Photographing The Stories and Struggles of Maternal Health in The American South

Bethany Mollenkof visualizes the many stories of women working to protect the reproductive health and rights of women in the United States. 

Reproduction rights, childbirth, healthcare and maternal support in the United States are forever contentious, particularly in the American South. And, as politicians continue to debate abortion bans, the health risks associated with having a baby increase.

These issues are at the heart of Luupe photographer Bethany Mollenkof’s series Birthing in Bama and Abortion in Mississippi. Supported by a Women Photograph grant, Birthing in Bama documents Alabama’s renewed midwifery movement through Black home-birth advocates, looking at the experiences and histories of Black women, and how race and class impact treatment and disparities. Abortion in Mississippi, a story she photographed for The New York Times in 2019 asks: “What does abortion access look like in Mississippi, a state with one abortion clinic?”

We speak with Mollenkof about how she uses photography to amplify the women and birth workers pushing to shift these narratives

Mobile, Alabama 5/30/19: Nafeesah Roberts is a full spectrum doula in Mobile, Alabama. Roberts started birth work after having to seven of her own kids and in a dream she gave birth to herself. Roberts is working to raise awareness of the availability of doulas and the important role they play as advocates for black women in a state where they are five times as likely to die in childbirth. She runs a community birthing circle where women can discuss their pregnancies, trauma, postpartum care and experiences with the healthcare system. “Doulas help women make choices. They are meant to be the mothers advocate because it is very difficult for them to feel like they have a voice. White doctors make them feel less than.” © Bethany Mollenkof from her series Birthing in Bama

The Luupe: How did your project Birthing in Bama start?

Bethany Mollenkof: I started working on my project about birthing in Alabama a few years ago when I found out that midwifery was becoming legal again after it had been illegal to practice without a license since the 70’s. Although women were able to choose home births, the births could not be legally attended by a midwife or other birth workers.

Knowing the long history of Black midwives, I was curious how this law might change birthwork in the state. From that starting point, I began to examine the complexities of birthing in Alabama. Black women in Alabama are about five times more likely to die during childbirth than white women. Alabama has the fewest maternity-care providers per capita, as well as one of the highest infant mortality rates in the country.

© Bethany Mollenkof. From her series Birthing in Bama

The Luupe: Do you see the project extending to other states?

Mollenkof: I do, this country has a maternal care crisis that is not limited to Alabama.

These are stark statistics and important topics for people to engage in. My goal with my work has been to share birthing stories in all of their complexity and humanity. I am making intentional choices that aim to present a counter narrative to the historic invisibility, erasure, and censorship of Black women in the South.

From my personal project “Giving birth in a time of death, a love letter to my daughter.” I never thought I would be sentimental about being pregnant, but I became intensely protective and tender as my daughter grew. Because of the pandemic, it was so hard being so far away from our big families. So, we decided to name her months before her birth as a way to actualize her existence for them but also for us. © Bethany Mollenkof

The Luupe: Has your own recent relationship to motherhood influenced, impacted, or given you new insights into this work?

Mollenkof: Absolutely. People want to speak for and about mothers when what they need to do is listen. The process of becoming a mother and then motherhood is complicated. All too often birthing peoples experiences are oversimplified and under supported in this country.

My empathy has grown as well as my rage for the ways women have been pushed to the margins. When we take care of mothers, we take care of the future and if we want an equitable, healthy, just future, we have to start with the people bringing life into the world.

5/30/19: Outside of Tuscaloosa, AL. © Bethany Mollenkof. From her series Birthing in Bama.

The Luupe: One of the first images on your website from this series is an open road (and a similar image appears in your abortion series.) We’ve seen a million open road images before, but somehow this, especially in the context of the series, hits heavier and goes beyond the obvious metaphors. 

Mollenkof: I think there is a lot of searching and questioning in my work and these images of roads literally embody those feelings. I drive a lot while I am working which allows me time to think and process, and now with a child, sometimes driving on assignment is the only time I am alone. When I create these images of roads it’s usually at an emotional moment for me in my process.

