The following are a small sampling of efforts around the nation led by midwives of color.
The JJ Way©: Toward Eliminating Disparities
Jennie Joseph, CPM, reminds us of “the foundational role that African American midwives played in the provision of maternity care for both Black and White women from slavery on upwards.” The overarching goal of Jennie’s model of maternity health care “is to see that every woman has an opportunity for the healthiest possible pregnancy, birth and postpartum, regardless of the color of her skin or her socio-economic status; a model where babies, mommies, families and communities thrive because the emphasis is on access, connections, knowledge and empowerment – quality care for every woman, every time.”
NABCC: Eliminating Disparities through Birth Centers of Color
The National Association of Birth Centers of Color (NABCC) was founded in February 2012 by a group of CPMs committed to serving all women, but particularly women of color, through community-based maternity clinic and birth center services. With a vision to eliminate racial disparities in birth outcomes, each founding midwife member has experience working with women of color through her own clinic and/or birth center, and has achieved better health and better care within her population through culturally-competent, evidence-based, comprehensive and cost-efficient midwifery and maternity-care home models.
ICTC Leads the Way: Reimbursing Doulas to Reduce Disparities
Thanks in good part to the leadership of Shafia Monroe and the International Center for Traditional Childbearing (ICTC), the Oregon legislature passed a law in 2011 requiring the Oregon Health Authority to investigate how doulas and other community health workers can improve the birth outcomes of underprivileged and underserved women. After a further 2 year process with the Oregon Health Authority and the legislature, ICTC recently announced a stunning victory: certified doula services are now reimbursed by Medicaid! To meet the Oregon Health Authority guidelines for Medicaid reimbursement, certified doulas are required to complete 38 hours of Doula training through an OHA approved doula training organization. ICTC is an approved OHA training organization. ICTC’s Full Circle Doula Training Program builds on a tradition and history of midwifery practice in the African American community and has trained over 400 doulas of color since 1991. One-third of those trained have continued on to become midwives. Congratulations to ICTC and the doulas and childbearing women of Oregon on Medicaid reimbursement for doulas!
Uzazi Village, co-founded and led by Executive Director Sherry Payne since 2012, works to improve perinatal health in communities of color. These communities reflect great disparities in pregnancy and infant health. At Uzazi Village we work with low resource clients and community partners to improve health and wellness during pregnancy and beyond. Through our innovative community health worker model, The Sister Doula Program, we pair pregnant women with trained perinatal community health workers that live in the same community, to companion them through the pregnancy while providing education, healthcare navigation, and informed decision making to assist clients in improving their overall wellbeing. We also have an IBCLC run free walk-in breastfeeding clinic two days a week. In addition to those services we offer childbirth class, breastfeeding support groups and babywearing classes. Our vision is: for every family, a healthy baby and for every baby, a healthy village. We work with local healthcare providers to educate them on the importance of culturally congruent care and what that care looks like. Finally, we support candidates of color as they work toward entry into the perinatal professions. We offer mentorships, scholarships, and continuing education to support the aspiring professional. We seek to strengthen our communities of color and ease the health risk burden of childbearing families through advocacy, education, and support.
Cultural Safety in Training First Nations/American Indian/Alaska Native Midwives
Sherrill Katsi Cook Barreiro
For the past 30 years, Sherrill Katsi Cook Barreiro has worked at the intersections of reproductive justice and environmental justice from the perspectives of a Mohawk traditionalist of the Haudenosaunee longhouse, or Six Nations Iroquois communities, in that area of tribal sovereignty having to do with the control of production and reproduction of culture and kinship. She describes the establishment of a birthing center in the Six Nations communities.
“It is at the most critical window of development in the mother’s womb – the child’s first environment, first relationship and first experience – that the embodied wealth of indigenous nations is determined. Cumulative impacts on each generation are effected through mechanisms and factors including fetal origins of adult disease, environmental influences that drive changes in gene function through macroepigenetic processes, adverse childhood experiences (ACE) and intrinsic and extrinsic social, biological and physiological vulnerabilities of American Indian/Alaska Native, Aboriginal children.”
~Sherrill Katsi Cook Barreiro
» Read Katsi Cook’s CPM Symposium presentation
» Learn more about cultural competency and cultural safety in the National Aboriginal Health Organization publication
» Visit the Maternal and Child Centre located on the Six Nations of the Grant River Territory
For more information about midwifery in the U.S. and Canada, explore the presentations made at the Invitational Gathering on North American Indigenous Birthing and Midwifery held in 2008 in Washington, DC, click here
With a background in community organizing, Paula Rojas understood that you can make change, building power locally by and for those who are directly impacted by the problem. But when she and others in her community started having babies, she realized that the issues of social justice that she had been working on were also central to pregnancy and birth. Mamas of Color Rising is a collective of working class and poor mothers of color based in and around Austin, Texas that has started working on birth justice issues. MCR is building bridges between Black and Latina communities with projects that include raising awareness that women of color should have choices in their childbirth; doing street and supermarket outreach; launching a campaign to include Licensed Midwives in Medicaid in Texas; creating Sankofa, a program training birth companions or doulas to provide free birth support; and building a prenatal clinic with volunteer midwives and birth companions.
New Mexico is considered a midwife-friendly state with many birthing options, but these choices are not widely understood or accessible in all communities. Micaela Cadena points out that midwives must do more to improve access to midwifery care for all women and provides several examples of promising projects. She describes two midwives working with the community in Espanola to address the problems identified as critical within that community. Micaela herself works with Young Women United, which has created a collective of women of color trained as birth supporters and birth companions. They have prioritized working with young moms and substance-using moms and will soon be working in the youth detention center.
Micaela says, “The families I work with don’t consider ourselves as consumers. When we do birthing justice work, what we’re doing is demanding equality in accessing health care and we see health care as a human right, as a matter of dignity, respect and justice, not just a financial transaction.”
Birth Workers of Color Grand Challenge: Critical Need to Education Midwives of Color
Spearheaded by Vicki Penwell, CPM, Claudia Booker, CPM, and Jennie Joseph, CPM, A Scholarship Solution and Grand Challenge from Mercy in Action, this initiative is a challenge to schools and other birth worker training programs to each offer a scholarship to a woman of color each year. A data base of scholarship and support opportunities for students will be collected and shared with aspiring students of color. Read how you can support and participate.