Series 3 Episode 2: Lucinda Canty on racism in institutions and birthing care

Transcript

INTRO — Welcome back to season three of Birthing and Justice. I’m Ruth DeSouza. This week my guest is Doctor Lucinda Canty. Lucinda is a nurse midwife and Assistant Professor at the University of Saint Joseph. She did her PhD in nursing at the university of Connecticut in 2020, and her research focused on the experience of severe maternal morbidity among Black women. She’s super qualified. She got her undergraduate degree from Columbia University School of Nursing, and her nurse midwifery education from Yale. Lucinda joins us to talk about Black perinatal health in the US, and specifically perinatal mortality and severe morbidity. We’ll also discuss care disparities and racism, and reproductive health and nursing. Just a warning that we’ll be hearing about very detailed examples of medical trauma and negligence in this episode, which could be confronting or distressing for some listeners.

 

RUTH DE SOUZA (host) – Hi Lucinda. It’s so great to be talking to you after meeting on Twitter and reading your wonderful work. So I’m gonna jump straight in and ask you: Lucinda, why do you care about birthing?

 

LUCINDA CANTY (guest) — Birthing! I just think, first of all, I think births are beautiful. I remember the first time I saw a birth, I was a nursing student. Didn’t know anything about midwifery and a woman delivered her baby in the hallway of the unit. And I just loved how her response when she saw the baby, how everyone responded, making sure she was okay. So that was kind of like my start. And I just feel like it’s just a memory that people have that never goes away. I could run into someone fifty years ago that had, you know, that gave birth and it’s like, it just happened yesterday. So I love that and I love how people light up, but I also feel that women are at their most vulnerable. I know they’re strong and powerful at that time, but they’re also very vulnerable. And I always wanted to be a part of that, and not be someone that causes trauma, but to be someone that offers support and helps them to have a safe passage.

 

Oh, beautiful Lucinda. I was thinking when you were talking of my own first experience—and, this was as a nursing student as well—it was kinda like, ‘Wow, this is a miracle. This is so amazing.’

 

Yes.

 

Can you tell us where you are and what you do?

 

So I’m in Connecticut, United States and I live in Windsor, it’s small town. But I’m a Assistant Professor of Nursing, I teach at the university of Saint Joseph. But I also still provide midwifery care, primarily reproductive health. I’m not doing deliveries at this time. So I still love that aspect of helping women, you know, helping people with their reproductive questions and care and just making sure that they’re supported in being able to take care of themselves.

 

You went to Columbia University, Yale University, and you got your PhD in nursing from the University of Connecticut. What was it like for you to be a first-generation college graduate? And what advice would you give someone wanting to pursue a career that’s similar to yours?

 

I would say that I loved my experience, from undergrad to graduate. I learned a lot about who I am and what I can do, because sometimes you’re in spaces where people make you feel like you can’t do it. So, and that was a motivator for me. So when I hear someone who is first generation and they’re going to college for the first time, I feel like a lot of times we’re not prepared—we know we have to go in, we have to study—but we’re not prepared for those other pieces of it. That if you have questions about like, financial aid, or you have a professor that may not be treating you the right way, that you have a voice in addressing that. So I wish that I had someone who mentored me throughout. I would say, each level of my education, there was someone that was there that helped me, but then I always look back now and I think of different pieces, like: how come I didn’t get more money for financial aid, so I didn’t have to work? You know, how come this person treated me a certain way in clinical? It’s like, I think back, and I wish at that time I had someone I could talk to about it. So I recommend to anyone—anyone period—who’s going to college, especially a person of colour. But I feel like if you’re first generation, you need to have mentoring; you have to find someone. Even if you just join a nursing organisation for support. It’s so important, ‘cause I think, like I feel like I had a good education, but I feel like it could have been richer. I feel like I could have explored a little bit more as a student. So I always tell people, you know, live the best that you can and know you don’t have to be alone in the process.

 

And I’m thinking, you know, you’ve been a nurse for a really long time—twenty-nine years. And, you know, in that time you’ve also been a nurse midwife and you’ve been a nurse educator for ten years. You’ve said in your own work, that nursing is where you began to understand the magnitude of racism.  

