Stéphanie Etienne and Tanay Harris are co-founders of the Bloom Collective, a collaborative group of maternal health and wellness practitioners providing community-based perinatal care in Baltimore. In this interview, they describe the joys and challenges of sustaining the radical birth work, its potential to shift birthing outcomes for individuals and families, the personal journeys that led them to this work, and the ways that birthing justice work necessarily comes out of and moves alongside movements for abolition and racial justice.
Miriam Neptune: We’re living now in an era of talking [more widely] about access to abortions and reproductive healthcare in general. Many people are using the phrase “reproductive justice,” but they may not have a grounded understanding of the different pieces that are part of it, especially for Black birthing people, or the nuances of being a reproductive healthcare provider. I feel like talking to both of you will really kind of tie together the different threads that people are invoking to talk about reproductive justice work and the activism that is necessary for Black people and communities to thrive.
What is the Bloom Collective and what is the ancestry of the work that you’re doing?
Stéphanie Etienne: My backstory is that I am from New York, born and raised, and come from Haitian ancestry, both my parents. Growing up I spent a lot of time in New York with other kids from various backgrounds, folks whose parents migrated up from the South and people whose families were from many other countries, particularly in the Caribbean. I went to school thinking I was going to become a doctor. I was pre-med for many years but realized pretty quickly once I started doing it that I wanted to understand more of why people struggle with different health issues. I decided that I wanted to focus more on public health and went that route instead of medical school. After undergrad, I got a master’s in public health with a focus on health behavior and health education. Once I started doing that work, I started realizing that I wanted to be in relationship with people, that I didn’t necessarily see myself as a researcher per se, or not solely from the program development side.
I wanted to be more intimately connected with people from the community, people who I saw as part of my community. So, I started thinking about becoming a doula after I met other activists in New York City who were moving in that direction. I was really taking direction from activist predecessors who had been talking about how we look at our everyday lives as opportunities for engagement.
What does it mean to be pregnant? What are the possibilities that exist in that space for people in our communities? Those were the type of questions that led us to forming a group, becoming doulas together, and providing free doula services in New York City. And that led to more and more involvement in birth justice. I decided to go back to school to become a midwife. I did that work for several years in New York City in the Bronx, and then came down to the DC area and worked in Virginia. Then I started having a family of my own and transitioned to Baltimore where I began working with Tanay and some other folks. And we got the Bloom Collective together. So now I think of myself as a midwife but I’m not working in clinical spaces. I think of myself as more of a community-based midwife focused on health education and family support. I think Tanay provides a really wonderful description of Bloom.
Tanay Harris: As a high schooler, I was very much an organizer’s organizer. I didn’t know all the ins and outs of it, but I was going to try to figure it out. I realize even now that what I knew a few years ago was that the catalyst or the foundation of that organizing work was really the anchoring of the Black church with all of its faults and all of its beauty and all of the things. How do you actually connect with people? I was the grandchild that I was. You couldn’t just tell me no, I had to know why. I guess that’s where my seven-year-old he gets it, honestly. So, when my grandfather told me I couldn’t have a friend who was Hindu, I was like, “What? What do you mean?” He’s like, “She ain’t Christian, you can’t be friends with her.” And I was like, this doesn’t make any sense. She’s a lovely person. I’m so confused.
So, I always wanted to understand people, how we exist and how we love. I was thinking, how do we really center family, community, and kinship, again with our own collective faults, our own individual faults, but also thinking of our ways of togetherness. I really did not ever know what I wanted to be. I didn’t really know what liberation was but in my heart of hearts, as I think about it now, that was what I was striving for. I just wanted Black folks to be their most free selves and that was important to me. So, it was always like that, whenever someone would say a terrible narrative about Black folks, I would say, “Where do you get that from? That’s not my reality.”
I was always trying to make sense of the world, whether that was through education, organizing, or whatnot. Just to have been a student at Temple in Philadelphia, we learned real deeply about the connection between the academy and the community, that one should never supplant the other and actually they should be working hand in hand in a way that’s holistic, where one person doesn’t hold all the knowledge.
