A digital exhibition · The Educated Birth®

Birthing in the Fire

Why do Black families have to be so careful and cautious from day one?

It is a question Black families carry into every appointment, every intake form, every birth. The answer is four centuries long. This exhibition lays it out in five acts — one thread followed in full, how the ground was built, how to see it now, what happens in medical care spaces, and where you fit.

Built for people working in healthcare and public health: clinicians, nurses, midwives, doulas, students, and public health practitioners. No prior background in this history is assumed.

Enter the exhibition → Take the workshop
Mid-19th-century cased daguerreotype: a Black nursemaid, most likely an enslaved woman, seated with two white children in her care. Collection of the Smithsonian National Museum of African American History and Culture. "The Hair Appointment" (2018) by Jeremy Rodney-Hall for Sunday School, framed and hung in the exhibition Feels Like Home: a young Black woman combs a small child's hair at home while the child, seated between her knees, combs her doll's hair in turn.

The name

What Birthing in the Fire means

The fire is the steady, lifelong pressure of carrying a pregnancy through systems that were never built to be fair. It’s the racism worn into daily life, the stress that accumulates over years and passes from one generation to the next. Dr. Arline Geronimus coined a word for the mark that pressure leaves on the body: weathering. It’s already there long before labor begins.

So birth doesn’t happen in a calm, protected place. For Black women and birthing people in America, it happens inside that heat — in bodies and lives already shaped by everything that came before. Naming this work “birthing in the fire” is a way of telling that truth plainly, and of refusing to treat what happens in the delivery room as separate from the history, policy, and pressure that led there.

Why we chose this name ▾

We didn’t choose this name lightly. Our team went back and forth on it, wary of anything that might sensationalize a subject that deserves care and precision. But when we stepped back and looked at everything we’d put together — the history, the evidence, the stakes — the weight of the name fit.

Stress load carried by the body

35Black
adults
45White
adults
LOWHIGH

The same wear on the body, reached ten years apart.

Allostatic load counts how many of ten routine clinical measures sit in the high-risk range: systolic and diastolic blood pressure, BMI, glycated hemoglobin, total cholesterol, triglycerides, C-reactive protein, homocysteine, albumin, and creatinine clearance. A score of four or higher counts as high. Measured in NHANES data on adults aged 18–64; the Black–white gap held at every income level. The gradient above is illustrative, not a measured scale. Geronimus, Hicken, Keene & Bound, American Journal of Public Health, 2006.

Before you begin

Who this is for

People whose work touches how a person is treated before, during, and after birth — clinical, community, and public health alike.

It assumes no background in this history. It does assume you are willing to sit with it.

How to move through it

Seventeen chapters in five acts, arranged in order. Begin with what existed before, then how it was dismantled, then how it reaches the body, then where you fit. Most take five to ten minutes.

What you'll leave with

A clear account of why psychological and physical safety at birth is not the same for everyone — and why that’s not just based on personal anxiety or opinion.

And specific, named things to change in your own practice, referrals, teaching, and spending.

The exhibition · seventeen chapters

Seventeen chapters in five acts, about an hour and 45 minutes from start to end. Each is arranged to build on from the other and they link to each other.

Act I

One thread

One profession, six eras. Black midwives carried reproductive care in this country for three centuries and were then removed from it.

1 chapter · 7 min

  1. 01The history of Black midwifery

Act II

How the ground was built

Back to the beginning. The law that turned reproduction into property, and the four centuries of wealth, statute, and enforcement built on top of it.

5 chapters · 35 min

  1. 02The commodification of Black birth
  2. 03How long slavery and discrimination lasted
  3. 04The literal cost of racism
  4. 05The racist laws in every state
  5. 06How criminalization works

Act III

How to see it now

These three chapters are about learning to recognize the changing architecture of race in the United States over time.

3 chapters · 18 min

  1. 07How the racial hierarchy evolved
  2. 08The racism below the waterline
  3. 09Why being white doesn't guarantee success

Act IV

Into medical care spaces

Where all of it arrives. What the specialty was built on, what the harm is called, and how accumulated weight becomes a chart.

