Inclusion, Justice & Care Commitments

Where I stand

Pregnancy, birth, abortion, loss, feeding, and parenthood do not happen separately from the conditions in which people live. Race, gender, disability, religion, sexuality, income, geography, immigration status, healthcare access, and conflict can all affect whether someone is heard, respected, and able to make decisions about their own body.

Mycelia Birth Co. believes evidence-based care cannot be separated from autonomy, historical honesty, racial and reproductive justice, and human dignity.

You don’t have to share every belief on this page to work with me. Whatever you believe, you’ll get the same respectful, nonjudgmental care. This page is about how I will treat you, not a test you have to pass.

This page shares my values and some history. It isn’t medical, legal, or therapeutic advice. Doula support is non-clinical and works alongside your medical team, not in place of it.

Who is welcome

Everyone. Specifically:

• People of every race, ethnicity, culture, and nationality, and every immigration background.
• People of every religious and spiritual community, as well as people who aren’t religious or spiritual.
• Disabled and chronically ill people, and people who are neurodivergent.
• LGBTQ+ people and families, including transgender, nonbinary, intersex, Two-Spirit, and Indigiqueer people.
• Every family structure and relationship status: single parents, co-parents, married or not, one parent or several, and chosen family.
• People of every income and background.
• Every pregnancy outcome, including miscarriage, stillbirth, and abortion.
• Every feeding decision: chest, breast, bottle, formula, donor milk, pumping, or a mix.
• Every birth decision: hospital, birth center, or home; medicated or unmedicated; vaginal or cesarean.
• Every path to pregnancy and parenthood, including fertility treatment, surrogacy, adoption, and fostering.

Women carry much of the weight of misogyny and gender-based discrimination in healthcare, and I name that plainly. Transgender men, nonbinary people, intersex people, and others also become pregnant, give birth, feed babies, experience pregnancy loss, and need abortion care. I say “women” when something specifically affects women, and use broader words when it affects more people. Neither erases the other.

A note on Two-Spirit: it is an Indigenous term, adopted in 1990 at an intertribal gathering near Winnipeg, and it belongs to Indigenous communities. It isn’t another word for LGBTQ+, and not every nation uses it (Canadian Museum for Human Rights on the origins of Two-Spirit). “Indigiqueer” is a term used and popularized by Oji-Cree writer Joshua Whitehead.

A flag isn’t a policy; the rest of this page is.

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What inclusive care means

Inclusion only means something if you can see it in how I work. In practice:

• Your name and pronouns. I use the name and pronouns you give me, and I correct myself if I get them wrong.
• Your words. Tell me the words you use for your family, your body, your pregnancy, your birth, and feeding, and I’ll use them too.
• Consent before touch. I ask before any hands-on comfort measure, every time. “No” or “not now” is always enough.
• Changing your mind. You can decline, pause, or change your mind about anything, without explaining why.
• Faith, culture, and daily life. Religious, spiritual, cultural, dietary, dress, prayer, and modesty needs are part of your plan, not an inconvenience to it.
• Access. Tell me what you need, whether that’s a disability accommodation, a different way to communicate, more time, or written notes. You never have to share a diagnosis or a trauma history to ask.
• Language. If you need an interpreter, I’ll work with you to find language support where it’s available.
• Who’s in the room. You decide who is present in your home and at your birth, and what visitors are told.
• Privacy. I can keep messages and voicemails neutral, and I won’t contact anyone about you without your OK.
• Photos and stories. I never photograph you, or share anything about your experience, without your explicit permission.
• No pressure. I won’t steer you toward an unmedicated birth, a vaginal birth, breastfeeding, formula, parenting, adoption, abortion, or any other particular outcome. My job is to help you decide, not to decide for you.
• When I get it wrong. I listen, take responsibility, and repair what I can (more on accountability).

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Black birth, medical racism, and reproductive history

American obstetrics and gynecology did not develop apart from racism; they developed through it. That history matters because it still shapes who is believed in a hospital today. So does the other half of it: Black women’s knowledge, care, and leadership, which kept families alive and still lead the fight for reproductive justice.