 

Yes.

 

Can you tell us more about that?

 

Yes. When I graduated, I was about—and please don’t do the math too quick—but I was about, I think I just turned twenty-one and I was… so I realised how naive I was, that I believe that nurses couldn’t be racist. You could be racist in your home, but once you came into the hospital it’s like, you’re supposed to turn that off. And I… that’s how I really felt. And I also felt that as, you know, as a Black woman, that I understood racism. But it was nursing that really opened my eyes up to what racism is. And that’s all levels of racism: racism in seeing how my patients were treated, racism and seeing how I was treated and how I was supported, how I worked hard and someone who worked half as hard as I did, was encouraged to go to school or to do more. And I started to see it. And I have to say at first I still didn’t really understand—I knew things were different, but it’s like you see the harm in it and you… I think a part of you doesn’t wanna believe it. And I think a lot of the structural racism comes in and makes you, kind of like, you’re unsure and you don’t have anyone to talk to about it. And one of the largest lessons that I learnt—and I share this all the time—is when I decided to go back to school to become a midwife. I told my—and I was exemplary employee, I could do no wrong; I came in when they wanted me to come in, I worked hard while I was there—and when I asked my manager for a letter of recommendation, she said that she would write it. But I went from exemplary to needing improvement. I couldn’t do anything right; it was always a problem. It doesn’t matter what I did, it was always somebody—you know, especially her, she kind of initiated it—and then other co-workers kind of like, got on the bandwagon and started trying… just making life difficult for me. And I couldn’t understand. I thought it was me and… when I don’t know what I was doing wrong. And it was actually a white nurse who said… who pulled me aside and said, ‘Lucinda, can you tell’ (you know, I’ll say the manager’s name is Kim) ‘could you tell Kim that you’re not going to school right now, that you’re going to wait?’ And I just still didn’t understand. So I said, ‘Okay.’ And she’s like, ‘Just tell her you’re gonna wait and I’ll write your letter for you.’ I never talked to this woman about needing a letter of recommendation. Went back to my manager and said, you know, ‘I’m gonna wait.’ And she was like, ‘Oh, wow, that’s wonderful. I waited ten years before I went back to school.’ And just like that, I was never a problem employee again, then everything was fine. And you know, the person wrote the letter from me, I got accepted to Yale, so I ended up moving on. But I really opened up my eyes that, not only am I seeing things happen within my patient because of race, I was impacted by that. But I still felt powerless in that process. But as I moved through my education, especially when I became a nurse educator, I really started to see and understand how the structures work. And I have to say, when I was also getting my PhD—because I studied Black women who had severe complications, and was really looking at Black maternal health—it helped me to understand racism even more. But it is really those structures that you can’t see, that are so embedded, but it’s like, once your eyes are open, your eyes are open. And for me, that started my journey of being able to talk about it, because I hear students talking about things I went through thirty years ago. And I’m like, this is not gonna end if we, you know, continue to let people get away with this. But nursing, I say this all the time, nursing gave me a PhD in racism, ‘cause it helped me to understand what racism was.

 

And I’m thinking about the ways in which nurses are being kind of both idolised and deprecated at the moment, you know, with the COVID pandemic all over the world, you know, nurses are heroes. And I think your project, your Overdue Reckoning project, is really, really timely, because while there’s so much public attention on nursing in a way that we never expected, it’s a really transformative time. And I’m wondering if you could tell us a little bit about this project, because it sounds very powerful.