4 chapters · 27 min

  1. 10How inequality reaches the pregnant body
  2. 11The founding of American gynecology
  3. 12What it means to name obstetric racism
  4. 13Personal, institutional, or systemic?

Act V

Where you fit

The part that moves us forward. Examine your own engagement, find your actual leverage, and decide what changes.

4 chapters · 24 min

  1. 14Fragility or allyship?
  2. 15Where do you fit in changing this?
  3. 16What's owed, and what you can give now
  4. 17The midwives and changemakers carrying this forward

Continue

Watch, listen, read

The exhibition is an entry point, not the whole record. These are the works it stands on — and the ones that will take you further than a website can.

Watch 4 films▾

The 1619 Project

Hulu docuseries · from the NYT Magazine project

Origins of American institutions, including the medical ones.

The Black Church

PBS · Henry Louis Gates Jr.

Where community care, mutual aid, and survival were organized.

Aftershock

2022 · Eiselt & Lewis Lee

Two families, preventable deaths, and the case for midwife-led care.

Death by Delivery

2017 · Dir. Nelufar Hedayat · Fusion TV

Why Black women in the American South die in childbirth at rates closer to the developing world than to the country they live in.

Listen 3 podcasts▾

NATAL

Martina Abrahams Ilunga & Gabrielle Horton · 2020 · natalstories.com

Black parents telling their own birth stories, with the birth workers, clinicians, and advocates around them. Start with the episode tracing the historical roots of modern obstetrics with Dr. Joia Crear-Perry and Dr. Mimi Niles. Transcripts available.

Birthright

Kimberly Seals Allers · birthrightpodcast.com

Positive Black birth stories, reported out with research and historical context. Seals Allers also founded Irth, the review app where Black parents rate OB-GYNs and birthing hospitals — the same instinct as this exhibition, pointed at next week’s appointment.

Birth Stories in Color

Laurel Gourrier & Danielle Jackson · since 2017 · birthstoriesincolor.com

Two Black doulas, close to 200 episodes of people telling their own birth stories — Black, Indigenous, Asian, Latino and Multiracial. The nearest thing there is to hearing Chapter 12 from the people it happened to.

Read 16 books▾

The 1619 Project: A New Origin Story

Nikole Hannah-Jones, ed.

See Linda Villarosa's essay on medical myths about Black bodies.

Stony the Road

Henry Louis Gates Jr.

Reconstruction, white supremacy, and the rise of Jim Crow.

My Grandmother's Hands · The Quaking of America

Resmaa Menakem

Racialized trauma held in the body, and embodied practices for safety.

Reproductive Injustice: Racism, Pregnancy, and Premature Birth

Dána-Ain Davis

Obstetric racism, named and documented.

SACKRED Birth: Mobilizing A New Quality Paradigm in Obstetric Care

Karen Antoinette Scott, MD, MPH, FACOG

Scott built the first patient-reported measure of obstetric racism, the PREM-OB Scale. This is the book that turns the concept in Chapter 12 into something a hospital can actually be held to.

Killing the Black Body: Race, Reproduction, and the Meaning of Liberty

Dorothy Roberts · Vintage, 1997

The book underneath Chapter 02. How reproduction became property, and what the law built on top of that.

Medical Apartheid: The Dark History of Medical Experimentation on Black Americans

Harriet A. Washington · Doubleday, 2006

The full record of medical experimentation on Black Americans, of which Chapter 11 is one episode.

Motherwit: An Alabama Midwife’s Story

Onnie Lee Logan · Dutton, 1989

A grand midwife in her own words. The shortest route into Chapter 01 that exists.

From Here to Equality

William A. Darity Jr. & A. Kirsten Mullen · UNC Press, 2020

Where the $10–14 trillion figure in Chapter 16 comes from, and the argument for who owes it.

Caste: The Origins of Our Discontents

Isabel Wilkerson · Random House, 2020

The framework Chapter 07 is built on.

Legacy: A Black Physician Reckons with Racism in Medicine

Uché Blackstock, MD · Viking, 2024

A physician’s account of leaving academic medicine, and of the mother who practised before her. The inside view of what Chapter 12 describes from the patient’s side.

Reproductive Justice: An Introduction

Loretta J. Ross & Rickie Solinger · University of California Press, 2017

The framework itself, from one of the women who named it. Start here if the term is new to you.