Reproduction under slavery

Under slavery, enslavers profited from enslaved women’s childbearing, and the law treated Black women’s reproduction as something owners controlled. After the international slave trade was banned in 1808, births became the main way the enslaved population grew. Enslaved women faced sexual violence and coerced reproduction, and mothers could be separated from their children by sale at any time (legal scholar Dorothy Roberts, Killing the Black Body; College of Charleston, “Reproduction and Resistance”).

Enslaved women also resisted, including with plant knowledge passed down through generations to prevent or end pregnancies.

Medicine built on Black women’s bodies

From 1845 to 1849 in Montgomery, Alabama, Dr. J. Marion Sims performed repeated experimental surgeries on enslaved women, among them Anarcha, Betsey, and Lucy, to develop a repair for vesicovaginal fistula. Anarcha underwent about 30 operations. The surgeries were done without anesthesia, which was not yet in routine use, and without consent that enslaved women had any real power to give (“The Legacy of James Marion Sims,” 2024). Historian Deirdre Cooper Owens shows how early American gynecology was built partly through this work (Medical Bondage, reviewed by AAIHS). In 2018, New York City removed Sims’s statue from Central Park.

Pain that isn’t believed

In a 2016 study, about half of 222 white medical students and residents endorsed at least one false belief about biological differences between Black and white people, such as Black people’s skin being thicker. Those who held more of these beliefs rated a Black patient’s pain as lower (Hoffman and colleagues, PNAS, 2016).

Black midwives: knowledge, care, and displacement

For generations, Black midwives in the rural South attended births in their communities and were central to Black maternal and infant health. Their work was clinical, communal, spiritual, and public-health work all at once. Midwives were not early doulas: they carried medical knowledge and responsibility that the non-clinical doula role does not.

From the 1920s, Southern states used federal Sheppard-Towner Act funds to train, license, and supervise Black midwives. Officials often described them in openly racist terms and blamed them for poor outcomes, and licensing rules gradually pushed them out (TIME, 2024; Center for American Progress, 2020). Margaret Charles Smith of Greene County, Alabama, licensed in 1949, attended thousands of births (Alabama Women’s Hall of Fame). In 1984, Alabama told its remaining lay midwives, among them Onnie Lee Logan of Mobile, that they could no longer practice (Encyclopedia of Alabama).

Segregated care

The 1946 Hill-Burton Act funded hospital construction while explicitly allowing “separate but equal” facilities. A federal appeals court struck that provision down in 1963 in Simkins v. Moses H. Cone Memorial Hospital (NCpedia), and when Medicare began in 1966, hospitals had to desegregate to be paid (KFF Health News).

Eugenics and coerced sterilization

In 1927 the Supreme Court upheld forced sterilization in Buck v. Bell; the decision has never been formally overturned (Encyclopedia Virginia). More than 60,000 people were sterilized under eugenics laws in 32 states, most of them disabled or institutionalized, with poor people and people of color targeted (The Conversation, 2020).

• North Carolina sterilized about 7,600 people between 1929 and 1974, and in its later decades Black women were disproportionately targeted. In 2013 it became the first state to compensate survivors (North Carolina Office of Justice for Sterilization Victims).
• In 1961, civil rights leader Fannie Lou Hamer was given a hysterectomy without her knowledge or consent. The practice was common enough in Mississippi to have a name, the “Mississippi appendectomy” (PBS American Experience).
• In 1973, Minnie Lee and Mary Alice Relf, Black sisters aged 12 and 14, were sterilized at a federally funded clinic in Montgomery, Alabama. Their mother, who could not read, had marked an “X” believing they would receive birth-control shots. The case led to federal informed-consent rules for sterilization (Southern Poverty Law Center).
• By 1965, about one in three mothers of childbearing age in Puerto Rico had been sterilized, often without full information about permanence or alternatives (Harriet Presser, Population Studies, 1969).
• A 1976 federal audit found that the Indian Health Service performed 3,406 sterilizations on Native women in four of its twelve areas between 1973 and 1976, with most consent forms failing federal requirements (US Government Accountability Office).
• In Madrigal v. Quilligan (1978), Mexican-American women sued a Los Angeles hospital over sterilizations performed without informed consent, often during labor. They lost, but the case led to stronger consent protections, including Spanish-language forms (Library of Congress).
• California’s state auditor found that 144 women in state prisons were sterilized between 2005 and 2013, 39 of them without lawful consent (California State Auditor, 2014).

