In 2018, Madison, Wisconsin – occupied Teejop, or Four Lakes in the Ho-Chunk language, where both of the authors live – became one of the newest sites of the Birthing Project USA, a network led by Black doulas and community advocates working to support Black infancy and maternity. Public health scholar and birth advocate Kathryn Hall-Trujillo founded The Birthing Project – which also claims the designation ‘the underground railroad for new life’ – in 1988 in response to high rates of Black infant mortality in her California community, and over the years it has operated in approximately a hundred sites nationwide and internationally. It entails one-on-one support for pregnant people from members of the same community, who help them navigate prenatal care, resources, postpartum wellness and the first years of motherhood. As anthropologist Dána-Ain Davis writes, ‘the project confronts the epidemiological crisis of Black infant mortality through the provision of maternal support to Black women’.

Not a one-size-fits-all model, Birthing Project sites ‘operat[e] from homes, churches … clinics, health departments and hospitals – any place where a group of ten women can commit to being conductors on The Underground Railroad for 18 months’, and centre the conditions, needs and visions particular to each site. While these grassroots efforts often do not have infrastructure or funding for formal evaluation, existing assessments demonstrate striking improvements in infant survival across multiple settings. In its Nashville site from 2003–8, participants’ infant mortality rate of zero was significantly better than that of their white counterparts locally and nationwide. As the Madison site exemplifies, the project continues to expand. Davis argues that the Birthing Project ‘follow[s] in the footsteps of health care organizers from the antebellum period through the twentieth century’, exemplifying ‘a form of resistance promulgated by Black women on behalf of Black women’. In its own self-designation as a contemporary underground railroad, the project frames racist reproductive health inequities as part of the ongoing legacy of slavery, and invokes a lineage of Black women's struggles for life and freedom.

The Madison Birthing Project Site

Given its prosperous and liberal image – often near the top of ‘best places to live’ in the United States – Madison might seem an unlikely place to begin a discussion of Black infant mortality as a manifestation of what Alys Weinbaum, extending Saidiya Hartman's pivotal formulation of the ‘afterlife of slavery’, terms ‘the afterlife of reproductive slavery’.