Birthing Liberation: How Reproductive Justice Can Set Us Free

Sabia Wade · Lawrence Hill Books, 2023

A doula’s case for reproductive justice as daily practice rather than theory. Reads as a companion to Act V.

Mothering the Mother: African American Postpartum Traditions, Recipes, and Healing

Shafia Monroe

Postpartum care as it was practised and handed down. Monroe founded the International Center for Traditional Childbearing and appears in Chapter 17.

The Women Who Caught the Babies: A Story of African American Midwives

Eloise Greenfield, illustrated by Daniel Minter · Alazar Press, 2019

Poems and portraits tracing Black midwifery from slavery to now. Greenfield and Minter were both caught by midwives; the closing poem names hers. The one book here you can read with a child.

Deep South: A Social Anthropological Study of Caste and Class

Allison Davis, Burleigh Gardner & Mary R. Gardner · University of Chicago Press, 1941

Two Black and two white researchers living inside a segregated Mississippi town, documenting caste from both sides at once. Groundwork Wilkerson builds on, done eighty years earlier.

Explore 2 archives▾

The Penn & Slavery Project

University of Pennsylvania · pennandslaveryproject.archives.upenn.edu

Undergraduate researchers documenting their own university’s ties to slavery — including the medical school’s role in producing racist science and its non-consented use of Black bodies for dissection. A model for what institutional self-examination looks like when it is done seriously.

Birthing Reproductive Justice: 150 Years of Images and Ideas

University of Michigan Library · apps.lib.umich.edu/online-exhibits

Archival images and primary documents on who attended births, where birth happened, and whose authority counted. The “Whose Birthing Practices?” section covers Grand Midwives versus the AMA directly — the campaign to legislate midwifery out of existence that Chapter 01 traces.

Before you go

You need to understand to make a difference. But understanding is just the beginning.

Everyone can’t do everything — but everyone can locate themselves somewhere and act there.

Go further

The workshop & workbook

This exhibition is self-guided. The workshop is the facilitated version — the full historical arc, case studies of modern systemic and institutional harm, and reflection prompts that turn all of it into practice.

  • The full live or recorded workshop
  • The complete course workbook (PDF)
  • Case studies, reflection questions, and brainstorming worksheets
  • Recommended reading, films, and continued learning

Birthing in the Fire™

Workshop & course workbook. For birth workers, educators, and reproductive health professionals.

Get access →

Why this exists

Reproductive education should be accurate, inclusive, and honest about context. That means naming history, honoring lived experience, and building practical tools that support dignified care in real time.

Care does not happen outside of context. It happens inside of it. If the ripples of inequity shape outcomes, then engaging that inequity is part of providing responsible care — not an add-on to it.

— Cheyenne Varner, The Educated Birth®

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About the author

Cheyenne Varner is a childbirth educator, birth and postpartum professional, and the founder of The Educated Birth®, a platform dedicated to making clear, accessible perinatal health education.

Her work explores the intersection of reproductive health, history, structural racism, and systems change, translating complex research into practical education for birth workers, healthcare professionals, and families. Since 2020, she has facilitated trainings on racism and reproductive health that help participants better understand not only what disparities exist, but why they persist — and what it takes to meaningfully address them.

Cheyenne collaborated with Dr. Dána-Ain Davis to create visual educational tools illustrating the dimensions of obstetric racism, and illustrated Dr. Karen A. Scott’s SACKRED framework, a portion of which was featured in the CDC Museum’s Health is a Human Right: Achieving Health Equity exhibition. She was selected as a 2023–2025 grantee of SisterSong, The National Women of Color Reproductive Justice Collective. In 2025, she was named a Richmond History Maker for her contributions to promoting healthy communities. Her work has also been recognized by the National Perinatal Task Force, which designated The Educated Birth® an Official Perinatal Safe Spot, and through collaborations with organizations including the National Black Midwives Alliance, the Southern Birth Justice Network, and others.

Through her teaching, writing, and visual education tools, Cheyenne is committed to helping birth workers and healthcare professionals better understand the historical and structural forces that shape reproductive health — and the role each of us can play in creating more equitable systems of care.