I think what was also beautiful about that time [at Temple] was to see the different variations of Blackness, Black genius in everyday life, where you would meet so many people that you would take for granted because they were just simply who they were. I wanted to understand more of that and what it means to be intergenerational. What does it mean to not just fight against systems and structures, but understand how those systems and structures manifest in us? We have to do the work to change that, and that’s the hard work. So, we can always condemn so many things which need to be condemned, they need to be broken down, but we also have to contend with ourselves.
It really just kind of put me on this journey. So, I was an educator in Philadelphia on top of being an organizer, and we were curating events at Temple with community members to have dialogue and, just like I said, center the genius of Black folks and all of those intersections.
Some of my deepest moments in understanding how deep white supremacist racism was came when I was working with folks like Pam Africa and Ramona Africa and finding ourselves thinking about who is the best organizer, whose strategy is the best? And we really need all of the people. There is not one best way or best person. But we do have to realize that we need more containers to build and cultivate great organizers who are focused on systems change and not celebrity.
I started working and organizing around different issues in Philly, police brutality, policing in schools, curriculum, and all of that, and really getting deep around political prisoners including Mumia Abu-Jamal. And then I received an invitation to apply for a National Organizer position with the NAACP Legal Defense Educational Fund, to be officially a part of Mumia’s legal team, in which a lot of that organizing work focused building and cultivating deeper relationships with clergy and ecumenical faith institutions to deepen understanding of the connection between capital punishment, life without parole, and mass incarceration.
It was there when I was working on all of these other cases that I started to see the hierarchy of the attorneys thinking that their case was the most important case. They would helicopter and parachute into a particular community and say, “This case is important. We’re going to only work on this and we’re going to just kind of leave you all.” And so, this activation would happen, whether it was voting rights or the death penalty, that would leave these communities who already had amazing things happening. They’d be left by the wayside because of this particular case. So, my goal was, how do we really utilize these moments to work together and collaborate more for more transformative change?
At that time, reproductive justice was seemingly new to me. I mean, I understood the language of it, but where I was first seeing it was when I had pregnant clients who were being shackled in prison. So, we were working with different organizations talking about the constitutional and human rights violations that were happening and making a broader connection to violence. I was really looking at how, if we can treat people the way that we do, looking at capital punishment—like, wow, we’re such a violent people. This is a violent system and it’s a violent structure. How does that manifest into ourselves? It really wasn’t until I had my son that I started really thinking about a village as something I really needed because at that time I was unemployed.
Part of the community that I had was because of the connections that I had or where people saw me in regard to status because of those organizations or my positionality. And then when those were no longer in existence, the community shifted. So, the community that I had loved and had felt like I was building with, I started to see that it really wasn’t my village. And then on the other end, I had my family, which is loving and amazing even with all of its faults, but it wasn’t who I currently was. And so, I needed to find a real village again. It just so happened that I created an opportunity for moms to get creative and come together. We called it Mamas and Mimosas.
And what I saw very quickly were the conversations on parenthood, lactation, family, and community. I just started to see the constancy of these narratives. And so, Bloom came from just a space. A space became available. A mutual person that we knew was like, “Hey, we’re all kind of doing maternal health, reproductive health work. Why don’t we all kind of utilize this space? You can do this, you can do this, you can do this.” So, it was almost going to be a reproductive health co-working space. And our community was so confused. They were like, this is great in concept, but are you all different entities in this one space? Who do I go to for this? Who do I go to for that? Really what they were calling for us to do was think more collaboratively. So then, Bloom kind of manifested into a team of practitioners working together to support people along the life course: preconception, pregnancy, and postpartum.
MN: Wow. It’s really powerful to hear your personal story as it’s a window on the past twenty years and more of social justice struggles. I hear a lot about the connection between your work and abolitionist frameworks, liberation strategies, and I’m interested to hear more about that as we talk more. But it also makes me think about how you all found alignment at the Bloom Collective once you decided that you were going to be working cooperatively. It sounds like people were coming in with different kinds of ideas and practices based on their own journeys. How did you make that into a cohesive thing? What’s the glue that keeps that together?
