Surviving in the midst of 'Nowhere': Disrupting the conceptualisation of a maternity care desert.

Abstract

The conceptualisation of 'care deserts' has gained increased public attention in recent years. This paper engages a reproductive justice framework to investigate the (mis)alignment of a maternity care desert within a predominantly Black rural community in the United States. I draw on a case study of Gadsden County, Florida-a community that is perceived by its members to be a maternity care desert but that is not technically defined as one-to demonstrate how Black birthing people are cultivating a reproductive liberatory consciousness. Semi-structured interviews with birthing persons and reproductive health experts reveal three overarching processes-naming barriers to health equity, resisting health inequity and cultivating health equity-that characterise a reproductive liberatory consciousness, which I identify as an analytical tool to outline how local social actors are identifying structural constraints as well as developing strategies of communal care and resistance. This work contributes to sociological research on reproductive justice and health equity by exploring the limitations of 'desert' frameworks. Pointing to the need to carefully consider the mechanisms that actively disrupt and potentially transform spatial stratifications and inequities, this paper advances a new understanding of birthing space that captures the layered movements of those living within a perceived maternity care desert.