Black Midwives: A Labor of Love and Change

Black Midwives: A Labor of Love and Change

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.”

AAMN Announces 2019 Best Schools for Men in Nursing Awards

AAMN Announces 2019 Best Schools for Men in Nursing Awards

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 Sciences
  • 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 Nursing
  • University of Cincinnati College of Nursing
  • University of Wisconsin-Oshkosh College of Nursing
    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.

Columbia Nursing Hosts Nursing Leaders for First National LGBTQ Health Summit

Columbia Nursing Hosts Nursing Leaders for First National LGBTQ Health Summit

The Columbia 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 collaborations. 

To learn more about the first national LGBTQ health summit hosted by Columbia Nursing, visit here.

University of Virginia Honors Hidden Nurses at Annual NAACP Freedom Fund Banquet

University of Virginia Honors Hidden Nurses at Annual NAACP Freedom Fund Banquet

At the 2019 Albemarle-Charlottesville NAACP’s Annual Freedom Fund Banquet, the University of Virginia (UVA) honored its Hidden Nurses, the first African American women to help desegregate the UVA Hospital.

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 hospital.

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 the banquet.

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.

“It’s a beautiful thing to witness…” A Talk with the Director of the VNSNY Gender Affirmation Program

“It’s a beautiful thing to witness…” A Talk with the Director of the VNSNY Gender Affirmation Program

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.

 Shannon Whittington, the Clinical Director of the Gender Affirmation Program at VNSNY
Shannon Whittington, the Clinical Director of the Gender Affirmation Program at VNSNY

DailyNurse: What is gender affirmation surgery (GAS)?

SW: A surgical procedure that creates or removes body parts that align with the patients’ gender expression. E.g. vaginoplasty, phalloplasty, metoidioplasty, facial feminization, breast augmentation/masculinization.

DN: Is this the same thing as “sex-change surgery?”

SW: It is the same thing but we don’t use the terms “sex-change surgery” anymore.

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.

DN: What are the components of the VNSNY Gender Affirmation Program?

SW: 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 had!

DN: What sorts of clinical training do nurses in the program need to take care of GAS post-surgery patients? 

SW: 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?

SW: 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.

DN: And can you tell us something about the SAGE training in your organization?

SW: 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.

More 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.

The 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 community.

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.

Frontier Nursing University Wins Second Consecutive HEED Award for Excellence in Diversity

Frontier Nursing University Wins Second Consecutive HEED Award for Excellence in Diversity

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.

INSIGHT Into Diversity magazine's 2019 HEED Awards
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.

FNU’s diversity 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.

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