In Australia, an estimated 1 in 4 pregnancies end in loss before 12 weeks and 76% of perinatal deaths in 2021 were due to stillbirth. October is recognised as Pregnancy and Infant Loss Awareness month and is a time to honour the pain and grief many parents and families endure due to miscarriage, stillbirth and infant death. It is also an opportunity for people to share their experiences and break the silence and stigma around miscarriage and stillbirth in Australia, and elsewhere.
While the Commonwealth Government’s $9.5 million funding package to support awareness, education and data collection in relation to miscarriage is a welcome initiative, it is essential that programs meet the needs of migrant and refugee women and gender diverse people who have been impacted by miscarriage and early pregnancy loss. One way we can do this, is to embed the principles of reproductive justice into our work.
Reproductive justice, a framework developed by Black and women of colour feminists in America brings a ‘social justice’ lens to ‘reproductive rights.’ For intersectional feminists, the language of ‘rights’ and ‘individual choice’ fails to capture the experiences of many women and gender diverse people whose ‘choices’ are limited due to systemic and structural barriers to equitable access to healthcare, information and support. Reproductive justice means considering the interconnected social contexts that limit people’s capacity to practice reproductive autonomy and decision-making.
Reproductive justice also asks us to centre those who are made most vulnerable by systems of oppression and power. To this end, we must advocate for, and amplify the voices of women and people experiencing reproductive injustice, globally. More than 12 months into Israel’s assault on Gaza, health organisations have reported, among other alarming trends, a 300 percent surge in miscarriages among women in Gaza due to health complications and lack of available care and resources. For families in Palestine who are mourning the loss of newborns, infants and children, their grief is compounded by the hardships enduring extreme violence, ongoing poverty and a decimated healthcare infrastructure that is vital for delivering essential, lifesaving care to millions. In honouring the lives of babies and infants lost over the past year, we stand in solidarity with parents and families in Palestine who have experienced the profound loss of an unborn baby, newborn or child.
In Australia, we can’t talk about stillbirths without acknowledging the impacts of settler colonialism on birthing. While not all stillbirths can be prevented, research shows that in many cases, the death may have been avoided had high-quality, culturally responsive antenatal care been provided in the first place.
We recognise Australia’s National Stillbirth Action and Implementation Plan calls for stillbirth research and focuses on ensuring culturally safe stillbirth prevention and care for First Nations and migrant and refugee parents. Notably, the Centre of Research Excellence in Stillbirth has co-designed culturally appropriate pregnancy information resources for First Nations and migrant and refugee parents as part of the Safer Baby Bundle.
These initiatives reflect the reality that those who are disproportionately impacted by stillbirth are those who are made to be most marginalised by our healthcare systems. Aboriginal and Torres Strait Islander birthing parents face almost twice the risk of Sorry Business Babies compared to the general population, and the disparity is a stark reminder of the ongoing impacts of colonialism on First Nations women and birthing.
When we take a reproductive justice approach and recognise and champion people’s right to birth and parent their children in safe and healthy environments, free from oppression, exploitation, and state violence, it is clear that our feminist struggles are interconnected. We can’t advocate for equitable sexual and reproductive healthcare in Australia without speaking against all forms of systemic oppression beyond borders. By aligning research, advocacy and policy around miscarriage, stillbirth and infant loss to the tenets of the reproductive justice movement, we can work towards a future where reproductive healthcare is inclusive, equitable and socially transformative for all.
This article was first published in edition #138 of The WRAP on October 2024.