The inequity today

In 2024, the maternal mortality rate for Black women in the US was 44.8 deaths per 100,000 live births, about three times the rate for white women (CDC National Center for Health Statistics, 2026). CDC reviews find that more than 80% of pregnancy-related deaths are preventable (CDC). Racism, not race, drives this gap, and the same myths that let pain go untreated are still part of being dismissed when you say something is wrong.

Black-led work today

Black women named reproductive justice. In 1994, a group of Black women calling themselves Women of African Descent for Reproductive Justice defined it as the right to bodily autonomy, to have children, not to have children, and to parent in safe, sustainable communities (SisterSong). That work continues through SisterSong, Black Mamas Matter Alliance, which founded Black Maternal Health Week in 2018, the National Black Midwives Alliance, and many local Black birth workers (see the resources below).

Where doulas fit

DONA International, founded in 1992, helped formalize one modern model of doula training and certification (ASU Embryo Project). It did not invent continuous emotional, physical, and informational support in labor. Family and community birth workers, especially Black midwives and Indigenous birth workers, carried that knowledge long before the word “doula” was used this way, and as birth work was professionalized, many of them were excluded or pushed out (Center for American Progress).

I’m DONA-trained. That training is one part of a much older history, and I owe that history honesty.

Further reading: Black maternal health and birth equity and Black birth and midwifery history in the resources below.

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Reproductive freedom and abortion

On June 24, 2022, in Dobbs v. Jackson Women’s Health Organization, the Supreme Court held that the Constitution does not protect a right to abortion. It overturned Roe v. Wade and Planned Parenthood v. Casey and returned abortion regulation to the states (Supreme Court opinion).

Dobbs didn’t itself ban abortion anywhere. It left each state free to allow, restrict, or ban it, so access now depends heavily on where someone lives, and the laws keep changing (KFF’s current state-by-state tracker). In Pennsylvania, abortion is legal through the end of the 23rd week of pregnancy (before 24 weeks, counted from the last menstrual period). After that, it is allowed only when a physician believes it is necessary to prevent the patient’s death or serious, irreversible harm to their body (18 Pa.C.S. § 3211; Commonwealth of Pennsylvania).

Restrictions fall hardest on people who already face barriers. About half of abortion patients have incomes below the federal poverty line, and Black and Latina women are over-represented among patients (Guttmacher Institute, 2023). Distance from a clinic, disability, being young, immigration status, childcare, housing, work that can’t be missed, violence at home, and the risk of criminalization can turn a legal right into an impossible trip.

What I believe:

• Abortion is part of reproductive healthcare.
• Everyone deserves accurate information, free from coercion and shame.
• I support your autonomy whatever you decide: abortion, miscarriage care, continuing a pregnancy, adoption, birth, or parenting.
• You never need to justify your abortion, to me or to anyone.
• Abortion can bring relief, grief, certainty, ambivalence, sadness, or all of these at once. Every one of those feelings is allowed.

My abortion doula support is non-medical: emotional, practical, and informational support around your care. I don’t provide medical, legal, therapeutic, or emergency services. For medical questions during an abortion or miscarriage, the M+A Hotline connects you with doctors and nurses. For legal questions, the Repro Legal Helpline is free and confidential. In a medical emergency, call 911 or go to the nearest emergency room.

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Global reproductive rights

Reproductive injustice is global, but it doesn’t take the same form everywhere, and US law and language don’t describe the whole world.

• The World Health Organization estimates that about 45% of abortions worldwide are unsafe, and that restricting abortion doesn’t reduce how often it happens; it makes it less safe (WHO).
• Around 640 million women and girls alive today were married as children (UNICEF).
• In 2019 the UN Special Rapporteur on violence against women reported on mistreatment during childbirth, including procedures without consent, detention over unpaid bills, and lack of privacy, and named it a human-rights issue (summary of the UN report).
• Seven UN agencies jointly condemned forced and coerced sterilization in 2014, noting it still affects disabled people, people living with HIV, Indigenous and ethnic-minority women, and transgender and intersex people (UN Women).
• War makes all of this worse. The UN verified 9,788 cases of conflict-related sexual violence in 2025 and says the true number is far higher (UN News, 2026). Conflict destroys the maternity care, clean water, food, formula, and medicine that pregnancy and newborns depend on, and separates families as they flee (WHO on attacks on health care).

