate that we’re both in the same club. I also had a traumatic birth experience. My son was in the NICU. My blood pressure spiked. We are, as you said, we totally dispel that myth that this is related to social economic status. It’s not—because when we look at the data, we see that Black woman with not just bachelor’s degrees or undergraduate degrees, but also secondary degrees, MBAs, doctors, lawyers, all have worse health outcomes and birth outcomes than white women that do not even graduate from high school, right? That tells you that there is something in the system. We’re both public health folks, so I know we love the data, right? If Black women are in prenatal care early, if we do all the things that, when we take these holistic public health approaches, should theoretically work, we still see these disparities. That lets you know that there’s something outside of the individual interventions that we must do. Even when we look at now, right? So, the maternal mortality, a large percentage of them are happening postpartum. When we look at the causes, over 3 quarters of them are preventable. That says, if we know when it’s happening, and we know that they’re preventable, why are we not stepping in like we need to? Then we start looking at the political will and what’s happening in our system, and all these other things that are largely, what we would say, directly related to our bodily autonomy.
I’m glad you mentioned this, because this is what we have found. Even in this conversation that we were having around access to abortion, we are one of the few organizations that actually… when you hear in the news, we hear a lot of polls, and they say, “Black women felt this way, Black women felt that way. Well, we actually talk to them and that’s why we were founded, because we were tired of having other people speak for us. We were tired of being on the defensive. That’s why we’re called “In Our Own Voice.” So, every year, we do a poll where we ask questions like, “what is the priority to you? What’s are your issues that are top of mind for you? What is going to cause you to turn out to vote, or what’s going to make you less likely to vote?” When we ask this question time and time again for the last 10 years, they will say, “my number one issue is the economy. My second is free and fair democracy, racial justice.” And then in the top 5, we do see abortion, right? Because to be clear, when we look at who’s being criminalized, it’s Black women. Those women that are in the parking lot or going into the emergency room because they are unfortunately experiencing miscarriage and they’re being handcuffed, right? Of course, it’s an issue for us. And, when we look at how Dobbs has impacted Black women—Dobbs being the decision that struck Roe v Wade down—we asked that question, and almost 60% of Black women who are of reproductive age that live in the states where there are abortion bans have said that Dobbs has really made them very scared, made them think about not even having kids anymore, moving to different states, their increased risk of maternal mortality—overall feeling less safe. There are so many things that we’re trying to uplift when we talk about this issue. Audre Lorde said this best when she said, “We do not live single issue lives,” right? There’s no way that a Black woman can just focus on one issue when there’s so many other pressing issues. That’s what we try to do, is just lift up all those other issues that are just as important.
Madison: Yeah, that reminds me of when we met at that reception at the NAACP, we had the Kimberlé Crenshaw there. That was reminding me when you said that just now about intersectionality and how we are more than just a monolith. There are so many different factors. Again, that intersectionality of, how are we being portrayed, not just by policy makers, but how are we being portrayed in the media? I think a lot of what we see, and unfortunately, a lot of the misconception around this is because we have been portrayed in the media as low income, getting access to public assistance, having multiple children, having different fathers, all of these things. That’s in the social consciousness, and then when you really come down to it, it has nothing to do with any of that; it’s very much a mischaracterization of the Black experience. As you and I both know we’re very highly educated, and it makes me feel like we need a PR makeover, right? When we talk about reproductive health, and even just the fact that you took the time to define what reproductive justice is. I think we really do need to do more public education, because I feel like if more people understood what we went through on a day-to-day basis, there would be more apathy and maybe even empathy for the fact that women are dying. It’s not necessary, and if anything, like you said, it’s preventable. I know that one of the forums that we were at with the Centers for Medicare and Medicaid (CMS) administrator, was talking about the implementation of having guaranteed Medicaid benefits after birth that were up to 12 months. I believe at this point, and I might be slightly off with my numbers, because there might be a few more states, but I think we’re up to 46 states that now have that expansion. I don’t know if you wanted to talk a little bit about that, because I know that that was something that was part of the discussion when we were at that forum.