Alabaster, Alabama 6/1/19: “Women need caregivers and healthcare providers that look like them. I was always the person in my community to help friends, cousins… my job is to mother the mother.” Carrington Glover is a full spectrum doula in Alabaster, Alabama. Having a trained labor companion during birth has been shown to reduce the rate of cesareans, reduce the use of pain medications, reduce the likelihood of instrumental delivery, and increase the likelihood of a vaginal birth. © Bethany Mollenkof. From her series Birthing in Bama

The Luupe: You approach portraiture with respect, empathy, honor and sensitivity to the people in front of your camera. Can you talk a bit about your approach/ process of ensuring that level of respect?

Mollenkof: Growing up, my mom taught me that showing up, sitting and listening to others is a radical act of care. To be attentive and present and meet someone where they are at, whether that be physically, emotionally or spiritually is powerful. I try to put that into practice in my portrait work.

Montgomery, Alabama 6/3/19: Alabama passed the strictest abortion law in the United States, banning all abortions except in cases where the mother’s health is at “serious” risk. © Bethany Mollenkof. From her series Birthing in Bama
© Bethany Mollenkof. From What Abortion Access Looks Like in Mississippi for The New York Times

The Luupe: Moving into your Abortion in Mississippi work series: this was made on assignment for the New York Times. Does your process differ working on assignment vs being entirely self directed?

Mollenkof: When I am working on a self-directed project I can let my mind and ideas meander a bit more than when I am working on an assignment. Although my approach is pretty much always the same – I commit myself to listening, showing up and being present. I consider it a sacred process to create images that tell others stories and that doesn’t change if the work is for a client or for myself.

Laurie Bertram Roberts at the Mississippi Reproductive Freedom Fund’s headquarters. © Bethany Mollenkof from What Abortion Access Looks Like in Mississippi for The New York Times

The Luupe: The importance of honoring and protecting ” every life” is key to both of these series – the question of what life is valued more…and the contradictions of those restricting abortion rights vs caring for the rights and health of mothers… Can you talk a bit about this? 

Mollenkof: None of these issues are clear cut. Abortion is an extremely polarizing topic and many people do not take the time to look at the nuance of individual people’s experiences. I find most people don’t want to sit with discomfort and implications of their views and the way they vote. I want to slow the conversation down and create a space for people to sit with the real stories of real people and see how that connects to systemic injustice. There is a lot of generalization and misrepresentation, so I am trying to create imagery that helps people think specifically and feel deeply.

© Bethany Mollenkof from What Abortion Access Looks Like in Mississippi for The New York Times
Alabama 5/30/19: Nafeesah Roberts dream that inspired her to go into birth work.© Bethany Mollenkof. From the series Birthing in Bama

The Luupe: You consistently balance calming, interstitial images with portraits, visual abstractions, and ephemera like handwritten letters to tell rich and complicated stories. Can you talk a bit about this part of your process for building story and metaphor?

Mollenkof: I want the work to reflect my experience with the stories, which is always sensory and multifaceted. I like being able to share lots of different elements that build the layers of a narrative.


Mobile, Alabama 5/31/19: A little girl stares up a tall hill. © Bethany Mollenkof. From her series Birthing in Bama
October 9, 2020 – Motherhood. Self-portrait with family. © Bethany Mollenkof
Self-portrait © Bethany Mollenkof

The Luupe: As one of the most active, inspired photographers we know, what’s on the horizon for you? Where do you see your work on maternal health going from here?

Mollenkof: I think about this Toni Morrison quote a lot, “I tell my students, ‘When you get these jobs that you have been so brilliantly trained for, just remember that your real job is that if you are free, you need to free somebody else. If you have some power, then your job is to empower somebody else. This is not just a grab-bag candy game.”I am trying to get free and use my work to free others in the process.