 

Oh yes. Yeah. So we started, this was last… this was 2020, and this was after George Floyd and I was just hot off doing my… finishing my… actually defending my dissertation in which I have to say: in my own experience, I had to fight to get outta school, because I kept facing barriers. And I’m like, I had to really realise, ‘No, I’m ready, and I know my research.’ I understand what I did and I had to fight. I actually… I just wanna share that I defended my dissertation February—I’ll never forget—February 24th, 2020. And I was actually encouraged to wait ‘till after spring break. And if I waited till after spring break, COVID hit. So I’d probably still be in school right now. But I had to learn to stand and fight for myself. And I was able to get everyone together and defend. So I was still kind of like, dealing with the… I would say the trauma from that. That on every level of nursing, I had to deal with racism. So that, and George Floyd, Breonna Taylor, these were all things that happened for me. And I was driving and, you know, and this story—I apologise if I get emotional—but I was driving with my son and I was speeding. I should have slowed down. And when the police pulled me over, my son was like, ‘Mommy, I’m scared.’ And that like broke my heart. But I felt like as nurses, you know, as a nurse, I have to do something. And then I was approached by Doctor Peggy Chinn and Christina Nerity—they wanted to do something to address racism in nursing. And I didn’t even know what we were gonna do, but I was like, ‘I’m doing it. I’m in, I wanna do it.’ And we were gonna do like a storytelling type of session where one person told their story, and then it changed throughout the process. And I said, ‘How about nurses, all nurses of colour, just talk about their experiences?’ And I said, ‘I’ll start.’ And what’s unique about our project is white nurses couldn’t talk. They could talk and they could say something in the chat, they could ask a question in the chat, but it was our space. Because there’s so many times when we experience something, and then we tell someone what happened to us and they’re like, ‘Oh, I don’t see that. I don’t think that person’s racist. They’re a good person.’ Or I heard someone once said, ‘Oh, but that person’ (a white person said) ‘Oh, I’ve never seen that happen to… you know, that person never did that to me.’ And I’m like, ‘Because you’re white!’ But still at the same time, it hurts, because for us, it’s really… it’s like trauma. And for us to share with anyone, we just want you to listen. We don’t want you to say ‘Yes’ or ‘No.’ I’m not looking for validation, because I’m going by how it makes me feel. So we want to make sure—and this was something that I said very early on—I don’t wanna do a project that’s gonna further cause trauma, and—unless of course there’s healing with it, ‘cause there’s no way to talk about racism without that pain. But I was like, ‘We have to be able to heal in this process, and I don’t want anyone exploited.’ So I said that I would start with my experience, and we did this over five weeks—five Saturdays. We didn’t know who was gonna come. My Black friends were like, ‘I don’t think anybody white’s gonna come.’ Or the next sentence they will say, ‘I don’t think anybody Black is gonna come.’ [Restrained laughter] So I’m like, ‘Well we’re gonna do it. Whoever shows up, shows up.’ And we had about a hundred and ten, to a hundred and twenty people come. We had three hundred people register and then we had about a hundred… I would say no more than a hundred and twenty, maybe close to a hundred and thirty come to it. And we had nurses, nursing students, new graduates. And we had nurses, Ms. Rinky Manning, who was in nursing for sixty years. So we had a wide range, a wide range. And she was, she was so supportive. The nurses who had that experience, they were so supportive that we were doing this. They were so grateful that we were doing this, and that they could talk openly about their own experiences. But the very first meeting, I knew. And I wanna say, that first meeting was predominantly white, maybe like about sixty percent white and forty percent nurses of colour. So we had a nice, you know, I think it was a nice representation of both sides, and everyone was pretty consistent throughout. We had new people that joined who, you know, later, but it was pretty consistent, like a core of people who came to every single session. And the first session I said that, you know, I’m gonna share my own experience. And for me it was very painful to think about it, ‘cause I realised how much I kind of just suppressed, that because I didn’t want it to take over. Even thinking about times like the experience with my manager, or if I was delivering a baby and the nurse was acting a certain way towards me—even the patient saw it and she was like, ‘What’s wrong with her?’ And I’m like, ‘I can’t focus on her, I need to focus on you. We have to get this baby out, I know you wanna see your baby.’ So I would push that down so I could deal and move on. And even to get to day-to-day, I couldn’t let that wear me down. But to go into it and look at it: it was painful, ‘cause I realised how much I was harmed. And I said, ‘You know, but I have to be vulnerable. I have to share ‘cause I want other people to know they’re not alone.’ And I really did it for those new graduates and students. I want them to know they’re not alone. And that first session, it was like, quiet, it was like crickets, nothing in the chat, you know, beginning with a few people introducing themselves. And then when I shared that story about my nurse manager, the chat blew up and people just wanted to share and they just talked about what they went through. And at the end of that first session, a lot of nurses of colour contacted me and said, ‘I thought I was alone; I thought I was the only one.’ And for me, even though it was painful to look at, it was like my start, or the beginning of me healing. ‘Cause I realised that sometimes you have to feel the pain so that you can develop and grow from it. And that was like my journey. I’m still on that journey. ‘Cause sometimes I remember things that happened. You know, I’m proud that I made it through, but I always say, ‘Did I have to go through that at the time?’ And that’s the hard… that’s the difficult part.

