How working with a midwife can help reduce health disparities

Health inequity is a major public health and social justice issue in the United States. Black women and families experience disproportionately worse maternal and infant health outcomes for a number of reasons, including limited access to care, dismissal of pain and other health concerns, and higher rates of underlying health conditions — and racism and unconscious bias play huge roles in all of these areas. 

Improved outcomes with midwifery

Increasingly it’s become clear that midwives can play a big role in achieving better health outcomes for the moms and families that they support. Recent studies show that access to midwifery can lower rates of complications in pregnancy, for both birthing parents and babies. Midwifery care, when offered on a large scale, seems to have the potential to help with gaps in care and reduce health disparities.

What does this mean for you? You may want to seek out personalized care when deciding what sort of providers you’ll work with during and after pregnancy, and this might include considering working with a midwife. In addition to lowering rates of complications, folks who work with midwives are happier and more satisfied with their care. They also report higher rates of breastfeeding. 

Midwifery as social justice work

Improved outcomes like this can be traced back to the midwifery philosophy and framework that views reproductive work as social justice work and equity as essential to health. This can be seen even in the history of Black midwifery in the U.S. The term midwife, which means “with woman,” seems particularly appropriate — Black midwives in the South used to deliver healthy babies when white doctors would not attend to the birthing needs of Black families. These midwives were known as granny midwives, a powerful tradition of work where they learned the craft of midwifery by observation and through apprenticeship with midwives in their community. These incredible women recognized that everyone should have access to dignified, thoughtful care and put their beliefs into practice as they cared for their community.

You deserve a provider who understands you

Care that’s personalized and thoughtful in this way is still just as important as ever, so consider care provider options that feel like a good fit for you. This means seeking out care providers who understand your unique needs and wishes, help you feel in control of your body and your care, and really understand where you’re coming from. For example, if you’re Black, you may want to work with a Black care provider, if that’s possible. Black midwifery groups, Black doula groups, and other such organizations or community health groups exist to provide just this sort of care. You deserve to work with a care provider who helps you feel seen and heard. A midwife might be a part of that care picture.


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Sources
  • Kennedy Austin. “End Racial Disparities in Maternal Health, Call a Midwife.” Columbia University Mailman School of Public Health. Columbia University, February 2 2020. Retrieved August 31 2020. https://www.publichealth.columbia.edu/public-health-now/news/end-racial-disparities-maternal-health-call-midwife.
  • Petraten Hoope-Bender et al. “Improvement of maternal and newborn health through midwifery.” The Lancet. 384(9949): 1226-1235. September 27-October 3 2014. Retrieved August 31 2020. https://www.sciencedirect.com/science/article/abs/pii/S0140673614609302.
  • Jill Litman. “Call the Midwives: Addressing America’s Black Maternal and Infant Mortality Crisis.” The Public Health Advocate. Berkeley Public Health, May 8 2019. Retrieved August 31 2020. https://pha.berkeley.edu/2019/05/08/call-the-midwives-addressing-americas-black-maternal-and-infant-mortality-crisis/.
  • Nina Martin. “A Larger Role for Midwives Could Improve Deficient U.S. Care for Mothers and Babies.” Pro Publica. Pro Publica Inc., February 22 2018. Retrieved August 31 2020. https://www.propublica.org/article/midwives-study-maternal-neonatal-care.
  • Cara Terreri. “Black History Month: The Importance of Black Midwives, Then, Now and Tomorrow.” Lamaze International. Lamaze International, February 22 2019. Retrieved August 31 2020. https://www.lamaze.org/Connecting-the-Dots/black-history-month-the-importance-of-black-midwives-then-now-and-tomorrow-1.
  • Koren Thomas. “The Black Midwives Movement.” MedPage Today. MedPage Today, LLC, February 23 2020. Retrieved August 31 2020. https://www.medpagetoday.com/nursing/nursing/85014.
  • Saraswathi Vedam et al. “Mapping integration of midwives across the United States: Impact on access, equity, and outcomes.” PLOS ONE. PLOS, February 21 2018. Retrieved August 31 2020. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0192523.
  • “Pregnancy Mortality Surveillance System.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, February 4 2020. Retrieved August 31 2020. https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm.
  • “Social Justice, Birth Justice, and Midwifery.” The Midwives Alliance of North America. The Midwives Alliance of North America . Retrieved August 31 2020. https://mana.org/healthcare-policy/social-justice-birth-justice-midwifery.

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