In the past few years there has been a new focus within our birthing community, albeit on a very old problem. In health care at large and maternity care specifically, there are significant disparities between the maternal and infant outcomes of white women and women of color. This is now an undisputed fact backed up by multiple large studies. Initially the disparities were thought to be primarily related to socioeconomic differences, but that has now been disproved.
The issue is racism. And many of us totally missed it.
Midwifery in the 1980s for me (Roxanne) was the place where I was exposed to the most diversity I had ever experienced in my young life up until then. When I was a student at FBS in the 1980s we welcomed and freely served clients of all races, religions, backgrounds and income levels, treated them equally, and saw similar outcomes. In this setting it took me – and I believe many of us older white midwives – a while to recognize what was happening around us in other communities and on a larger scale in America.
Then one day I looked up and realized I was in a room with fifty midwives at a conference and only two of them were Black. With some help from patient friends, I began to unpack the fact that the reason I had been able to miss this trend in my profession all these years was my white privilege. My white privilege allowed me not to have to notice race, or to think about race as a factor in who came to train – and more importantly, who didn’t come to train – at our birthing center, or for it to dawn on me that very few of my colleagues were women of color.
I also had not been aware that in spite of the fact that while from our point of view we were freely serving many minority women and women of color in birth, there were still whole communities of women who might not be comfortable seeking us out for care because our staff was primarily white. I also never thought that the reason young women of color were not choosing non nurse midwifery as a profession and applying to our program was because there was a certain level of family and personal privilege required to be able to enter a full time apprenticeship which would require studying and attending births full time, and not earning an income for two years.
This is inexcusable, in light of the fact that then as well as now, Black and minority women and babies have been and are dying in childbirth in America at a significantly higher rate than that of white women. As midwives we should have been paying attention to this a long time ago. As one Black birth worker said to me recently, “You all are late to the party.”
(For more information and real facts on racial disparities in childbirth click here.)
As always, there are leaders and pioneers who notice trends early and lead the way for the rest of us. One of these is Vicki Penwell CPM. Vicki, in collaboration with Claudia Booker CPM and Jennie Joseph CPM have given the rest of us The Grand Challenge. The Grand Challenge is a scholarship program designed to remove barriers that women of color may face when they wish to become non nurse midwives and serve their at risk communities:
“The idea to provide scholarships to women of color in America came from discussions with my friends and colleagues who are themselves women of color in the USA. (Black, Asian, and Hispanic) They shared with me that due to economics, fewer women of color had access to CPM out-of-hospital based training programs within America. This is why we see more CNMs of color than CPMs of color, because the access to scholarship and funding programs is greater for a mainstream RN to CNM route to midwifery. However, if we are to right a centuries old wrong, it is going to take more than a handful of black and brown midwives. The population of midwives must reflect the population of birthing women within this diverse nation.”- Vicki Penwell
With apologies that it has taken us 36 years to be intentional in this area, today we are finally recognizing where we have previously failed and are taking the first step by offering scholarships to women of color for future Family Birth Services apprenticeships.
Potential students may email and request an application. Our next opening will be summer of 2018.