Unfinished Business: Tending to Matricentric Feminism in Maternal Child Health

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In the United States, maternal health has aptly been regarded as “in crisis.” However, the person beyond the patient – the one who mothers – is frequently left behind, challenging us to confront the crisis in motherhood. This crisis is particularly evident within maternal child health (MCH) – a public health field focused on improving the physical, mental, and social well-being of women of childbearing age, infants, children, and adolescents. Yet, as it stands, MCH operates under a narrow biomedical definition that privileges the child’s health over the mother’s. Embracing matricentric feminism – a theory and practice of feminism tailored to the specific needs, experiences, and empowerment of mothers within MCH – has the potential to confront this crisis. Through a mother-centered MCH framework of practice, we can more fully confront the crisis of motherhood and move towards a maternal child health model for thriving that recognizes the Mother in fullness.

Maternal-Child without the ‘Mother’

While motherhood is a social experience, psychologically embodied, and labor, it is currently treated as a site for biomedical intervention within MCH. Consequently, mothers become invisibilized, as does the social experience of mothers, the work of mothering, and the institution of motherhood. MCH currently focuses on mothers during their entry into motherhood – from pregnancy, birth, and through the postpartum period (1-year or from “zero to three”). Then, clinical attention shifts to the infants: birthing outcomes, early developmental milestones, and safe childhoods. While some scholars and practitioners consider mothers during their child’s early adolescence, research is often focused on the labor of parenting alone. The capacity to support families is one facet of what it means to be a mother, but the psychological and social experience of motherhood is often neglected. Public health efforts are short-sighted, as we craft a workforce focused on supporting mothers just as they begin to mother.

MCH actors often use children as justification to care about their mothers’ wellbeing. The epigenetic “blame game” posits maternal mental health as important to infant growth and development. Statistics on how a mother’s wellbeing impacts infant health, their quality of life, and their development are used as justification for intervention as compared to the statistics of a mother’s health. In fact, this rhetoric has led federal actors to challenge the use of medications (e.g., mental health medications) during preconception, pregnancy, and the postpartum period, subjugating the stability and health of the mother to the development of the fetus. As a discipline focused on Maternal-Child Health, we must move beyond maternal health purely in relation to the child and consider the full breadth of what it means to be well as someone who mothers. This distinction is not to say that mothers’ health and wellbeing are not shaped by their children; rather, as a discipline, we will not fully confront the needs of mothers if we do not craft a more comprehensive scope of practices and considerations. Maternal health is worth studying as much as on the basis of the mother, the person who labors.

When we move beyond the biomedical frame, we can see numerous other crises. Maternal labor, which remains unpaid and without structural support like affordable childcare and paid maternity leave, is delegitimized. The Mythical “Perfect Mother” and “Bad Mother” create daily crises for mothers. ³ Further, ideas about who “mothers” are and how they ought to behave subjugate women to unsafe pregnancies, lead to untreated mental health needs, and create a crisis of motherhood – from womb to tomb. While there is growing attention to the maternal mortality crisis, more attention is warranted to the broader social crisis in motherhood and the divestment in mothers across the life course.

Making the Mother Visible: Matricentric Feminism

The absence of the mother in maternal-child health pushes us to move beyond the narrow perinatal window and instead embrace a new framework for improving the health of mothers: Matricentric Feminism.^[1] Motherhood studies scholar Andrea O’Reilly introduced matricentric feminism, a mother-centered framework that challenged mainstream feminism’s marginalization of mothers, identifying this neglect as the “unfinished business of feminism.”^[2] O’Reilly states that a matricentric feminist approach “asserts that the topic of mothers, mothering, and motherhood deserves serious and sustained scholarly inquiry […] and seeks to correct the child-centeredness that defines much of the scholarship and activism on motherhood.” Notably, O’Rielly’s introduction of matricentric feminism recognizes anyone who takes on the labor of mothers and the social role of mothers, including transgender men and gender queer parents/caretakers.

Matricentric feminism sees motherhood as valuable without reducing women to their roles as mothers. At the same time, it does not abandon the child or diminish the importance of the parent–child relationship. The field of social work provides an instructive example of how matricentric feminism can be embraced in practice. For instance, Erin Kuri and Dianne Fierheller have shown that motherhood and mothering experiences are siloed in research agendas, practice settings, and course curricula.^[3] Meanwhile, Sarah Epstein and Pippa Mulley have developed a framework for “Matricentric Feminist Social Work” to make mothers “visible.”^[4] Such a framework doesn’t yet exist for public health.^[5] Like social work, MCH has an opportunity to define a matricentric feminist approach to our theory, research, and practice.

The “Unfinished Business”: Making Mothers ‘Count’

A matricentric feminist approach, in both definition and action, to maternal child health should first and foremost be crafted in partnership with those who mother. The discipline can redefine what is meant by ‘maternal health’ to recognize 1) the social location of motherhood, 2) the work of mothering, and 3) the experience of (the institution of) motherhood. In doing so, we can confront the racist practices and narratives of ‘deviant’ and normative mothers, which create daily crises for mothers. As public health embraces a biopsychosocial framing – which sees the experience of health as an interlocking of biological, psychological, and social domains – practitioners and researchers focused on maternal-child health can integrate the social location of motherhood into this framework.

