{"id":269012,"date":"2020-09-17T06:09:10","date_gmt":"2020-09-17T10:09:10","guid":{"rendered":"https:\/\/canadianinquirer.net\/v1\/?p=269012"},"modified":"2020-09-17T06:09:10","modified_gmt":"2020-09-17T10:09:10","slug":"black-women-turn-to-midwives-to-avoid-covid-and-feel-cared-for","status":"publish","type":"post","link":"https:\/\/canadianinquirer.net\/v1\/2020\/09\/17\/black-women-turn-to-midwives-to-avoid-covid-and-feel-cared-for\/","title":{"rendered":"Black Women Turn to Midwives to Avoid COVID and \u2018Feel Cared For\u2019"},"content":{"rendered":"
\"\"<\/a>
But the growing interest in home births in recent years has fueled a growing Black midwifery movement that harks back to a venerable, if long-forgotten, tradition in the United States. (Pexels photo)<\/figcaption><\/figure>\n

From the moment she learned she was pregnant late last year, TaNefer Camara knew she didn\u2019t want to have her baby in a hospital bed.<\/p>\n

Already a mother of three and a part-time lactation consultant at Highland Hospital in Oakland, Camara knew a bit about childbirth. She wanted to deliver at home, surrounded by her family, into the hands of an experienced female birth worker, as her female ancestors once did. And she wanted a Black midwife.<\/p>\n

It took the COVID-19 pandemic to get her husband on board. \u201cUp until then, he was like, \u2018You\u2019re crazy. We\u2019re going to the hospital,\u2019\u201d she said.<\/p>\n

As the COVID-19 pandemic has laid bare health care inequities, more Black women are looking to home birth as a way not only to avoid the coronavirus but also to shun a health system that has contributed to African American women being three to four times more likely<\/a> to die of childbirth-related causes than white women, regardless of income or education<\/a>. Researchers argue that the roots of this disparity \u2014 one of the widest in women\u2019s health care \u2014 lie in long-standing social inequities, from lack of safe housing and healthy food to inferior care provided at the hospitals where Black women tend to give birth.<\/p>\n

\u201cIt feels like we are needed,\u201d said midwife Kiki Jordan, who co-owns Birthland, a prenatal practice that opened early this year in a 400-square-foot storefront in Oakland\u2019s Temescal neighborhood targeting low-income women of color.<\/p>\n

Since the COVID-19 pandemic hit in March, she said, the practice\u2019s clientele has more than tripled.<\/p>\n

Images of hospitals inundated with coronavirus patients have sparked a flurry of new interest<\/a> among women of all races in home births, which account for just over 1% <\/a>of deliveries in the United States. Birth centers and midwives who attend home births say they\u2019ve been swamped by new clients since the pandemic.<\/p>\n

\u201cEvery midwife I\u2019m talking to has seen their practice double or sometimes triple in the wake of COVID,\u201d said Jamarah Amani, a Florida midwife and co-founder of the National Black Midwives Alliance.<\/p>\n

Many Americans think of giving birth at home as backward and scary, or as a quixotic practice of privileged white women, akin to cloth diaper services and home-cooked baby food.<\/p>\n

But the growing interest in home births in recent years has fueled a growing Black midwifery movement that harks back to a venerable, if long-forgotten, tradition in the United States.<\/p>\n

Jordan\u2019s practice is now 98% Black, \u201csomething I\u2019ve never seen before,\u201d she said. She provides pre- and postnatal care regardless of where women plan to deliver, though the majority of her clientele choose home births.<\/p>\n

African American infants are more than twice as likely to die as white infants, and the risks extend across social class. Tennis superstar Serena Williams\u2019 harrowing 2018 account<\/a> of her own near-death postpartum experience with a blood clot in her lungs and a cascade of life-threatening complications was a sobering reminder that even wealth and fame<\/a> are no protection from being dismissed or mistreated during one of the most vulnerable moments of a woman\u2019s life.<\/p>\n

At least three Black women<\/a> have died<\/a> in childbirth<\/a> since March in New York City, which was hit hard early on by the coronavirus. One of the women, 26-year-old Amber Isaac<\/a>, had reportedly tried<\/a> to switch to a home or birth-center delivery after not getting<\/a> an in-person appointment with her obstetrician as providers abruptly switched to telemedicine in the wake of the shutdown.<\/p>\n

For Katrina Ayoola, 29, avoiding unnecessary medical interventions<\/a> that researchers<\/a> say can lead<\/a> to dangerous maternal complications<\/a> was a key reason for switching to a home birth. As the coronavirus hit last spring, when Ayoola was around five months pregnant with her first baby, she was already frustrated with her obstetricians in Martinez, California. She didn\u2019t like their system of rotating providers, to whom she felt she constantly had to reexplain herself. The last straw was being told to go shopping for a home blood pressure monitor. They were sold out everywhere. \u201cI ended up canceling what would have been an online appointment, and I haven\u2019t heard from them since,\u201d said Ayoola.<\/p>\n

\u201cI did not feel cared for,\u201d she said.<\/p>\n

On Aug. 1, Ayoola delivered her son, Oluwatayo, at home in Fairfield with her husband, Dar\u00e9, and her mother at her side following a 29-hour labor supervised by Jordan and her partner, Anjali Sardeshmukh.<\/p>\n