 

I think, you know, this work is powerful also because it’s a collective process, right? And so many people feel like they’re on their own, they’re isolated, they’re dealing with it by themselves. But like you’ve said earlier, we’re talking about these systems and structures that support racism. And I’m thinking about your PhD and whether you could tell us a bit about that. You’ve said racism—not race—places Black women at risk for poor maternal health outcomes. And for those who aren’t familiar with the statistics, Black women are three to four times more likely to die from a pregnancy-related complication, and twice as likely to experience severe maternal morbidity when compared to white women in the US. And this is an area that you looked at in your PhD, where you talked to nine Black women who had experienced life threatening complications during childbirth or postpartum. Can you tell us a bit about what you found?

 

Yes, yes. And, what even brought me to looking at that is when I came in and started my program, I wanted to understand disparities. And when I started to look into Black maternal health—and I had to be honest, I knew that we had an issue in the United States, but I didn’t know the disparities were that wide, the gap was that wide. And so I… when I started asking why, I was hearing things like: ‘Oh, you know, she’s poor; she doesn’t get prenatal care; she has a lot of diseases.’ Someone even had a nerve to say, ‘Oh, because her partner’s not involved.’ And it didn’t make sense. But when I looked at the literature, I couldn’t find anything, you know, that would support that. Like if an article, a research article did say, ‘Oh, they start prenatal care later,’ I would look at the numbers and it would say, you know, maybe fifteen percent. So I’m like, so eighty-five percent is starting prenatal care in the first or second trimester. So I’ve realised that people take statistics or research and turn it the way they want, but they weren’t looking at real people. They were getting their statistics from death certificates, birth certificates, how the insurance company’s billed, and nobody was talking to the women. So I said, that’s what I wanna do, I wanna talk to the women, because this isn’t making sense to what they’re saying. And they’re blaming the woman for her circumstance. And I wanted to know, where is nursing in this? And I found that nursing wasn’t even doing the research. Very few researchers were looking at this. You know, one that even comes to mind is Monica McLemore. And I have been looking at her research and that gave… that made me even realise that it’s not my imagination, this is real. But it was very few nursing research articles. So I was like, I wanna talk to women who almost died, ‘cause they can give us insight into what happened. And the women that I interviewed, they all started prenatal care less than ten weeks or less, only three of them had conditions like hypertension. One had an issue with thyroid disease, but they were all controlled. They were controlled when they started their pregnancy. They had insurance, they were all educated from high school to PhD. So that already contradicted what I was reading in the literature. And then when I talked to them, and a lot of their stories were heartbreaking, just heartbreaking, how some of them were treated. So what I learnt though, was that education is important. A lot of… most of the women were not educated about their complication. If they had education, it wasn’t really… like for example, pre-eclampsia—and quite a few women in my study had pre-eclampsia. They thought it was just swelling of your feet. You know, those who knew about it. One woman who had eclampsia, she was like, ‘I just thought my aunt had it, her ankles were swollen, I thought that was it.’ So she didn’t know. And she had symptoms, so she didn’t know the symptoms. So she was driving around in her car. It was her friend that told her: ‘Something is wrong; you have to go in and be seen.’ And when she called, she didn’t realise even how… still how serious it was. So she told her friend to drive her to the hospital and she had seizures on the way. But she was just, she was just totally, she was like, ‘I had that headache for three days and, you know, I didn’t know it was a complication.’ So education was a big piece. So women had postpartum pre-eclampsia. One woman had postpartum cardiomyopathy. And she was like, ‘I didn’t know anything about heart disease. And I was having the symptoms of it. She was like, ‘I had… since I had my baby’ (and she was diagnosed about eleven months) she was like, ‘I was having the symptoms the whole time and I thought it was just part of normal postpartum recovery.’ So it was like, them not knowing placed them at further harm.