The discipline can also move towards matricentric feminism in practice by ensuring priorities are established through participatory means. For example, Maternal Mortality and Morbidity Advocates Voices and the Alliance for Innovation on Maternal Health at the American College of Obstetricians and Gynecologists have partnered to provide an enhanced integration of lived experiences into Quality Improvement initiatives.^[6]  While impactful, co-designing with people who mother is not thoroughly utilized within the field. In fact, Lucie Vicat-Blanc and colleagues found that only 9 out of 6000 screened articles focused on co-design with “structurally marginalized” populations.^[7]

MCH can more robustly consider the unique problems mothers face economically, politically, culturally, and socially. An integration of the Reproductive Justice framework and Matricentric Feminism can illuminate these problems and how they are shaped by racism, ableism, xenophobia, and other social violences. While Matricentric Feminism is the theory and practice on the social object of the mother, Reproductive Justice frames the rights of the mother and the structural injustices constraining parenting. The integration of the former theory with Reproductive Justice would recognize parenting and also the rights of the mother beyond the right to parent a child safely. While a Reproductive Justice framework offers a critical and robust theorization of rights around reproduction, matricentric feminism offers a critical and robust theorization of the identity and labor of the mother. Together, they offer a mother-centered framework for addressing economic, political, and social injustices.

The discipline must also move our science and practice (clinical and non-clinical) beyond merely preventing mortality and toward ensuring that everyone who seeks to mother has the support and resources to experience motherhood on their own terms – with joy and pleasure. For example, Opara and Elmi have observed that the maternal health narrative has “been dominated by crisis-focused frameworks that emphasize morbidity and mortality”, especially among Black mothers. Their framework instead centers “joy, resilience, and thriving,” offering an “expanded, empowered, and complete lens” that enables the field to move beyond outcome-oriented practices and toward improving mothers’ lived experiences and quality of life.^[8]

Finishing the Business: Putting the ‘Mother’ into MCH

Tending to matricentric feminism as a discipline can propel the field forward and advance more holistic support for mothers. Using matricentric feminism, we can reimagine what maternal health means and subsequently how it can be measured and supported by actors within MCH.

There are several actions as a discipline that we can take:

1. 1. Move beyond the perinatal window in research, theory, and practice by studying maternal health across the lifespan, as maternal health does not end in the postpartum period.
   2. Reconstruct curricula to fully recognize motherhood across the life course – through emerging, middle, and late motherhood.
   3. Integrate theorizations of matrescence into the public health models for research and practice.
   4. Apply new metrics for assessing wellbeing during the perinatal period. What metrics are important to mothers, and how can we let these guide our standards?
   5. Embrace the ‘social’ of biopsychosocial, recognizing how the economic, political, labor, and cultural conditions of mothers interact with their biological and psychological wellbeing.
   6. Integrate reproductive justice and matricentric feminism to create a mother-centered framework for addressing economic, political, and social injustices in the institution of motherhood.
   7. Reframe maternal health through joy, resilience, and thriving, moving beyond a mortality-only mindset. We can embrace the framework of Opara and Elmi and reimagine what health can mean through “an expanded, empowered, and complete lens.”

Through a mother-centered MCH framework for doing, studying, and teaching, we can more fully confront the crisis of motherhood and move towards a maternal child health model for thriving that recognizes the mother in fullness.

Notes

1. Reproductive Justice is a distinct, but complementary framework, coined by Women of African Descent for Reproductive Justice in 1994. ↑
2. Matricentric feminism is the theory and practice on the social object of the mother, and reproductive justice frames the rights of the mother and the structural injustices constraining motherhood. As the “unfinished business” of feminism, the wellbeing of mothers was left behind by mainstream and white feminists whose work was often siloed to abortion rights. ↑
3. Kuri, Erin, and Dianne Fierheller. “Social Work and Mothering: Mapping the Intersections of Social Work and Matricentric Feminism.” Journal of the Motherhood Initiative for Research and Community Involvement 13, no. 1 (2022): 7–29. ↑
4. Epstein, Sarah, and Pippa Mulley. “Matricentric Feminist Social Work: Towards an Organising Conceptual Framework and Practice Approach to Support Empowered Mothering.” In The Routledge International Handbook of Feminisms in Social Work, edited by Carolyn Noble, Shahana Rasool, Linda Harms-Smith, Gianinna Muñoz-Arce, and Donna Baines, 384–393. London: Routledge, 2024. https://doi.org/10.4324/9781003317371-38 ↑
5. The author of this article is working on a framework and welcomes collaborators. ↑
6. https://preeclampsia.org/the-news/mommas-voices/mommas-voices-and-aim-launch-the-first-ever-lived-experience-integration-into-qi-community-of-learning-in-23-states ↑
7. Vicat-Blanc L, Merry L, Harguindéguy-Lincourt MC, Tang Y, Van Hulst A. Co-design of interventions and services with structurally marginalized populations in the context of maternal and early childhood primary care: a rapid scoping review. Prim Health Care Res Dev. 2025 Jun 16;26:e48. doi: 10.1017/S146342362510011X. PMID: 40518975; PMCID: PMC12175099. ↑
8. Opara, I. N., & Elmi, Y. M. (2025). Reimagining Black maternal health narratives: Embracing a Vitality Framework for joy, liberation, and healing. PLOS Global Public Health, 5(7), e0004703 ↑

 

Feature image: Bathing babies, “A school for mothers.”Wikimedia