DONATE: Birth Workers of Color Conference Scholarship Fund

AROMidwifery is raising money for scholarships for birth workers of color to attend the 8th annual ICTC  conference this October in Florida. I cannot even begin to tell you how important this is. Scholarships and other funding for student midwives of color was one of the specific requests of the Midwives of Color working group in MANA (back before the MOC inner council resigned en masse). It’s a definite need. Frankly, it’s one of the single most important ways of combatting the racial disparities in the maternal and infant mortality rates in this country. We absolutely completely need more midwives of color working in this country and this is one of the ways we can do this.

From the AROMidwifery blog:

I want to be a midwife as much as I want to breathe. I know this is something I can do.  I have the resources and support I need to achieve my goal. I also know that when I am among a group of midwives, chances are, they will look like me, talk like me, and among them I will feel comfortable, welcomed, and safe. They will see me as a unique individual, rather than a representative of my ethnic group. They will accept me as one of them. This is my privilege – my white privilege; always present, even as a student midwife.

I also know there are many other people who want to become midwives as intensely as I do. Yet women of color who hear this call don’t have the privilege that I have. Generations of economic injustice mean that aspiring midwives of color often lack the financial support that many white student midwives can count on. Moreover, when students and aspiring midwives of color are among a group of midwives, there is a good chance that the majority of the people in the room will not look like them. They may not feel truly accepted, safe, or welcomed. If they speak in these groups, they may be expected to represent their ethnic group, rather than being listened to as individuals. They very likely cannot find preceptors or peers of their own skin color. This is institutionalized racism, and it is always present in the United States, even in midwifery.

Please donate. Give what you can. Give $5 or $500. Give more if possible. Think you can’t make a difference? Think again. Supporting student midwives of color is one of the single most important things we can be doing to change birth and midwifery in this country.

Graduation!

At the tail end of June, I graduated from Birthwise Midwifery School! It was an incredibly proud moment for me, and represented the culmination of a lot of hard work. It was very sweet to stand there with these women, so many of whom walked this journey with me from the very first day. (Never mind that I’m still not quite done with all of my births, that will come with time.)

It was also satisfying and affirming to speak with several people in the Birthwise administration about important conversations happening in midwifery right now, including the recent MOC chair and inner council resignation from MANA. I have to say I have been impressed with Birthwise’s continuing commitment to these conversations and the ways in which they are changing to create a better program. Their classes are changing, their student population is changing, and all of this has been a lot of change in the last few years for this small institution in Maine. I see a really bright future for Birthwise under it’s current leadership. Honestly, I only see things getting much better in the years to come.

The ceremony itself was simple and touching. I was asked to be a speaker at graduation. I want to share the text of my speech with y’all. I took this opportunity to speak about some things very close to my heart and where I hope to see midwifery moving for these recent graduates.

Maternal Health is a Human Right

As we leave Birthwise today and head into the world as new midwives, we are tasked with the sweet privilege and honor of attending and facilitating the birth of families. We are also inheriting some incredible challenges and responsibilities. According to new data from the United Nations, women are more likely to die from pregnancy and birth-related complications in the US than in 50 other countries and its getting worse.

I have a hard time getting beyond those numbers. 50^th place for maternal mortality. I cannot wrap my brain around the fact that we are in country where we spend more money (by a long shot) on medicine than any other country in the world and yet our maternal mortality numbers look like that. But then it just gets worse. In the US, black and Native American women and their babies die at rates disproportionate to their white counterparts. Black infants are 2.4 times more likely to die in the first year of life than white babies. Black women are 4 times more likely to die from pregnancy-related causes than white women. Frankly, these statistics are unconscionable. They are horrendous and abhorrent. And we HAVE to do something about it.

Fortunately, I think we have a piece of the answer. That answer is midwifery care.

