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
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.”
A History of Midwifery in the United States: the Midwife Said Fear Not
Written by two prominent leaders in the field of midwifery, this book spans the historical evolution of midwives as respected, autonomous health care workers, and discusses the strengths, weaknesses, threats, and opportunities for midwifery in the US. Featuring a range of photos and illustrations, and engaging stories filled with cultural and spiritual content, this book is a must-have resource on the history of midwifery and women.
Duke, Rutgers, University of Alabama-Birmingham, and nine
other colleges and universities have been recognized as the “2019 Best Schools
for Men in Nursing” by the American Association
for Men in Nursing (AAMN).
Winning institutions are selected based on the significant efforts they have made to increase the number of male applicants, enrollees, admissions, and/or retentions in their programs, and have been shown to provide a supportive educational environment for male student nurses. All schools applying for the award are accredited by the National League of Nursing or the Commission on Collegiate Nursing Education and have had a minimum NCLEX pass rate of 80% over the past three years.
2019 Best Schools for Men in Nursing
In alphabetical order, the winners are:
Duke University School of Nursing
John Hopkins University School of Nursing
Lewis University College of Nursing and Health
Nebraska Methodist College of Nursing
Northern Illinois University School of Nursing
NYU Rory Meyers College of Nursing
Rutgers School of Nursing
University of Alabama-Birmingham School of
University of Cincinnati College of Nursing
University of Wisconsin-Oshkosh College of
Vanderbilt University School of Nursing
West Coast University College of Nursing
2019 Best Workplaces for Men in Nursing:
New York Presbyterian Hospital
Vanderbilt University Medical Center
For a full list of 2019 AAMN awards, visit the AAMN awards page.
University School of Nursing recently hosted the first National
Nursing LGBTQ Health Summit, drawing deans and other leaders from top
nursing schools, representatives of nursing organizations including the
American Academy of Nursing and American Association of Colleges of Nursing,
and the National Institutes of health. The summit was conceived by the Nursing
LGBTQ Summit Advisory Board with a focus on advancing nursing’s progress in
addressing LGBTQ health issues.
The Summit was the first step toward creating a national health action
plan to raise awareness of and improve LGBTQ health. Participants were tasked
with mapping out an action plan, and discussing and brainstorming strategies
for bringing attention to LGBTQ health within the nursing profession and around
nursing education, research, and practice.
Keynote speaker Perry N. Halkitis, PhD, dean of Rutgers University’s School of Public Health, tells newswise.com, “One in five LGBTQ people do not seek health care because they fear discrimination… Moreover, the interaction between discrimination and other minority stressors—race and ethnicity, poverty, geography, lack of insurance—further drives LGBTQ health disparities.”
Participants identified a need to reduce disparities and improve
the health of people who are LGBTQ, which will require support from nursing
leadership to increase LGBTQ-specific content in nursing curricula and in
faculty development programs, policy development, and nursing research.
Lorraine Frazier, PhD, Dean, Columbia University School of Nursing tells newswise.com, “We’re here because we share a commitment to health equity, diversity, and the needs of the LGBTQ community and to looking at how we can advance education, clinical programs, research, and policy.”
Nurse leaders ended the summit with a call to action for the
nursing community to prioritize LGBTQ health through innovations in education,
research, and practice and to advance LGBTQ health policy. Following the
summit, attendees will devise a national LGBTQ health action plan focused on
the dynamic intersections among nursing education, research, and practice, as
well as a forum allowing participants to network and plan future
To learn more about the first national LGBTQ health summit
hosted by Columbia Nursing, visit here.
One of the nurses honored was
Louella Jackson Walker, part of the Licensed Practical Nurse program class of
1958. The program was a partnership between UVA Hospital and Burley High School,
an African American segregated school, to help fill a nursing shortage.
Walker tells cbs19news.com, “We took our jobs very seriously and they had a shortage of nurses and this was one way to fill that gap.”