 

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The other part was how their provider treated them. If their healthcare providers—from the nurse, to the midwife, or even the OB [obstetrician]—if they treated them like they were partners with respect, they felt well cared for, even having a severe complication. But the other side of that was, women who felt like their providers ignored their symptoms, made them feel like they were exaggerating—women described it as feeling like a part of someone’s routine: you come in, you do the blood pressure, then you leave; you come in, you check the hematocrit hemoglobin, you tell the patient whether it’s up or down, or you do a pain scale. So they felt very much like they didn’t have that connection, or there was no compassion. One woman described to me how she needed an emergency caesarean and they started to cut her and she was like, ‘I feel that.’ And they were like, ‘Oh we gotta get the baby out.’ And they kept cutting! So she screamed the whole time through. It’s almost like we’re not human. Another young lady had a postpartum haemorrhage. She said ‘Blood was coming out of me. It sounded like someone was pouring a gallon of milk into the toilet.’

 

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She passed out. When she woke up, she said her nurse was like, ‘Oh you made it; you were haemorrhaging.’ And she was like, ‘I didn’t even know what haemorrhaging meant.’ And then she asked, she said, ‘Do you know, did anyone call my mother?’ The nurse said, ‘No, you could call your mother when you’re ready.’ She was twenty-two years old. You know, we’re human, we’re human beings. You know, wouldn’t you think that someone’s mother should be there? I understand things happen very quickly, but call her mother when she’s stable, she should not have woken up without her mother present. So it’s those pieces where they felt like they were not human. So that was another major thing, was just how the providers treated them. Providers were either a source of support, or a source of stress and trauma. And it’s unfortunate that you go through a complication and you feel like you’re not treated with the care that you should receive.

 

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Other things that I found was just that the women were traumatised by their experience, being in childbirth and realising that I may not make it. You know, one woman said she just had her baby and she was like, ‘Who’s gonna take care of my baby.’ The woman with cardiomyopathy said that she was told, ‘We’re trying to prolong your life.’ She was like ‘Prolong my life! Who says that to someone who just had a baby?’ So it was that moment that they realised that they may not make it. You know, they survived, but I just can’t imagine that you’re giving birth, or you just gave birth, or you’re about to give birth, and then you don’t think that you may survive it. You know, you just think about the trauma that people would go through when they experience that. But then, to not have the mental health support. Women said they weren’t even assessed for their mental health wellbeing. Or even when they left the hospital to say, ‘If you need help, this is where you go.’ You know, one woman was twenty-one years old, had her first child and the C-section went fine. She heard her son crying, but she noticed after it was taking a long time. So she was like, ‘It’s taking a long time.’ And she said, first the nurse came up to her and said, ‘Oh sweetie, just relax. Just relax. We’re just stitching you up.’ And then she said, not even five minutes later, she came by and said, you know, ‘We’re gonna have to put you to sleep, you need a hysterectomy.’ And she said, all she remembers was them putting the gas over her face, and she just kept thinking about her family.

 

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You know, she was like, ‘Who’s gonna take care of my baby.’ But she said postpartum, nobody wanted to talk about it. Everyone was like, ‘Oh we heard you had a bad day.’ She said that she—and she again— she felt like she was part of someone’s routine. So she was like, ‘I just want to go home. I want to be surrounded by people who loved me.’ But when she… she said, ‘When I left, no one said, you know: ‘You went through a lot, here’s a number that you could call, here’s where you could follow up.’’ Or even, ‘What does this mean, for someone who’s twenty-one that had a hysterectomy.’ None of that. So that was something that was, you know, kind of shocking to know, is that their mental health was not assessed, and there was no support in that. Just kind of like, ‘Okay, that happened. Now I’m gonna send you home, I’m gonna send you on your way.’ One woman said, ‘It felt like they were done with me and I was done with them.’ You know, which is not the way you wanna remember your childbirth.