As midwives, I think we’re doing a lot of things right. We provide competent, compassionate care to our clients throughout their entire pregnancies. We spend hours and hours in prenatal appointments getting to know women and their families, providing support when they have challenges, and giving excellent and often life-changing education. We facilitate their births start to finish cognizant of the many varied expressions of normal, holding space for our clients to navigate this journey however they need and want to as long as it is safe. Postpartum, we go above and beyond the care women get in obstetrical practices, doing home visits and multiple postpartum visits, catching things that are often missed by standard hospital care and lead to morbidity and mortality such as HELLP, infection, late post partum hemorrhages, and the list goes on and on.

And even still, we have a long long way to come. When you envision your future practice, are you serving the clients who need you the most? When you think about your preceptorships to date, are the women walking through your door an accurate reflection of the demographics in your area? Or do you serve a disproportionate number of white women?

In the 2011 update to Amnesty International’s seminal paper, Deadly Delivery, we learn that in addition to higher rates of maternal and infant mortality, “[w]omen of color are also less likely to have access to adequate maternal health care services. Native American and Alaska Native women are 3.6 times, African-American women 2.6 times and Latina women 2.5 times as likely as white women to receive late or no prenatal care.” We cannot provide the excellent midwifery care I know we all provide to women who are not even walking through our doors.

These galling numbers and statistics are beginning to come to the forefront of our thinking as midwives. I hear midwives talking about race disparities in obstetric care all over the country, both in person and online. I am so pleased that we are starting to have these conversations in earnest. Unfortunately, we have to do more than say we want to change outcomes for moms and babes. We need to get down to work to create real and lasting change. Maternal health is a human right and we need to work towards that truth. In doing so, we might have to stretch our comfort zones further than we thought we could and then keep pushing. But do it we must, because reducing infant and maternal mortality is more important than just about anything else we will do in our careers. Our very lives depend on it.

The challenge as I see it is combating racism and building a praxis of reproductive and birth justice. Racism is a central reason why these maternal mortality statistics are so skewed by race. When you rule out other confounding factors such as socioeconomic status, education level, geographic location, the race-based disparities remain. Personally, I believe unexamined institutionalized racism is the main factor why so many of our practices have a white-majority client base even if it doesn’t mirror the people who actually live in our communities. It’s why women of color are not accessing and utilizing the services of midwives at the same rates their white counterparts are. As midwives, we are failing families and their babies through our own inaction.

We need to examine our practices as we build or join them. We need to begin to have the difficult and uncomfortable conversations with our peers, mentors, teachers, and students. We need to talk about racism as a facet of midwifery and put our brains together about ways to eliminate it. Ask yourselves: When you have women of color in your practice, are you providing truly culturally competent care? Are you providing a welcoming environment where women are free from racism and racist practices, whether intentionally committed or not? If not, let’s fix it.

Here’s the real crux of the situation – we choose to make these changes out of love. I have decided to be an active participant in the work to fix these problems as long as I’m a practicing midwife BECAUSE I so love the work I do and I so love the clients I serve. I love my birth community, I love my peers, and I love each and every one of you and that’s precisely why I am willing to do this hard work. It is that love that pushes me on and gives me the strength to continue and it is that same love that inspires me every time I see change being made.

There are so many places to start:

• Take a good anti-racism or anti-oppression training in your area. Attend relevant workshops at MANA conferences. Read books, websites, blogs, anything you can get your hands on. Do not ever stop learning.
• Know your history as midwives and share it with your peers and clients. Make sure people know that what you do was built on the backs of immigrant women, black Grand midwives in the deep south, and Latina parteras in the southwest. Don’t let anyone believe the myth that Ina May Gaskin single-handedly resurrected a dead profession from the ashes. Not even she believes that.
• Begin to get involved with reproductive justice groups.
• Tap your local birth community for people you respect who are already engaged in this work. Find our how you can be involved.
• Seek out allies to start having conversations about race with.
• Find out ways to serve women of color and the organizations that support them in your community.
• Advertise and do outreach to women of color in your community, make sure they are knowledgeable about midwifery care as an option. Make sure they feel welcome and included in your client activities. Begin to change your demographics and you will begin to change birth outcomes.
• Seek out other birth professionals of color to collaborate with. Are the doulas, lactation consultants, ultrasonographers, massage therapists, chiropractors, and acupuncturists, that you refer to all white? Change that if you can. Add new referrals to your list. Be on the look-out for qualified and competent professionals of color to refer to.
•  Join the national conversation. What changes can be made to MANA, NACPM, MEAC, the MAMA Campaign and your local and state organizations? Can you help them come to an awareness of the seriousness of this issue and begin actively working towards combating it?
• Train women of color as midwives, because they are our future.
• End the institutionalized racism women of color experience in the medical system and commit to making sure that women never experience those kinds of indignities and injustices in your practice. Ever.