Being an African American nurse at the time was not
easy, but Walker says she learned to show kindness to her patients, no matter their
behavior toward her. However, despite making history and helping to keep the
hospital and its patients afloat, she was unappreciated. She reports that she
is not sure where UVA would be today if she and other “hidden nurses” hadn’t served
as some of the first African American nurses at the newly desegregated
Honoring these hidden nurses came about after Walker
and another former classmate found old photos from the program at a yard sale.
They gave the photos to the UVA School of Nursing, which decided it was time to
make things right. Susan Kools, Associate Dean for Diversity and Inclusion at
the UVA School of Nursing, reports that the hidden nurses received a formal
apology from the dean for being excluded from their community, and were inducted
into the alumni association.
Albemarle-Charlottesville NAACP President, Janette
Boyd Martin, said she wanted to recognize the nurses because the black
community needs to celebrate leaders like them. She helped recognize the nurses
at the freedom fund banquet. Sixteen nurses from the LPN program were present at
Martin says, “People need to know about them and what they’ve done. Especially for our children, so they can see role models.”
To learn more about the UVA hidden nurses who were
recognized at the 2019 Albemarle-Charlottesville NAACP’s Annual Freedom Fund
Banquet, visit here.
In early 2016, Mt. Sinai Hospital* approached the Visiting Nurse Service of New York (VNSNY) to propose that VNSNY offer home care services to post-operative transgender patients. This was the genesis of VNSNY’s Gender Affirmation Program (known as GAP), which to date has provided home care to over 400 transgender patients. *a strategic partner of VNSNY
DailyNurse recently interviewed Shannon Whittington, RN MSN PCC C-LGBT Health, the Clinical Director of GAP at VNSNY. We asked her about the nature of gender affirmation treatment, the home nursing care that VNSNY provides, and the outstanding LGBT-friendly services that VNSNY offers to patients across the Tri-State New York area.
What is gender affirmation surgery (GAS)?
A surgical procedure that creates or removes body
parts that align with the patients’ gender expression. E.g. vaginoplasty,
phalloplasty, metoidioplasty, facial feminization, breast
Is this the same thing as “sex-change surgery?”
SW: It is the same thing but we don’t use the terms “sex-change
Gender Affirmation or Gender Confirming surgeries are the correct terms now. Understanding that this is a linguistically fluid language, words and meanings are always changing and we need to be mindful of correct terminology.
What are the components of the VNSNY Gender Affirmation Program?
The program emphasizes home care following surgery from other providers. I train clinicians (nurses, social workers, physical
therapists, home health aides, speech and occupational therapists) in cultural
sensitivity as it particularly relates to transgender patients. The training is extensive and they are also
educated in how to teach the patients to care for their new or altered body
parts (i.e. penis, vagina, breast, face)
DN: How did you come to specialize in the treatment of Gender Affirmation surgery patients?
SW: Fortunately, I was chosen for this project by my
manager. I had no idea what I was saying
yes to but this has literally changed the trajectory of my career path. I discovered a passion that I did not know I
What sorts of clinical training do nurses in the program need to take care of
GAS post-surgery patients?
They need to know what to assess for and what is
normal and what is not. They learn about
vaginal dilation because the patients who undergo vaginoplasty must do this on
a regular basis. Patients come home with VACs, JP drains, foleys and supra
pubic catheters. Although the nurses are already familiar with these devices,
they need to teach the patients how to manage them. The clinicians are also
trained in social determinants of health for this cohort.
DN: What sorts of cultural issues do nurses need to learn about before tending to a GAS patient?
SW: We really need to understand that these patients, like all
of our patients, are patients first who happen to be transgender. We must
respect their chosen names, their pronouns and their gender expression. We
focus on getting them better and integrated back into society. It’s a beautiful
thing to witness and an honor to be associated in such a transitional journey.
DN: How does the Gender Affirmation Program reflect the larger VNSNY commitment to LGBT patients?
It reflects our commitment to this population on an
agency wide basis. What is great is that
we are now getting non-operative transgender patients who are seeking home care
services for reasons other than gender affirming surgeries. They feel safe here and seek care outside of
gender affirming surgeries.
We are initiating various ways to continue to be inclusive along
the binary spectrum by hiring gender non-confirming and non-binary individuals.