Mycelia’s services are for families in the Philadelphia and Harrisburg areas of Pennsylvania, and virtually for qualifying services. Caring about reproductive justice everywhere doesn’t mean I can offer services everywhere.

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Global solidarity

Last reviewed September 21, 2026

Palestine

My position

I stand in solidarity with the Palestinian people. I oppose the genocide in Gaza, and I oppose forced displacement, collective punishment, and the deprivation of food, clean water, shelter, and healthcare. I support Palestinian safety, dignity, freedom, healthcare, and self-determination.

Current reporting (time-sensitive)

Pregnancy and birth have not been spared. As of September 2026, UNFPA reports about 50,000 pregnant women in Gaza, up to 180 births a day, fewer than half of health facilities functioning, and nearly 4,000 pregnancy losses in the first half of 2026 (UNFPA). Famine was confirmed in Gaza in August 2025, and WHO’s Director-General called it man-made (WHO, 2025). It has since been pushed back (UN agencies, December 2025), but most of Gaza’s 2.1 million people remain displaced and short of clean water and medical supplies (UN OCHA, 4 and 11 September 2026).

Findings and legal status

In September 2025, the UN Independent International Commission of Inquiry concluded that genocide is being committed against Palestinians in Gaza, including measures intended to prevent births, such as the destruction of Gaza’s largest IVF clinic (Commission of Inquiry report). Amnesty International and the International Association of Genocide Scholars reached the same conclusion. These findings are disputed, and the International Court of Justice has not yet ruled on the merits of the case brought by South Africa; in January 2024 it ordered measures to protect Palestinians in Gaza from acts of genocide (Human Rights Watch summary), and written pleadings are scheduled to run until 2029 (ICJ). My opposition to genocide is a moral position, informed by these findings. It is not a legal ruling, and I keep the two clearly separate.

Against hatred of any faith

Supporting Palestinian liberation is never hostility toward Jewish people or Judaism. I oppose antisemitism, and I oppose Islamophobia. People of every religious and spiritual community, as well as people who aren’t religious or spiritual, are welcome here.

Relief organizations: see Palestine and humanitarian relief in the resources below.

Other crises

• Sudan. Since April 2023, war has caused the world’s largest displacement crisis (IOM), with nearly 9 million people displaced inside the country. Famine was confirmed in parts of Sudan in 2025, millions still face severe hunger, and UN agencies report widespread sexual violence against women and girls (UNICEF, 2026; UNFPA).
• Democratic Republic of the Congo. In the east, fighting involving the M23 armed group has displaced millions, and a UN Secretary-General report found that sexual violence by M23 against civilians more than doubled between 2024 and 2025 (UN News, 2026).
• Ukraine. WHO has verified more than 3,000 attacks on health care since February 2022, including attacks on maternity hospitals (UN News, 2026).

This is not a complete list of every humanitarian crisis, and a crisis not named here doesn’t mean I don’t care about it. I keep this section short on purpose and review it regularly.

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Resources and further reading

Organizations and sources I’ve checked. I’m not affiliated with any of them, and listing them isn’t an endorsement of every position they take. Before donating, please look at each organization’s current work and financial information.

Last reviewed September 21, 2026

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Learn More from Mycelia

Longer pieces I’ve written on these subjects.

Accountability and feedback

Mycelia aims to provide a safer and accountable space. I may not always get everything right. If I make a mistake, I am committed to listening, taking responsibility, repairing harm where possible, and continuing to learn.

If something on this page is wrong, out of date, or missing, or if I’ve let you down in your care, please tell me. You can send a message through the contact page or email contact@myceliabirth.com. If you’re a client, you can also use the feedback page in your client portal. You never have to explain why you’re raising something.

Page last reviewed September 21, 2026. Time-sensitive sections are reviewed every three months.