TH: I don’t know if it’s cohesive, and I don’t know if it ever will be. It’s just life. It is life, but there’s something about being in alignment and working towards that particular goal. And so, if we’re saying we want to be the village, we have to be the village of one another as much as possible. That doesn’t mean it doesn’t have its own struggle, but it means that we center love in that work and what we’re doing. I think it really was allowing it to manifest and then finding the thing that can hold us together, which we knew was preconception, pregnancy, postpartum, maternal health, reproductive justice, abolition, human rights, birth justice, movement building and all of that.
What we did really center is that when we’re thinking about doing this work differently, it means we’re not a nine-to-five entity. We have opened it up so that everyone can show up in the way that they can show up. And that means that you have to hold space for everyone’s life circumstances being different. If that means this practitioner is only going to do prenatal lactation once a month, that’s their focal point. If this practitioner’s going to meet clients ten hours a week, that’s what they’re going to be doing. That way people can be within the space with shared alignment, shared goals, and shared vision in doing the thing that brings them the most joy. I think that is really centering communication and collaboration and just knowing that it’s going to look different for every single person.
MN: Was there a conscious choice to not register the Bloom Collective as a non-profit?
SE: I would say that there was intention around the decision not to become a 501c3 in order to be able to prioritize the collective nature of the group, to respect the work that folks were doing more holistically, to allow us to work as independently as possible and to be guided by our own values and grounding in the different movements we were a part of, rather than having to be beholden to funders and grant requirements and the busy work of maintaining an organization on that level.
All of it comes with its own challenges. I had a lot of reservations about becoming an organization, having worked in many nonprofit organizations and having been through that grueling cycle where at a certain point you’re not even sure who you’re doing the work for because there are so many external responsibilities that take precedence over the actual work that you want to be doing.
There are not a ton of examples of organizations that have this sort of independent drive, that are businesses, but also looking to make change in the world, looking to support communities, and to be a grounding force within communities. I think we’re trying to figure it out as we walk the walk.
TH: In the conversation around social impact and social enterprise there’s this idea that nonprofits are the people who are doing the most impactful work, which is very much riddled in gaining control over Black folks’ work. The reality is we always want it to be able to shift as needed without anyone trying to dictate that.
SE: When we were forced to be more insular because of Jim Crow, because of all of the limitations imposed on our community, we were doing these things on an everyday basis, we were supporting each other, and we didn’t have to do it as named nonprofit organizations. We were doing it through churches, through businesses, through our art and creative practices. So sometimes it feels like we’re out here, people are looking at us saying, “What are they doing?” But there is a historical precedent for the work that we’re doing.
There’s a memory, I think, in the community of a way of being that used to be. You can find what you need within your community with your own people who look like you and who are not different from you.
MN: What you are talking about in terms of models makes me think of mutual aid societies and community banks, places that historically kept capital within the Black community and distributed and redistributed resources with other goals in mind, when they were at their best. I noticed in some of your communication, on Instagram and so on, that you talk about mutual aid, but you’re also talking about taking Medicaid money. I’m fascinated by the work that you all have to do to make all of these different kinds of logics interact with each other and benefit patients or people who are coming for services. What do systems of care need to look like and how are you attempting to build something that looks the way people need it to look and feel? And how do these mixed economic models help you do that?
TH: Something about it that stands the test of time is that, anchoring in the point Stéphanie made, none of this is new. So even the whole phenomenon of social impact, social enterprises, just what Black folk been doing. I make a pot of soup, such and such makes a pot of soup, and then the whole neighborhood eats. That’s mutual aid. That’s philanthropy in our own communities. When we’re talking about these mixes in income or money as the mixed reality of Black folks in this country, we have to ask, how do we meet people where they are?
We accept insurance for our perinatal therapy work, which is connected to certain practitioners. We ain’t all the way all up in it, but you need perinatal therapy, here you got Medicaid as an option. It also must be understood that some folks just don’t want Medicaid because it is invasive, and you do get treated very differently. We must also understand that having access to something doesn’t mean it is quality.