Davis Moss: Yeah, absolutely. So, this is a major win for us. When we talk about all the other things that are happening—the fact that there is this reduction in the quality of maternal care, taking away our federal abortion protections—there are other wins, that being the expansion of Medicaid coverage, postpartum to 12 months postpartum. Because when we look at the number of Black women that received their coverage through Medicaid, it is pretty high. That has an impact, but in a number of ways. Number one, since we’re on the topic of abortion, if you receive your health care that’s covered by Medicaid, and you need to have access to abortion care, well, it’s not covered by Medicaid. So that’s why, when we say just the right to an abortion is not enough for Black women, it’s for that very reason, because if you can’t access it even though there’s a law, then how is that a just law? That’s why we use words like reproductive justice. And then, we know that when we’re talking about things like birth justice, which is an aspect of reproductive justice, part of that is really leaning into the fact that we are our own experts. We are the best judges of our body and the things that we need. We were pushing for coverage, not only the to extend the coverage, but also to allow coverage of things like traditional birth workers, like doulas, midwives, because those have proven—I could talk about the history of the field of gynecology and how that came about—but for a very long time, we relied on midwives in these more traditional, holistic approaches. We’ve lost a little bit of that in this process.
So, absolutely, we want to make sure that we are lifting what we know works well to improve birth outcomes. The coverage is one piece of that; having access to traditional birth workers. But things like the right to refuse unnecessary cesarean sections, the right to have your birth plan and to respect it when you go into the hospital. I came in there and I said, “This is my birth plan. I hung it on the wall. Please do not keep asking me, do I want X, Y and Z.” Now, I had a unique situation, and so I had to pivot. But I can’t tell you how many people say, “Everything happened so fast, and the next thing I know, it was totally different than what I wanted and what I requested,” right?
Madison: I mean, Serena Williams talks about this, one of the most successful Black women in America, and she talks about how she was forced to do things, and even with her husband trying to advocate for her, knowing that she’s had a history of a blood clot, and she still had complications. It impacted her professional career, because she wasn’t able to get back to tennis after her first child and then retired because she wanted to have a second child. I think stories like that, the fact that she wrote about itin Vogue, that’s hugely important to have those symbols out there of people that are talking publicly about things that have happened to them. One of the things that I’ve realized as I’ve started to talk about my own personal story is that it’s not unusual—it’s actually common—and it and it makes me livid, because if somebody had told me that these are the things that are possible, that you need to be able to stand up for yourself, that things do happen so quickly during the birthing process, and that your chances of having a birth-related issue are so much higher, I feel like I would have potentially sought care quicker, because I was like, “Oh, I’m just tired. I have a toddler at home and a 7-week-old.” I justified all these things happening to me. I feel like if somebody had said, “You, as a Black woman, is so much more likely to have these complications,” I feel like I would have been more on the lookout for those things. And I think the fact that we don’t talk publicly about the fact that this happens so frequently is a problem. And I know for me, personally, I blamed myself. I was like, “there had to have been something that I did. It must have been the way that I spoke to the provider. I must not have explained myself well.” It took me years before I spoke about it publicly. I feel like that alone, the fact that we blame ourselves is a product of the system.
Davis Moss: Yeah, I’m glad you picked up on this, because that reminded me of another point you were making about the narrative that has been told about us. We have this long history of trauma and reproductive oppression that in Black communities that goes all the way back to slavery, right? We were responsible, through breeding, of keeping this economy growing and going. To do that, number one, we had to be dehumanized. And then, there had to be a story created about us, right? There had to be a narrative about, we’re promiscuous, or we’re asking for it, right? And then when slavery was abolished, and we still needed to continue in workforce, then we became—well, not even then—we were always considered their property. Then we started passing laws saying that Black women couldn’t be raped, right? We still have the continuation of that; when we come forward and say, “I was assaulted,” we’re not believed. Because when we went to court—there’s studies about this one—you were considered and told “That’s not possible,” right? You have those kind of stories and narratives. You have narratives about us being unfit. If you’re thinking about eugenics and these notions of which population or groups should be able to have children and who should not? All of that requires a narrative. That is not something that’s created by us, right? Even when you said, “I thought it was something that I was doing,” I’m sure somewhere in that encounter, the notion that you said, “maybe they thought I was pushing too hard,” is because you’ve had an experience where you felt “You know what? This is not a partnership, but I’m in the doctor’s office. This is not culturally sensitive or certainly the best quality of care that I know I should be entitled to.” The other piece of that is we don’t believe, in America, in human rights. We believe in civil rights. We’ll fight for the ability to sit at a lunch counter or whatever. But human rights is the belief that no matter who you are, race, creed, sexual orientation, gender, all that stuff, just by virtue of being born, you should have the same rights and the same access to the basic needs, human and general daily needs, to be able to thrive. We don’t believe that, as a country, everybody should have equal access to that. That’s a major reason why we see these differences in the birth outcomes.
Madison: Just gave me the chills.Oh, my goodness.It’s heavy. It’s heavy to talk about, but it needs to be spoken, and it needs to be spoken out loud, because for us to be able to fix a problem, we must identify a problem, and if we don’t teach about it, then we’re never going to be able to even be able to move the needle at all.
