Birthing While Black

Rodney and Temecia Jackson, residents of DeSoto, a suburb of Dallas, seem ideally suited for parenthood: They have a stable seven-year marriage, own their own home, and have raised two pre-adolescent boys.

Nonetheless, on March 28, Texas Department of Family and Protective Services (DFPS) and Dallas County Constables took custody of their newborn daughter, Mila Jackson, based on a complaint from their pediatrician, Dr. Anand Bhatt, who opposed the couple’s decision to treat the infant’s jaundice at home under the supervision of a licensed midwife.

National news coverage and public protests over what the Jacksons deemed a “kidnaping” led to Mila’s return on April 20. Despite the reunification, I could not help but question whether implicit bias and racism influenced the actions of the family pediatrician, DFPS, and law enforcement.

Most media coverage recounted the facts of the story; however, a news conference video captured the anguish of a soft-spoken, teary-eyed father and the heartbreak of a distressed mother over the removal of their daughter.

During a press conference on April 6, Cheryl Edinbyrd, a certified, licensed midwife, who assisted at the home birth of Mila on March 21, 2023, explained that three days later, the Jacksons took their daughter for a newborn check-up. Temecia Jackson alleged that during the exam Dr. Bhatt assured them that “Everything is good, she looks good,” but said that Mila had jaundice, a common, treatable condition in newborns. (According to the Centers for Disease Control and Prevention (CDC), “About 60% of all babies have jaundice.”)

After that visit, Dr. Bhatt called the Jacksons to urge them to admit Mila to Children’s Medical Center of Dallas due to her high bilirubin level; over the next several hours, they received numerous calls and texts from Dr. Bhatt, who cautioned them not to ignore his medical advice. He threatened to call the police for a welfare check and to report them to the DFPS If they did not comply. The Jacksons informed him that they preferred to treat Mila at home, with the assistance of their midwife.

CBS News reports, “(Edinbyrd) saw the bilirubin levels as "high" but not critical. She said that the Jacksons had already ordered a blanket and goggles to provide light therapy, one of the options to treat jaundice, and were also planning to provide enhanced nutrition, another treatment option.”

At 4:00 a.m. on March 25, DFPS investigator, Brenda Martinez, and police arrived at the Jacksons’ home to take custody of the child; however, the parents refused to let them enter.

An hour later, DFPS returned with officers, a fire truck, and an ambulance to take the infant. Once again, the Jacksons denied them entry.

On March 30, officials arrived with a warrant to take custody of Mila. Rodney Jackson was not at home. When he returned, police arrested and detained him and charged him with possession of drug paraphernalia and preventing the execution of a civil process. After taking his keys, they entered the home.

Temecia Jackson explained to Martinez that the warrant had another woman’s name on it and it identified Rodney Jackson as the “alleged” father. Nonetheless, officials took custody of Mila.

“We have come to learn,” says Temecia Jackson, “that the mother that’s listed has previous cases with CPS where her children taken from her, so I feel as if my child was removed because they have this other mother’s name on the affidavit.”

DFPS placed Mila in foster care. During one supervised visit, the Jacksons noticed that she has a bad rash and “a buildup of white crust inside her vagina.” DFPS said that they would have the foster parents take Mila to the doctor. The Jacksons voiced their objection: “(This) is the same foster family where this buildup and irritation occurred and yet you’re returning her back to the same foster parent, and we feel helpless.”

In a 2022 article for Mother Jones, Dorothy Roberts, a professor of law and sociology at the University of Pennsylvania and author of Shattered Bonds: The Color of Child Welfare, notes, “More than half—53 percent—of Black children in America … will undergo a CPS investigation at some point in their childhoods, compared with less than a third of white children. By the time they reach age 18, one in nine US children will have a state-confirmed maltreatment report; the figure for Black children—one in five—is the highest for any racial group … The chances of affluent white parents getting on the CPS radar are relatively minuscule …”

Edinbyrd concurs, “It’s not just happening to (the Jacksons); unfortunately, they are the sacrificial lambs.”

Although Mila is back with her family, I believe that the circumstances surrounding this removal warrant consideration. For example, despite their reported mistrust of “modern medicine,” the Jacksons had entrusted their children’s care to Dr. Bhatt’s for 12 years. He, on the other hand, did not trust or honor the Jacksons’ decision to make informed, responsible decisions about their daughter’s care under the guidance of a professional, state-licensed midwife.

A reasonable alternative might have been to work with the Jacksons and the midwife to monitor Mila’s at-home treatments.

Key to understanding why Temecia Jackson opted to give birth in the comfort of her home, with the support of a midwife and her husband, is the fact that she had had two births by cesarean section in the clinical setting of a hospital.

In an article on Black maternal mortality for The Philadelphia Inquirer, Layla A. Jones writes, “Modern American doctors are significantly more likely to give cesarean sections to Black birthing people than to white ones, studies show. With an estimated 15% to 64% increased likelihood for surgical delivery, Black parents face elevated risk for surgery-related complications like infection, blood clots, and hemorrhage.”

Temecia Jackson’s choice to treat Mila’s jaundice at home was rooted in her belief that early bonding with her baby was crucial, and that breast milk would provide vital nutrients, along with other treatments, to cure Mila’s jaundice. She also had confidence in Edinbyrd’s training and extensive experience. Likewise, as Mila’s parent, she believed that she had the right to make decisions about her daughter’s health and well-being.

According to WebMD’s Grow, a guide for families, “human rights in childbirth include the right to autonomy. “You have the right to make informed medical decisions for your baby, including refusing recommended care (emphasis added). However, healthcare providers must inform child protective services (CPS) if they believe that your refusal qualifies as abuse or neglect.”

Dr. Bhatt obviously felt that the Jacksons’ decision to care for Mila at home—even with a licensed midwife--constituted abuse or neglect.

Last August, the Journal of the American Medical Association (JAMA) published “Mandated implicit Bias Health Training for Health Professionals: A Step Toward Equity in Health Care” stating that disparities in health care could be due to clinical bias, or prejudice, against Blacks and other marginalized groups, which affect doctors’ clinical interactions and clinical decision making.

One recommendation from a study on racial disparities in health care, published by Women and Birth journal, is to increase the number of midwives of color to tackle racial inequalities in health.

Without accusations of severe physical abuse or neglect against the Jacksons, DFPS’s actions seem premature. The agency did not even conduct a brief investigation to determine the child’s home environment or the parents’ history before removing the child.

In support of the Jacksons, Edinbyrd said: “They were guilty until proven innocent. Well, (if) these people aren’t guilty, there’s an injustice being done.”

Of course, authorities should take reports of child abuse seriously; however, nationwide there have been cases when teachers or day care providers have reported, often repeatedly, visible signs of severe physical abuse or neglect of a child, but these complaints do not always lead to a swift removal of the child from the home. In some tragic instances, that child later succumbs to injuries or neglect. The Jackson’s situation did not indicate acts of neglect or abuse.

Why did Dr. Bhatt overlook the Jacksons’ history of responsible parenting? Would he have done the same if they were white, middle-class parents?

In summarizing issues related to removal Edinbyrd says “The attack on Black families has to stop. The attack on Black midwifery, the attack on Black bodies, and the emasculation of our men has to stop.

Wista JohnsonMay 12, 2023