These individuals have a lot to offer and need to be the best expressions of
themselves in their work environment just like the heteronormative society we
all live in.
And can you tell us something about the SAGE training in your organization?
All divisions of the Visiting Nurse Service of New York have been awarded Platinum
certification (the highest level possible) from SAGE, the world’s largest and oldest organization dedicated to
improving the lives of LGBT older people.
than 80 percent or more of VNSNY’s clinical and other staff have received SAGE Care LGBT cultural competency
training, further establishing VNSNY as a
preferred health care provider for New York City’s LGBT residents.
SAGE training is designed to increase awareness among VNSNY clinical and
administrative staff of cultural issues and sensitivities around sexual
orientation and gender identification, so as to ensure a welcoming and
respectful health care environment for all individuals within the LGBTQ
Among other things, the training stresses the importance of approaching each patient in a non-judgmental fashion and never making assumptions about anyone’s sexual orientation or family structure. We want every patient to feel they can be totally open about who they are with every member of our GAP team who walks through their door.
Coming in March 2020!
Annals of LGBTQ Public and Population Health
The mission of Annals of LGBTQ Public and Population Health is to bring together state-of-the-art cross-disciplinary scholarship which seeks to enhance the health and well-being of sexual and gender minority (SGM) individuals at the population level with an eye to the intersectional identities that SGM people possess.
We are interested in papers that advance education, policies, laws, and approaches to enhance SGM care and SGM health.
INSIGHT Into Diversity magazine has just recognized Frontier Nursing University’s commitment and accomplishments for the second consecutive year. FNU has now added the 2019 Health Professions HEED (Higher Education Excellence in Diversity) award to their shelf alongside their award from 2018.
About the Health Professions HEED Award
“The Health Professions HEED Award process consists of a comprehensive and rigorous application that includes questions relating to the recruitment and retention of students and employees and best practices for both; continued leadership support for diversity; and other aspects of campus diversity and inclusion,” said Lenore Pearlstein, co-publisher of INSIGHT Into Diversity magazine. The magazine is the oldest and largest publication on this topic in higher education and is well-known for its annual Higher Education Excellence in Diversity (HEED) Awards.
Pearlstein adds, “As we continue to see a record number of Health Professions HEED Award applicants each year, nearly every school tells us they use the application itself as a tool to create new programs and to benchmark their accomplishments across campus. The process allows them to reflect on their successes and also determine where more work needs to be done. We also continue to raise the standards in selecting HEED institutions.”
Diversity Impact at Frontier Nursing University
FNU’s history of emphasizing and valuing inclusion was formally instituted nine years ago, when it instituted the Diversity Impact Program in 2010. Each summer, FNU holds the Diversity Impact Conference for nurse practitioner and nurse-midwifery students plus faculty and staff to foster collaborative discussions, address health disparities, and find proactive solutions to improve minority health among underrepresented and marginalized groups.
initiatives span all facets of the university, but one of the most telling and
important data points is the percentage of students of color enrolled at FNU.
In 2009, that number was 9 percent. In 2019, it has grown to 23 percent.
“We are incredibly
proud to receive the prestigious HEED Award again this year,” said FNU
President Dr. Susan Stone. “To receive this award two years in a row is a
wonderful honor. Our graduates serve people of all races and cultures and are
increasingly coming from diverse backgrounds. It is imperative that our
students, faculty, and staff have cultural awareness and competency in order to
effectively advance our mission. The HEED Award confirms the value of our
efforts and validates our continued emphasis on diversity and inclusion within
the culture of FNU.”
INSIGHT Into Diversity Magazine
INSIGHT Into Diversity magazine is the oldest and largest diversity publication in higher education today and is well-known for its annual Higher Education Excellence in Diversity (HEED) Award. In addition to its online job board, INSIGHT Into Diversity presents timely, thought-provoking news and feature stories on matters of diversity and inclusion across higher education. Articles include interviews with innovators and experts, as well as profiles of best practices and exemplary programs. Current, archived, and digital issues of INSIGHT Into Diversity magazine are available online at insightintodiversity.com.
For further information on Frontier Nursing University and the Health Professions HEED Award, visit the FNU site.