Davis Moss: We can’t keep relying on the system that created it to fix the problem as well.
Madison: And that’s what people say all the time. “Oh, the system is broken.” When I hear people say that, it gives me the cringies, because I’m like, “No, the system is working exactly the way it was meant to: to suppress and oppress specific members of society.” The system works for some, but it doesn’t work for all, and that’s because of the way that it was structured, and it was done that way on purpose.
Davis Moss: Yeah, it’s a hard thing to have to really sit with that. When I say that a lot of this stuff is about power, it seems so simple, and when people say, “No, no, no, how can you simplify it to that,” right? Maybe people don’t sit up maniacally and say, “Oh yes, how can I do all these things to make sure that I have power?” But certainly, what we do feel in certain populations is things like zero-sum game: if they get that, that means less for me, right? It shows up in different ways, which usually reduces to the need to maintain a hierarchy in our country, and that essentially is power.
Madison: Wow. Well, I want to just pivot for a moment and chat a little bit about your book, because I know that that is something—first and foremost, congratulations. That’s a huge accomplishment. I just wanted to touch a little bit about what your motivation was for writing the book. Obviously, as another public health professional, I think these stories and narratives are extremely important so that we can teach folks. But if you can maybe just chat a little bit about that, and then, I’ll add in the show notes a link so that folks can check out the book as well.
Davis Moss: Sure. So, it was 2021, I was sitting at my desk and watching yet another webinar live stream about maternal mortality, and they said Black women are more likely to die,” and I threw my hands up, and I said, “Oh my God, if you say that one more time, I’m going to scream,” right? I need you to say why. I just got tired of hearing doctors, researchers, people like me, public health people, simplifying that to just rate and a risk, right? A lot of our research, until the last 10-to-15 years, has really been related to Black women’s health interventions that focus on the bad things, right? We’re more likely to get chlamydia, more likely to get pregnant, all these other things, and then what are the outcomes? But there was very few sex-positive research, and certainly anything related to like sexuality and having that in a positive light was not very present.
Madison: By the way, the CDC just released a report that our STI rates are going down. So just a little bit of good words on that. I haven’t seen all of the ethnic and age breakdowns, but it’s been going down in all categories; syphilis, gonorrhea and chlamydia. I thought that was a nice bright spot in the news.
Davis Moss: That’s great, yeah, I was excited to see that. As public health professionals, our job is really to try to control for all the different factors that contribute to something until we boil it down to where we can say that this is absolutely the cause of that, right? We just talked about all those things, such as the narratives and all these external factors that contribute to these things. What I was trying to really do, honestly, was just write a book that was a selfish gift to myself, having my thinking evolved. I said, we can’t really do this work if we only look at it from a scientific aspect only. We have to be able to incorporate these other disciplines in there, such as women’s studies and talking to people and focus groups and all these other things, so we can get those nuances. I said [in the book] that this is everything that I wish I would have learned, or people that I would have talked to when I was in public health school. Also, going back to those people that said that thing that made me throw my hands up, was like, “Okay, I just want to write a book so that you can have this on your desk. So, when you’re talking about something, you can have this as a resource.” I basically called all my smartest friends together and said, “I want to write this book that’s going to be kind of like a reference book.” Or I call it…you think about Stevie Wonder’s album, or there’s certain albums that from start to finish—there’s certain songs you like, but you can literally play it from start to finish, because there’s several pieces in it. That’s what this book is like: each chapter can stand on its own, but if you start from the beginning and you read it to the end, you should be able to pick whatever part of the work you’re doing in there and be more nuanced in it.
It starts by telling that story, of when we were in slavery. It talks about all that stuff. It talks about Dr. Marion Sims. It talks about all of the horrific things that were being done to us so that we can have—Henrietta Lacks, all the things. Then it takes us all the way up to modern day. When we’re talking about, how do we do this work, right? If you want to be a researcher, if you want to work in policy, if you were to start your own nonprofit. The beautiful thing about this book is it is written, it is all contributed to by Black women. It is for Black women. It is by Black women. To that point about, we can’t keep relying on a system that created it to save us. But it’s also because I knew that this work was out there, and that this body of literature is growing, but it’s not being promoted the way it needs to. It talks about, the Me Too movement; a lot of people don’t know that that was started by a Black woman. A lot of the major movements in this country, we’ve been at the center of them.
Madison: Even women’s suffrage. We were fighting for the right to vote, even though we knew we weren’t going to get it.