We center mutual aid. It is a way to center what we have in our hands and in our community. For Bloom, we don’t need you to sign a ten-page paper to prove to us that you’re in need. And if you want Whole Foods food, we’re not going to say beggars can’t be choosers. No, we’re going to give you the food you want from where you want it, because if we’re serious about this work, if Whole Foods is what makes you feel like you’re giving yourself and your child and family the best of the best, and if we can help be a bridge to support you along that journey, that’s it. If we have it, you have it. And so it is that level of care, a system of care, of doing whatever we can do to support the whole ecosystem. And we do this while equally being totally underfunded and under-resourced, but we rely on our communal ecosystem.
I think that that’s also the point of Dána-Ain’s work, to showcase that when we’re thinking about radical birth workers it’s not just the doula supporting you along birth and sometimes postnatally. It’s the work surrounding how we know our own community. Who do we know that can help with housing? Who do we know that we can help with food? The more that we’re connected to our own community, the better we’re able to utilize and share those collective resources.
There are birth workers who you might meet who believe in the systems and the structures that are centered on harm. If you’re talking about any domestic issue, they’ll say, “Call the police, get them locked up.” And that’s hard for us when we’re thinking what abolitionist framing could help in this situation? It’s not perfect, but really that is what abolition requires of us: not knowing which way I want to go with this but wanting to build, as Dr. Ashon Crawley says, “the otherwise possibilities.” The everyday practice of a thing, not necessarily a destination.
If we do the little pieces that we can and just simply say hello to someone, love on someone, help someone who might need childcare or find someone who can do that, then it lets us know that we’re not doing it all alone. Seeing the gifts, talents, and genius in so many other people, we realize we have everything that we need in our own collective communal hand.
SE: Yeah, I would 100% agree. The process of doing this though, it’s a long game and it takes time to build relationships. It takes time to build trust in community, especially when what might have been there before was something extractive, punitive, or judgmental. Even doing introductory work around what birth justice is, what birth workers can offer, what it means to be an organization committed to a more holistic view of care, this may not feel familiar to people right away because it’s not couched in what we know as a kind of organizational language. It may not have the markers that people are used to seeing.
MN: What are some of the challenges of doing care work outside of or alongside systems rather than deeply entrenched within them? Do you feel like this work is valued?
SE: I think it takes time to pull people out of the frame of mind where we’re supposed to go outside of our community for the things that we need. And that can take a while. Because we do this work in a non-hierarchical way, we do not position ourselves as the be-all and end-all of knowledge. We do a lot of wisdom sharing with our clients as well as looking to them to set the tone and bring their level of experience and wisdom. It’s more of a relationship than a transaction. Because we do it in that way, it can sometimes go unnoticed.
People don’t necessarily know how to identify the work that we do because it’s caring work, which our society tends to undervalue anyway. And then, I think on a relational level, people, clients can sometimes feel like, “this is a friend, this is somebody who’s just here caring about me and helping me,” but they are not necessarily seeing that this work should be financially supported as well. So, I think those might be some of the challenges of doing work outside of systems or maybe alongside systems rather than deeply entrenched in systems.
TH: Thinking about those preconceived notions—that it is sometimes hard for people to know if they’re getting healthcare because they’re so used to the harmful tactics and hospital settings—we’re like, no, you can sit on the couch and it’s like being with your sister. No, we didn’t give you tips. We laugh about this because people have been like, “Thanks for the tips.” I’m like, I’m not giving tips. This is stuff we’ve been studying. That other part of your brain is like, look, uh-huh, no, but there are those moments that it is hard for some people because they’re used to coming in, getting an armband, getting their weight checked, being told that they’re overweight, and hypothesizing about all of the issues, but they haven’t really been cared for.
When we’re thinking about being place-based, that’s something that we have to hold near and dear in a place like Baltimore, which is a heavily disregarded and traumatized city. I’m saying that with a lot of love, having lived in Philly and New York. I’m saying that with a lot of love and realization that you must come into this community holding much respect and space for the culture here.
Having worked here in different capacities for the past eighteen to twenty years, I’ve seen the manifestations of it and what it means to commune and be in deep relationship. But if you kind of come into a place like Baltimore not knowing that, you don’t understand people have been left without, they’ve been left by the wayside. Baltimore is the birthplace of redlining. It is a heavily Black-populated city, with Black folks in position of “power” and yet white supremacist and anti-Black ideals paramount here. The material conditions in Baltimore need to be transformed for folks to be truly liberated here.