 

No.

 

Yeah.

 

It’s heartbreaking hearing these stories, and it’s a devastating indictment of our profession that is supposed to care, you know? And as I’ve been listening to you listen, I’ve been thinking about working in maternal mental health, and so many women who said, ‘I was abandoned, you know, I was abandoned.’ And what we know about birth trauma—because I set up a service to look at that—is, you know, it’s not the event, it’s how you are supported around the event, as you’ve said, you know. Who was there? Were they loving? Did they, you know, ask for consent?

 

 Yes.

 

You know, did you get informed… did you give your informed consent? And, you know, Cheryl Beck who was one of your PhD supervisors and who I know well from a long time ago, you know, her work’s been very instructive around post-traumatic stress and birthing.

 

Mm-hmm!

 

And I just kind of think, how awful that the participants in your study experience such callous disregard, you know?

 

Yes, yes.

 

From people that were supposed to care. And I think what’s even more alarming is, these aren’t isolated incidents, you know? Monica’s research, Monica McLemore has shown us that this is prevalent right across the board.

 

Yes.

 

I’m wondering what kind of recommendations you made from this work that you did?

 

Oh, yes. Yes. And as you mentioned also earlier, is that, you know, it’s not just being Black that puts you at risk; just because you’re Black doesn’t mean you’re gonna die or come close to dying. It all relates to the care, to your experience. And that’s one of the main points that I took out of it, is that experience of care, you know? ‘Cause that’s how we understand what these women go through, when they experience… you know, even if they… you know, these women have severe complications, but we hear stories from women who did not. You know, who had normal pregnancy, normal childbirth, but they received—because of their care—some type of trauma from their healthcare providers. So it’s so important for healthcare providers to just be aware, even just the history. Because you look at, for example, implicit bias in what we say relates to pain: that came from slavery; that Black women didn’t feel pain so that we could give birth and go back and work. Or we could give birth and someone take our child. But it’s still being played out today, where someone complains of pain and they’re not believed, and they’re having a serious complication. So I just think it’s important for nurses, midwives and other healthcare providers: be aware of this history. So you understand that when you’re, you know, when you’re looking at your textbook, or you hear someone dismiss someone who has pain, you could say, ‘Wait a minute, we know that Black women feel pain, so let’s do something about it instead of ignoring it.’ But I also just say, it goes back to just treating people as humans—just treat people as human beings. And our care is supposed to involve compassion and listening and establishing a relationship. I think if we do those things, then we can create a better experience. ‘Cause women in my study, like there was one woman who actually thought she was gonna die. She had pre-eclampsia, they couldn’t get her blood pressure down, but she says, ‘You know, my nurses were on it. My doctor was on it. Even when I went home, my doctor said, ‘You know, any problem is a big problem. So if you, even if you think it’s small, I want you to call me, let me determine that.’’ And that gave her strength that she, she had pre-eclampsia, she had a postpartum haemorrhage, and then postpartum she developed pre-eclampsia again, she was stable and then she had symptoms. But because of the comfort that she had with her provider, she called right away and he was like, ‘You have to come in, we need to see you.’ So we have to develop that relationship where, if somebody needs help, they know that they can rely on us to help them, and listen to them, and care about the symptoms that they’re talking about. It’s just, it’s so important.

 

