Midwives, Mothers, Miracles!

By Jennie Joseph

I often get a surprised response from people when I tell them I am a midwife. “Midwives are still around? I had no idea!” It seems that African Americans especially look at midwives as ‘old-fashioned’ relics of the past and certainly not necessary in today’s technological age. Well, after arriving in Orlando from London nearly seventeen years ago, I can attest to the fact that midwives are here and are becoming more and more necessary every year. We have seen a tremendous increase in the death rate for Black babies as far as prematurity and low-birth weight are concerned. A Black infant is 2 -3 times more likely to die before its first birthday than its white counterpart. African American women are less likely to be healthy before and/or during pregnancy and therefore have higher risk pregnancies and an increased death rate as well. Something is very sad about a situation like this in the most developed country in the entire world.

When I first arrived in the USA I began to research the history of midwives because I quickly learned that unlike Europeans, Americans do not choose midwives for their maternity care. I realized that to practice my craft I would have to be independent even though I had spent years working in London hospitals. I began a home birth practice, and then started a free-standing birthing center, The Birth Place, and although well- supported by Caucasian women, I could not figure out why I had such a low population of African American patients. As I began to understand the history, however, it became clear that the rural ‘granny’ midwife of the past had been pushed out of practice gradually as hospitals and physicians began to be able to be reimbursed by the government for delivering Black babies. Black women began to choose the hospital option and considered it a ‘step up’ from the standard home birth with the lay midwives. Over time it became ‘the norm’ to deliver at the hospital. Many Black people remember the midwives, most over age 50 were delivered by them and in fact up until they were eradicated, all Black people were pretty much delivered by midwives.

One of my greatest concerns for African Americans is the access to quality healthcare. In 2001 I began to look at the possibility of offering hospital birth to women of color to encourage them to consider using a midwife for prenatal care. I knew that with good, careful practice, listening to the women, educating and supporting them throughout their pregnancy, that I could impact the awful statistics that Black women were experiencing. Five years later I am thrilled with the turn around in birth outcomes in my practice. My patients are from all races but approximately 70 % are Black. Last year (2005) there was only one premature birth of amongst 150 deliveries and very few Cesareans. In other words, all of the women went to fullterm and delivered healthy babies; many initiated breastfeeding and continue to this day. Many women decided to deliver onsite at the birthing center instead of the hospital, preferring to experience a natural birth, including water birth. Especially exciting is the number of moms who come back for a second baby and or refer their friends; I currently have women coming from as far way as Tampa. Now, although the hospital choice is still available, women are opting for the ‘one-on-one’ care and attention that a midwife can give them.

The Smithsonian Museum has an amazing exhibit which is currently touring the country. It will be in Gainesville, Fl. from May 6, 2006 until June 3, 2006 at The Birth Center of Gainesville. The 19th Annual International Midwifery Day Celebration will be Saturday May 6th at 7pm and will feature the opening of Reclaiming Midwives: Stills from All My Babies, an exhibition of photographs by R. Galbraith. Let us not forget our history and the amazing legacy of these women who delivered Black America. The midwives of the past had little or no training but passed the skills down through the generations, delivering both Black and White women since slavery times. Their outcomes were phenomenal, their patients were hardy and their community respected and honored them. If saving our babies is important to you, let’s reconsider and reclaim our midwives.
Jennie Joseph © 2006