I personally challenge each and every one of you to utilize your incredible skill, tools, and love as midwives to make significant change regarding race-based maternal and infant mortality rates in North America. I urge you to make solving this problem a significant focus of your lives and practices. My deepest hope is that you find the challenge and reward, and the joy that is there in this transformative work. My dream is that your soul will catch on fire with the need and drive to do this work out in the world and that it will sustain you in all the years to come. You are the next generation of midwives and through your actions, we can transform midwifery care into a profession that truly is for ALL women.

“It’s Not Acceptable”: Midwives Address Health Disparities

This.

“It’s not acceptable that African American women, regardless of their educational and economic background, still have a four times greater chance of dying in the childbearing year than their white counterparts… It’s not acceptable that three to four times more Native American and African American babies die than their infant white counterparts.”

This is how the incredible Geradine Simkins opens this new film in MANA’s new I Am A Midwife series. I love this short film. None of these midwives are beating around the bush here. They give you the facts and make it clear just how serious of a problem racial inequality is for maternal and infant mortality. This film features some of the most brilliant CPMs today working on reproductive justice within a midwifery context including not only Geradine Simkins, but also Katsi Cook, Claudia Booker, Umm Salaamah Abdullah-Zaimah, Tamara Taitt, and Arizona’s own Marinah Farrell. I can’t even tell you how honored I am to be joining a community of midwives that includes these women. I feel like they and other midwives and birth professionals like them have been laying and continue to lay the groundwork and foundation that will allow these crucial changes to take place and transform maternity care as we know it in this country.

To that end, I leave you with this quote by Tamara Taitt:

“I feel like health disparities is really the battle ground on which midwifery will be proven to be the gold standard.”

 

Deadly Delivery

Amnesty International has decided to get on board with the USA’s atrociously poor numbers on maternal and infant mortality when compared to the rest of the world. They state “This not just a public health emergency, this is a human rights crisis.” I fully agree.

More than two women die every day in the USA from complications of pregnancy and childbirth. Approximately half of these deaths could be prevented if maternal health care were available, accessible and of good quality for all women in the USA.

Maternal mortality ratios have increased from 6.6 deaths per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006. While some of the recorded increase is due to improved data collection, the fact remains that maternal mortality ratios have risen significantly.

The USA spends more than any other country on health care, and more on maternal health than any other type of hospital care. Despite this, women in the USA have a higher risk of dying of pregnancy-related complications than those in 40 other countries. For example, the likelihood of a woman dying in childbirth in the USA is five times greater than in Greece, four times greater than in Germany, and three times greater than in Spain.

African-American women are nearly four times more likely to die of pregnancy-related complications than white women. These rates and disparities have not improved in more than 20 years. barriers to care; lack of information about maternal care and family planning options; lack of active participation in care decisions; inadequate staffing and quality protocols; and a lack of accountability and oversight.

During 2004 and 2005, more than 68,000 women nearly died in childbirth in the USA. Each year, 1.7 million women suffer a complication that has an adverse effect on their health.

This is not just a public health emergency – it is a human rights crisis. Women in the USA face a range of obstacles in obtaining the services they need. The health care system suffers from multiple failures: discrimination; financial, bureaucratic and language barriers to care; lack of information about maternal care and family planning options; lack of active participation in care decisions; inadequate staffing and quality protocols; and a lack of accountability and oversight.

Read the rest of the summary or read the whole report here.