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So many providers are not aware of their own implicit bias. And that’s a part that is still, you know, one of the challenging things as I do anti-racism work, or as I’m looking into maternal health. I did a presentation on my research a few weeks ago and there was a midwife that was practicing for years. And she was like, ‘Oh, when I came, you know, I was like, when I heard your title and what you were gonna talk about, I was like: everybody, anyone can have a complication.’ But then she goes, ‘But then when you brought the race in, you helped me understand, you know, it better.’ But I’m like, ‘You have to wait for me to tell you that there’s something wrong with the way that women of colour are receiving care?’ You know, again, practicing for years. So I just say, there’s still people out there who don’t realise their own implicit bias. Our patients can see it. You know, even now I’ll just talk quickly about the COVID vaccine. I hear stories where, ‘Oh, people of colour, they’re not going because they don’t trust the system because of Tuskegee’—you know, the Tuskegee Syphilis Study. I’m like, most of the people who don’t trust the system don’t know that, they’re going by their own experiences with healthcare. They don’t even know the Tuskegee Study, but they’re going by when they saw someone, how they were treated. So they don’t trust you, when they come in. So I feel that, if people are aware, that’s the only way that they can address it. And now when I’m in spaces and people do say things, I call attention to it. I’m like, ‘Wait, we have to talk about this. You can’t say that.’ So I just say that implicit bias, addressing racism, that we have to do better in educating future nurses, but also those who are currently practicing, even those who are retired. You know, you need to know that this was a issue, and we have to do something about it. But that’s the only way things are gonna change, and that people get the care that they deserve, that they have a right to.

 

Building trust just seems so central to all of this, right? And then showing up and demonstrating that care and concern. I was thinking, if there was one thing that could improve birthing, what do you think it would be? Is it the trust? And you’ve also talked about education.

 

Yes.

 

And I kind of think, oh, can we educate people out of racism? Is that possible?

  

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Yeah, it’s embedded so deep. Like, I see people all the time that say, ‘Oh, I wanna be anti-racist.’ Or they say, ‘I wanna be a ally, I’m an ally,’ but then their actions don’t show that they’re any of that. So I think that we could do the education, but people have to do their own work, and they have to realise: it’s hard work! You can’t just say, ‘Okay, I’m not gonna be racist today.’ You know, and that’s it. Because I’ve been in meetings where people talk the talk. I have been in meetings where people cried about George Floyd and then they leave that same meeting and they cause trauma. They caused trauma to students, they caused trauma to their patients. And I’m like, ‘Weren’t you the one that was just crying in the meeting, realising what people of colour have to go through in this country?’ So I think that it’s gonna be a process that takes time. And I know people are all on their different journeys, but I think that I’m also in spaces where I rely on people—especially white people—to do right. And a lot of times I’m disappointed. So I feel like, I wanna be able to see white people change, ‘cause a lot of times they control a lot of these system issues. Most of them are part of the problem. But sometimes I feel like, what can I do to empower myself, to not wait for them to change, but to make them change? You know, I always say like, it just reminds me of like, if my son went… one time he went in the store and he put a candy in his pocket. He was in Target—I hope they don’t come for us. But he put a candy bar in his pocket and he was terrified that whole time. And then at home he finally confessed ‘cause he was scared I was gonna find out. But I wish that with racism, people had that same fear. And I did scare… I have to tell you, I scared my son. I was like, ‘Don’t do this again. I’ll call the police myself.’ And I knew I wasn’t gonna call anybody’s police, but he was terrified, he didn’t do it again. But I’m just saying, I wish that we could do the same with racism. Say, you know, you’re a busty, this was a racist action. Cut it out. If you do it again, something is gonna happen. You know, I feel… give somebody a chance, ‘cause sometimes people don’t know better, but have them… hold them accountable. And I feel like we don’t have enough to hold people accountable. A lot of times I see certain behavior in nursing academia, or on the clinical unit. I see so much, but they have the system backing them up. So I can do what I did and I could blame it on the patient. You know, I’ve seen patients have a bad outcome and they were, ‘Well, if she’d came sooner, this wouldn’t have happened.’ Or, ‘If she took that medication, this wouldn’t have happened.’ But I’m like, we know how to treat that complication. So regardless of how they come, we’re supposed to know how to provide their care. And if there’s something that we’re not doing on our part, we have to acknowledge that. And if we’re not doing something on our part because of their race, then that’s a problem on our part and our system, and we have to do something. But until people are held accountable, the behaviour’s just gonna keep coming, keep happening.

 

Mmm, mmm. On a lighter note Lucinda, I’m wondering what brings you joy, you know? And I know you’ve been writing poetry and you’re a visual artist. Can you…

 

Yes. Yes.

 

tell us a little bit how you keep going because…

  

Oh sure.