Davis Moss: Right. There’s another major scholar, Professor Michele Goodwin, who says Black women are the canary in the coal mine, which basically means, that was the bird that was sent in there ahead of time, if it made it back, then that meant it was safe. If it didn’t, then that means it was danger, right? Basically, Black women are like that; oftentimes, we are an early indicator of something that is wrong in our system, or certainly when things have broken down. We are sent in, kind of to sound the alarm, but also, we sound the alarm, we rise up, we begin the resistance, but we often have to wait at the back of the line before we actually reap the benefits of it. Whether that be voting… all of it. We’ve been there, and we often have to say, “you go forward.” Even for our brothers, in the fight, they got to vote before we did, right? What a gift that we keep giving to this country. We have to do this often, having experienced both sides of it—usually the oppression—until we finally get to the joy.
Madison: I couldn’t have said it any more beautifully. Thank you so much. I feel like I’ve learned, even about my own history, and I thought I was pretty knowledgeable these things. I definitely need to get a signed copy of your book next time I see you in person.
Davis Moss: I’m happy to do that. Actually, I would say because my book now is going to have a new sleeve, hopefully you will put the picture of my book cover, pop it into this thing, but it’s intentional. There was a story that I wanted to tell in that cover. it’s multi-layered in that there’s a new image every time you look at it. I wanted you to notice something else, like as a Black woman in her crown, there’s the red, gold, and the green, the beautiful silhouette of our stomach, the strength of our back. I just found out, it was just announced earlier this week, that my book received a Choice Award, which is the American Libraries Association’s award. They review over 4000 books, and they choose; my book is in the top 3. It’s only the second public health book, I believe, at least, for my publisher, that has received this award. My book is one of, maybe there’s one other book of its kind, that centers Black women’s sexuality in a positive way. I’m really proud of it, and I’m proud because it’s contributed by these brilliant Black women, many of whom I have loved their work, and that we could all bring it all together so that not just other Black women are who are doing this work have a resource, but those that consider themselves an ally. If you are not going to be educated about this work, and you’re not going to do what you need to do when you’re using your place of privilege, and I mean no offense, but we don’t really need you in the fight if you’re not going to be coming fully armed to this fight, in there with us to the long haul.
Madison: Yeah, and I think wording it that way is very intentional, because it is a fight. We have to, unfortunately, we have to fight for everything. You said it so beautifully, talking about the strength of our resolve and our resilience and I’m hopeful, and I’m looking towards the future with optimism, but it is going to be a fight. We’re going to have to speak up, and we’re going to have to probably be exposed to some things that are uncomfortable, but I’m so grateful for you and what you do and your organization, because without that, we would not have a voice. I’m so grateful for your time today, especially in our current climate of uncertainty, that you were able to take this time to discuss your work with me and with my audience, and I know that they will take a lot from it. If folks want to reach out to you, know more about your organization or your foundation, where can they find more information?
Davis Moss: Absolutely. So In Our Own Voice, you can follow us across our socials @Black WomensRJ. That’s Instagram, Facebook, X/Twitter, as well as LinkedIn. Also, our website is BlackRJ.org for In Our Own Voice National Black Women’s Reproductive Justice Agenda, and then for our action fund, it’s BlackRJAction. If I had to give my parting thoughts to just say, this is a time that is unfortunately not unfamiliar to us. But we do what we do best, which is we rest, we strategize, and we get back out there. We remain unwavering in our resolve. We stand firm and we’re not afraid. I mean, the playbook is to make us uncertain, make us feel uncertain, to make us want a course correct, to do all these things in anticipation of what someone might do. The reality is you’re probably going to do it regardless. So, we might as well fight.
Madison: Yeah. So, there’s a question that I typically ask my guests at the end of the episode, and I know that I haven’t prompted you for this, so if you don’t have an answer, it’s okay. I usually ask the question: if there was one thing you could tell your younger self, what would it be and why?
Davis Moss: I would tell myself absolutely to give myself some grace. What is meant for me to experience, or the things that I’m meant to learn only come from being open and not trying to plot out everything and not trying to control or decide what I think is best for me, because my eyes would not have ever imagined, or I would not have conceived, that I would be here. But it is the best decision that I’ve made, and certainly for a moment like this, I’m so proud to be doing this work.
Madison: Well. I am proud to know you, to admire you, and again, could not thank you enough for taking the time to record this podcast with me again. Dr. Regina Davis Moss, you are a beacon of hope and light, and I’m so glad that you were able to join us today. Friendly reminder, again, this has been an episode of Public Health Matters, part of Pharmacy Times®: Pharmacy Focus podcast series. I am your host, Dr. Christina Madison, also known as the Public Health Pharmacist. And remember, public health matters.
Learn more about In Our Own Voice: National Black Women’s Reproductive Justice Agenda and the In Our Voice Action Fund.