Other people have come in and taken their ideas and left and gone somewhere else. So, people carry that experience deeply in their DNA here and it is something that we have to hold space for collectively, for ourselves, how we feel, and the hard work, and then knowing when we need a break while also trying to learn better ways of being engaged in community and the type of work that we’re doing as well.
MN: I appreciate you bringing the specificity of that, that trauma shows up differently in different places, and having Black political representation in your city doesn’t fix all the harm of anti-Blackness.
I’m wondering if sometimes you might feel like although you’re doing radical birthing work and it’s kind of making an intervention, but the problem is always bigger. It makes me think about… What is the political work that has to be done from within the medical industrial complex? Where do you see the strategies that you’re using having an impact locally, or beyond Baltimore even?
SE: Well, I’ll just say that I do think that the work has to happen on so many levels. A lot of what we do on a day-to-day basis at Bloom is around shifting our understanding of birth, reproductive systems, our reproductive lives, and who we are in relation to the healthcare that we receive. I think this is foundational education that most people have not necessarily accessed because we live in a society that tells us that the medical system is the be-all end-all and that we have to trust everything our doctors tell us. They have all of the information. We couldn’t possibly believe that we know more than our doctors. But in many ways, we should believe that we know more than our doctors.
I think, at a foundational level, a lot of the work that we’re doing is putting birthing people, Black women in particular, in the position of recognizing themselves as the experts of their own lives and their own understanding of their bodies, which I think is a radical act to help someone realize that their providers don’t know more about their lives than they do. And that when they show up in a healthcare setting, that they have the right to hold themselves at that level of expertise.
They have the right to say, you are here to help me, but you’re not here to tell me everything that’s happening. And you have a responsibility to answer my questions. You have a responsibility to treat me with dignity. You have a responsibility to engage with me in a way leaves me with a different understanding of what’s going on and leaves me in an even stronger position of knowing myself. I should not feel depleted or less-than when I leave this interaction. That’s the work that we’re doing. But there’s so much other work that needs to happen.
We’re also involved at the policy level, engaging and challenging health systems, as well as pushing for programs that are focused on healthcare equity. So, there are a lot of different things, but I think there are spaces for engagement at every level from the individual all the way up to governmental agencies.
TH: There’s moments where it’s hierarchical, when you’re like, look, look, I’m tired of mediocre people in well-resourced institutions who always feel they are educating everyone else, but who really have no idea. So, some of the work we do on the policy or institutional levels is sometimes with institutions who have so much money and yet the quality of their work is lacking. Grassroots organizations and private practices have made a choice to be in our community, but they attempt to act as though we are on a lower level. We are actually doing the work they receive millions of dollars to conduct research on. We are already doing it. The models already exist in community.
People who might even have good intentions, their impact can be equally harmful. And this is across the board because it’s not just the white folks. It is the anchoring and the way we’ve been socialized. People have been socialized to believe in particular things where they’ll say, Black women don’t want to breastfeed because they’re lazy or they think it’s terrible. And that’s people within our own community, buying into the pathologies that are rooted in anti-Blackness. So, we have to do that shedding. Sometimes sitting in these spaces, these folks really do not want us there.
Not just us as in Bloom, but folks who are thinking in more radical ways. And they will do everything possible to stand in the way. I’ll be very transparent with you. I’m the co-chair of the Maryland Maternal Health Improvement Task Force. That don’t mean shit. It’s just a title that is said. I don’t have no rights. I don’t have anything. They literally have someone who is situated there who will do everything to shift what we come up with based upon centering reproductive justice. Legislatively, one of the things I learned very deeply as an organizer doing policy is how things can get manipulated in government. Even when we got rid of the death penalty here in Maryland, the provisions in the bill were terrible.
MN: Has an increase in funding for Black maternal care work garnered much change in traditional health settings?
