Every childbearing woman should have access to the best possible care.  Too many women in the United States today suffer from poor outcomes for themselves or their babies.  And the problems are far worse for women of color.  The midwifery model of care has been shown to produce better outcomes and we often speak in midwifery circles about providing a "midwife for every mother." Yet we fall far short of that ideal.  To meet this challenge, we must increase the percentage of women of color served by midwives and the number of women of color who become midwives.  We are challenged to think and act more critically by the panelists represented in this symposium report and inspired by their examples!  

Responding to the call for action, the National Association of Certified Professional Midwives recently issued the following "Statement of Strategic Intent to Address Racism and Racial Disparities in Maternity Care in the U.S."  It can be found at this link on the NACPM web site.

We have recruited nearly 400 women since 2002 and we are proud to say that one-third of them have gone on to higher education in nurse-midwifery schools or CPM programs.~Shafia Monroe

The mission of the International Center for Traditional Childbearing is to increase the number of Black midwives, doulas, and healers to empower families, in order to reduce infant and maternal mortality. ICTC President Shafia Monroe describes their proven outreach strategies for inspiring and connecting with women who will become doulas and midwives. To get their message out, ICTC makes use of influential people, like their current national spokesperson, Grammy-award winning singer and songwriter Erykah Badu. They hold national conferences and local events where midwives can connect with each other and women like themselves who want to become midwives. Knowing it's never too young to plant the seed, ICTC's Sistah Care program also works with high school students to nuture their interest in midwifery.

Why focus on prenatal care and birthing when there's so much else to work on? It's what we decided to do because we believe there's something about that experience that sets off a chain of reactions that will affect the whole rest of your life - for yourself as a mother and for your children. So if the beginning of it is under scrutiny, harassment, anxiety or violence in pregnancy, what is that going to mean in terms of outcomes, the way you parent or take care of your children? This is not an individual problem; it's affecting all of us together. Today there is more general awareness about the problems in the education and criminal justice system leading to an actual School to Prison Pipeline for poor, Black and Latino youth. What we are finding, as mothers of color working in our communities, is that the tracking begins much earlier. We are calling it a Womb to Prison Pipeline. And that's why working for social justice for poor women of color during pregnancy and birth is so important.
~Paula Ximena Rojas Urrutia

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.

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. Micaela Cadena

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.

 

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

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.

Note: Unfortunately there was no video recording of Katsi's presentation, but she did provide her notes and links to other background materials. (See sidebar.)

A number of symposium participants, challenged and inspired by the discussion of racism and disparities in maternity care, have organized a new group, Anti-Racism and Anti-Oppression Work in Midwifery (AROM). Nearly 100 others have joined their Facebook group, which you can visit by clicking here.

This is their statement of purpose:

The CPM Symposium 2012 was designed to be interactive because we know that we have so much to learn from each other. Please share your opinions, ideas, resources, and news related to the topics addressed in this report or the symposium generally. We'll post responses in the next report.

Simply hit "reply" to send us your thoughts!