Yesterday, I met an old friend for breakfast. We met at Norma’s in Le Parker Meridien hotel. As we noshed on a delicious breakfast, pondered who has actually ordered the $1,000 caviar breakfast item, we had a ground shaking conversation about the role of midwives in changing the landscape for maternal health.
My fellow diner was my good friend Shirley McAlpine, a beautifully statuesque British woman. She became my friend when I lived in London and is now doing some amazing work in the U.K and U.S. about prenatal education and natural childbirth through her popular Birthwise DVD http://birthwisedvd.com/us/ and consulting work. The tagline for Birthwise is "Your Creation. Your Choice." I love that.
Shirley had just returned from the Midwives Alliance of North American conference in the Nashville, Tenn., area and she was buzzing. Her energy was infectious. And while we are both involved with maternal health issues across the board, as two black women we are also particularly concerned about the issues in our community. So the questions began to roll. Could midwives be key to helping reduce the high pre-term birth and low birth-weight baby rate that continue to plague black women of all socioeconomic levels? Could midwives help reverse the high exceptionally C-section rates among black women and reduce the shamefully rising maternal mortality rates among black women?
Shirley and I are convinced, yes. And birth center models like The Birth Place, http://thebirthplace.org an unique midwifery and women’s health center in Winter Garden, Florida run by Jenni Joseph, show impressive results in reducing pre –term births.
But, why? The answer, as it unfolded before us, was in the education that midwives provide. Expecting moms who work with midwives are more informed about the birth process than women who work with doctors only. We all know that most doctors prefer that you know less, and trust them more, so that they can do what works best for them and not deal with any pesky little questions about your own life that you may have.
After all knowledge is power.
So when a woman who has had a midwife is told she needs to be induced. She knows she can ask why, if the baby’s heart rate is fine and other measures she’s been educated on are still ok.
When a woman whose water has broken is told that she must be induced, a woman with a midwife may have been taught that actually unless other indicators show otherwise a baby can be fine for up to 24 hours after the water breaks. It is Hollywood that has told us otherwise, and turned the water breaking into the mad dash to the hospital event that makes for great cinema but woefully misinformed moms to be.
And when a woman has a true (not Hollywood or doctor-friendly) understanding of how long the labor process can be, she won’t stand for being told that a C section is necessary because it’s been five hours and she hasn’t dilated. She will also have been educated on the real signs of labor, so she won’t go the hospital too soon where labor can be stunted by laying in a bed and you are more likely to be given unnecessary medical interventions.
These are key pieces to the puzzle. As we know, the answer is not in the prenatal care. Women are getting that. But that hasn’t improved matters. The key is in the education–an education that often does not happen in its full measure at a traditional doctor’s office. And that midwives can provide.
And that nuanced understanding of how black women end up on the operating table more and remain six times more likely to die from pregnancy-related complication is worth more the $1,000 caviar.