TH: We are seeing even on a national level, and then in community-based organizations like Bloom and so many others, there’s no trickle down of federal money for actual community-based organizations that are built by Black women, Black people that actually center our holistic standard of care. In this moment when so many foundations are giving dollars to create Black birth workers, that’s because they know it’s not going to lead to any real transformative change. I love the idea of having tons of Black doulas or doulas who are doing radical birth justice work, but it doesn’t change the racism in the medical industrial complex. Black maternal health is more than the need for doulas. We need to fund more Black midwives, we need more Black doctors who have these foundational principles, values and virtues who are trying to do this work that changes the course. Not just simply to say they are Black excellence, but to really change the course. Black excellence can’t be saved for only people with certain degrees. What does it mean to be a Black doctor, but behave just like the problem? We need intentional nurses, lactation consultants, access to fertility support, abortion care, therapists and so much more that make up the arc of reproductive justice. It’s really about the ways in how we are thinking, the ways in how we’ve been conditioned to think of the pathology of Black folks and Blackness that we have to really kind of debunk and work through.
There’s just so many fronts to it but the reality is, who really holds a narrative? What are the narratives that we’ve been told that we hold onto? We have to start thinking about what of those narratives are oppressive and harmful and don’t get us to the path of liberation or transformative change.
SE: Yes. It’s really about the transformative change part. I think it is easy to launch programs here and there and not ever see the totality of what needs to be changed and how at every level of impact transformation needs to happen.
I think Dána-Ain’s book, Reproductive Injustice, is so important because there’s a focus on storytelling and centering the narratives of people who have not been listened to before. 1 When I was talking about being the expert in our own lives, I think this is a text that helps us understand the value of that. The thing that I find most amazing every single time I’m engaging with somebody who has just had a baby or is pregnant and has had some sort of complication is that they feel like they’re the only one going through something. The work of storytelling and centering the experiences of Black women helps to break down that isolation and create a space where people understand that their experience is part of a larger system of injustice that’s impacting not just them, but other people who look like them. I think it’s part of that long game approach. It’s part of undoing of a lot of harmful, internalized racism. It’s undoing a lot of harmful systems that we’ve been a part of, but it’s the necessary work.
TH: I think on a very personal level Dána-Ain is a really great example of what it means to be deeply rooted in community. And just because you’re deeply rooted in community, you’re intentional and you love Black folks, that doesn’t mean you can’t be in the academy. Sometimes we think that those things are at odds. And it’s like, no, there’s the both-and: you can be a doctor who is from the community. It’s all about your intentionality in how you’re doing the work. I feel like Dána really brings so much of the deep movement building that it’s not just about her, it’s for the collective liberation. In writing the book, how she shows up, how she loves, how she checks in, she is really conveying this is what it means to be the anchor of support, this is what it means to be the “otherwise possibilities.” And we’re not always going to get it right, but at least I’m going to do my due diligence as much as possible. I don’t even know if she calls herself an organizer, but I told her recently, “You know you organizing because you see people.” We oftentimes see what someone does, but we don’t really see someone.
I think Dána does a really great job of anchoring who she is into this work in a way that helps others. I think to the point of storytelling and narrative shifting, she’s amplifying folks’ stories from their own vantage point. They are the expert; they are the person. It’s not any particular elite or celebrity person or model, it’s really just the everyday people who are sharing their stories that I think is an amazing opportunity.
MN: Yeah, that’s beautiful. Her own story of coming to birthing work in the process of doing this research is really compelling and admirable because a lot of times people say, “I’m just studying the thing,” but her commitment is really evident.
SE: I really appreciate Dána-Ain’s work. I think the light that she’s been able to shine on our stories is not only beautiful, but it’s affirming. It is also adding something to the canon, the body of research, the resources at our disposal for folks in activism spaces. The book is a critical resource. When we talk about academics and scholars participating in movement, this is a beautiful example.
WORKS CITED
Davis, Dána-Ain. Reproductive Injustice: Racism, Prenancy, and Premature Birth. New York: NYU Press, 2019.
- Dána-Ain Davis, Reproductive Injustice: Racism, Pregnancy, and Premature Birth, New York: NYU Press, 2019.[↑]