\u201cAt the hospital, I\u2019d probably have had a C-section,\u201d said Ayoola, who said her home birth was \u201can amazing, empowering experience,\u201d worth every penny of the out-of-pocket $4,500 the couple paid for it \u2014 a discount, based on their insurance and income, from Birthland\u2019s typical $6,500 fee.<\/p>\n

Cost is a major barrier for poor people to access out-of-hospital births. Medicaid, the federal-state health insurance program that covers many low-income pregnant women, pays for home births in only a handful of states. Since 2015 these have included California, but reimbursement is low and bureaucratic requirements make it difficult for most midwives to accept Medi-Cal, California\u2019s Medicaid program. A quarter of U.S. states <\/a>do not even offer midwife licenses, making the practice of home birth effectively illegal.<\/p>\n

Jordan led a free-standing birth center in San Rafael that was the first in the state to accept Medi-Cal when it opened in 2016. She and a handful of other Black midwives around the country are leading the effort to make out-of-hospital births more accessible to low-income women, a group that could particularly benefit from community-based midwifery, according to a 2018 study<\/a>.<\/p>\n

Many of these birth workers are struggling to break even, but that\u2019s nothing new.<\/p>\n

In past generations, Black midwives sometimes walked miles<\/a> and stayed days with laboring women, massaging their feet, cooking and babysitting, and reading from the Bible in exchange for a few dollars or a chicken, according to historical<\/a> accounts<\/a>. Immigrants and African Americans dominated midwifery during much of this country\u2019s history, and in the South, enslaved women passed from mother to daughter childbirth techniques and remedies brought from West Africa starting in the 1600s.<\/p>\n

In certain rural pockets, Black midwives continued to deliver babies for poor Black and white families alike, even into the last century, as modern obstetrics regulated traditional birth attendants virtually out of existence. Midwives delivered half of the nation\u2019s babies in 1900 and just over 10% by the 1930s, as physicians launched a campaign to promote hospital birth as safe and hygienic, while dismissing midwives as \u201crelics of barbarism<\/a>.\u201d<\/p>\n

But in recent years, with hospital birth as the norm, the United States has registered the poorest<\/a> birth outcomes in the industrialized world. The numbers have worsened<\/a> during the past 25 years even as they\u2019ve improved <\/a>in most of the world, largely because of the disproportionate toll on African Americans.<\/p>\n

California has led<\/a> the effort to reverse that trend, cutting its maternal death rate by 55% between 2006 and 2013, though the disparity for Black mothers has persisted.<\/p>\n

Researchers have documented countless instances of pregnant African American women being ignored, drug-tested<\/a> without permission, or sutured without pain<\/a> medication.<\/p>\n

There is a growing consensus among medical researchers and social scientists that discrimination<\/a> can result in toxic stress<\/a> that causes<\/a> maternal complications or premature births<\/a>. Respectful, holistic prenatal care can improve outcomes, said Jennie Joseph<\/a>, a British-trained midwife. Her prenatal clinic in Florida serving mostly low-income women of color has had consistently low rates of maternal complications and premature and low-birth-weight babies.<\/p>\n

Joseph believes it matters less where a woman gives birth than how she is treated during the previous nine months, and most of her clients deliver in hospitals.<\/p>\n

Groups like Amani\u2019s are encouraging more midwives of color to penetrate what she calls the profession\u2019s \u201cold girls\u2019 network.\u201d Just 2% of American midwives are Black, and research<\/a> has shown that Black patients tend to do better with Black providers.<\/p>\n

There is evidence that their numbers are growing with demand, however. California now has about half a dozen licensed Black midwifery practices, including three that have opened in the San Francisco Bay Area since 2017.<\/p>\n

Camara said she wanted to support them: She\u2019s had supportive, competent white birth attendants in the past, \u201cbut it wasn\u2019t the same,\u201d she said. \u201cThis is returning to what we did before.\u201d<\/p>\n

At around 6 on a Saturday morning in mid-August, as a heat wave gripped the Bay Area, she phoned Jordan to tell her she was having contractions. Barely two hours later, the midwives helped her give birth to her son, Esangu, 8 pounds, 6 ounces, on her hands and knees on her living room floor.<\/p>\n

 <\/p>\n

 <\/p>\n

This KHN<\/a> story first published on\u00a0California Healthline<\/a>, a service of the California Health Care Foundation<\/a>.<\/em><\/p>\n

 <\/p>\n

Subscribe<\/a> to KHN’s free Morning Briefing.<\/p>\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

From the moment she learned she was pregnant late last year, TaNefer Camara knew she didn\u2019t want to have her …<\/p>\n","protected":false},"author":44,"featured_media":269013,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[37],"tags":[],"class_list":["post-269012","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","mauthors-rachel-scheier","mauthors-kaiser-health-news"],"_links":{"self":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts\/269012","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/users\/44"}],"replies":[{"embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/comments?post=269012"}],"version-history":[{"count":1,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts\/269012\/revisions"}],"predecessor-version":[{"id":269014,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts\/269012\/revisions\/269014"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/media\/269013"}],"wp:attachment":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/media?parent=269012"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/categories?post=269012"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/tags?post=269012"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}