 

you know, as you say, racism is unrelenting, you know.

  

Mm-hmm.

 

It’s deeply embedded in the United States where you live. It’s in your professional practice, you know, it’s in your broader world that you live in. And then you’re trying to fight it, and you’re trying to build a community that can fight it. But I’m just wondering how you keep going?

 

Yes. And it is heavy. It’s heavy, but also, just from, like people who attend Overdue, there’s so many connections, we support each other. And that has helped a lot. When I have someone who comes to me that says, ‘You know, I spoke up, and things changed for me,’ or ‘I spoke up, and I was able to finish my program.’ Those are all things that just give me some joy, just knowing that, you know, it’s like, it’s almost liberating for me. It’s like, even though you know, it’s hard work, that makes it worth it. And I do also use my art, I use my poetry. Those are things that I kind of use to kind of help me with stress. And I love the end product, and then I love to see people’s response from that. So I like that as well. You know, and my son, my son who… sometimes he’s in the background when I’m doing things and he listens. [Laughs] Sometimes, even once I was reading a poem and he came, he was like, ‘Mommy I like that poem!’ Like, those are all things that give me joy, and that keep me moving. It’s hard work, but when I see like, little changes, that’s what makes me feel good. You know, that’s what makes me feel good.

 

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Lucinda, where can listers find more of your work, and where can they connect with you online?

 

I’m on social media, I’m on Twitter, I’m on LinkedIn, on Instagram. I also have… we have the Overdue Reckoning website that has information. I’m starting an initiative called Lucinda’s House. I’m working on getting a website up right now. I receive funding to start programs to help address maternal health. So I’m gonna start out with a virtual space and will become more of a physical space hopefully later. But I’m going to have what’s called the Kitchen Table, but we’re gonna talk about the issues, and we’re gonna come up with our own solutions. We’re gonna be addressing structural issues. I plan to have a website that will talk more about me, about the things that I’m working in. In the meantime, I’ll be having a lot posted on social media.

 

Lucinda, I’ve been so impressed with our conversation today, and the work that you’re doing, and the community you’re trying to build, and your future aspirations. It’s been such an enormous joy talking to you. And very sobering that these issues that occur in the US also have resonances—and of course differences—but resonances with other setter colonies like Australia and New Zealand, where I’ve lived. And I think your interview is a powerful call to action to whoever’s listening. And I thank you deeply for taking the time to talk with me today.

 

Yeah. Thank you for having me.

 

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OUTRO — You can find more episodes, transcripts and links at ruthdesouza.com/podcast. As usual, I’ll throw some links up so you can keep in touch with Lucinda’s work and find out about some of the things we’ve discussed. If you’ve got something out of this conversation, please subscribe to the show, leave a rating or review, and tell someone who you think might also like it. It makes a real difference to us. Next time on Birthing and Justice:

 

ARUNA BOODRAM (guest) — I don’t really have an answer for what it is exactly to be an abolitionist parent. But I think that for me, it’s about, how can we support other people to have access to the things that we also have.

 

I’ll be speaking with Aruna Boodram, a community organiser, DJ and legal worker based in Toronto who specialises in anti-oppression, decolonisation, fertility and queer and trans family planning. Birthing and Justice with Doctor Ruth De Souza is written and hosted by me, and recorded at my home on the traditional lands of the Boonwurrung people of the Eastern Kulin Nations. Our sound design and mix is by the amazing Jon Tjhia, who’s also the producer and editor. Artwork for the show comes from Atong Atem, with design by Ethan Tsang, and Raquel Solier composed our theme music. This podcast is supported by funding from the RMIT University Vice-Chancellor’s Fellowship Program. Thanks so much for listening, look forward to catching up again soon.

  

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END NOTES — Audio transcript edited and designed by Abbra Kotlarczyk, 2022. Note: t­­­­he purpose of this audio transcript is to provide a record and pathway towards accessing all Birthing and Justice conversations. Editorial decisions around the omission of certain words and non-verbal utterances have been made purely for stylistic purposes towards greater legibility, and do not infer a desired ethics of speech.