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A midwife–especially a Black midwife–can tilt the balance between life and death for African American infants and their mothers. Regardless of income and education level, childbirth for Black women is more dangerous than it is for White women. Even Serena Williams had a dangerous close call during her pregnancy, after doctors failed to heed her request for a CT scan and blood thinner medicine. Despite her history of blot clots, it was posited that “Williams’ pain medication must be making her confused.”
The Centers for Disease Control reports that African American mothers die at three to four times the rate of White women, and the mortality rate of Black infants is higher than that of any other ethnic group in the US. Why? As AmericanProgress.org states in a 2019 policy blueprint, “Racism is part and parcel of being black in the United States, and it compromises the health of African American women and their infants… Put simply, structural racism compromises health.” According to Dr David Williams, a pioneer in measuring the effects of racism on health, “We now know that discrimination is linked to higher blood pressure, to high levels of inflammation, to low infant birth weight…”
Enter the Midwife
One action that promises to change these dire statistics is expansion of the midwifery movement, especially within the African American community. Angela Doyinsola Aina, interim director of the Black Mamas Matter Alliance (BMMA) recently told an American Public Health Association (APHA) conference, “We have to go beyond just talking about giving people, especially low-income people, access to care…. We also need to ask whether that care is high quality and culturally relevant.”
Where do Black midwives come into the picture? ProPublica notes in a report on how increasing the role of midwifery in the US could reduce maternal complications and mother/infant mortality rates, “Many… [US] states characterized by poor health outcomes and hostility to midwives also have large black populations, raising the possibility that greater use of midwives could reduce racial disparities in maternity care.” And Lamaze.org suggests, “When Black families are cared for by Black health professionals, like midwives, they are better heard, seen, respected, understood, and get their needs met, which relates directly to health outcomes.”
One of the women at the forefront of the Black Midwives movement is Jennie Joseph, founder of the Birth Place in Winter Garden, FL. Joseph’s work as a provider of perinatal services to underserved and uninsured women of color has already brought about positive change in the CDC numbers. Trained in the UK, where half of all babies are delivered by midwives, Jennie Joseph arrived in the US to find that in the most affluent country in the world, owing to concerted opposition from doctors and hospitals, midwives attend only 10% of all births. She also found that the US has a much higher incidence of maternal and infant mortality rates—particularly among minorities and the disenfranchised—than in countries such as Canada, Sweden, and the UK, where midwives attend the majority of births.
Joseph’s “open access” clinic at the Birth Place provides pre-natal and post-partum care for women regardless of their ability to pay and focuses on minority and underserved women in the area. As Miriam Zoila Perez marveled in the New York Times, the Birth Place manages to beat the dire maternity figures for women of color: “When you look into her statistics, you find something quite rare: Almost all of her patients give birth to healthy, full-term babies… maybe not surprising until you learn that the majority of them are low-income African-Americans, Haitians and Latinas….”
Expanding the Midwives’ Movement
Another pioneering Black midwife is Shafia Monroe, who has long been one of the major forces behind the Black midwives’ movement. Founder of the International Center for Traditional Childbearing (which was re-formed in 2018 as the National Association to Advance Black Birth) and winner of a Lifetime Achievement Award from the Human Rights in Childbirth Foundation, Monroe started working with mothers and infants as a nurse’s aide in the postpartum ward at Boston City Hospital at the age of 17. It was in 1991, when she encountered difficulties in finding a midwife of color for her own pregnancy, that Monroe founded her influential International Center for Traditional Childbearing. Under the auspices of the ICTC, she became a pioneering figure in the cause of Black midwifery. Monroe has worked tirelessly to reduce mortalities linked to pregnancy and to increase the number of Black midwives and doulas. To women who are interested in becoming midwives, Moore urges, “Join an organization! There’s MANA (Midwives Alliance of North America), ICTC, ACNM (American College of Nurse Midwives); there’s so many organizations. Look into organizations that are familiar with black reproductive issues, and our history.”
As the co-director of Black Mamas Matter Alliance (BMMA), Elizabeth Dawes Gay, says, “If even one more person just says they want to take up the cause, they want to become a doula, they want to become a midwife, they want to start an organization—to me that’s a success.”