Why Midwives And Maternal Health Need To Go Hand-In-Hand

May 5, 2011

On the International Day of the Midwife, we have a guest post from Jennie Joseph, a midwife in Winter Garden Florida. Jennie is owner and clinical director of The Birth Place, a full-service midwifery clinic and birth center and developer of the JJ Way, a midwifery curriculum geared toward eliminating disparities. She is featured in Christy Turlington Burns’s documentary “No Woman No Cry” that we blogged about yesterday.

Talk is cheap! But right now talk is also becoming effective! When it comes to mothers and babies it appears that recent talk is finally leading to action. Thanks to social networking I am beginning to hear talk from ‘the grassroots’ about the state of maternal and infant health and the need for a drastic change.  If we are ever going to be able to do better than ranking 50th in the world when it comes to maternal mortality, then let’s keep talking.

We can talk about the facts. Amnesty International brought our focus front and center with the publication last year of Deadly Delivery: The Maternal Health Care Crisis in the USA.  It was a wake-up call for so many. Historically we focus on the dire situations of third world countries and direct our humanitarian efforts oversees.

Deadly Delivery pointed out the truth; that right here at home women are dying giving birth and worse yet, in many cases we don’t even really know how, why or where. Sadly, African American women are disproportionately at risk; 3-4 times as likely to die as White women.  The fact is, that of the four million women who give birth in the US each year, every 15 minutes there is a woman in serious jeopardy battling  a ‘near-miss’ incident which could take her life and leave her baby without a mother. And then there are those that actually lose that battle and die. Yes, let’s keep talking.

We can talk about how we got here. The American system of maternity care is different to most other systems around the world because it depends on highly trained surgeons and specialists to manage and deliver babies for normal, healthy and straightforward cases. The system is structured around perverse incentives that maintain the billions of dollars generated for such service, at the expense of women’s health. Worldwide, women are cared for and delivered by midwives – practitioners trained as experts in normal physiological pregnancy and birth. Midwives delivered the vast majority of Americans until the early 20th century when physicians began to expand their practices and encouraged women, especially the affluent, into hospitals for delivery.

Today we find ourselves with a situation out of control, birth is becoming riskier. For example, national cesarean section rates are so high at 33%, with some hospitals reporting 50%, that women are at risk for surgical births simply due to the ‘cascade of interventions’ that has become standard hospital fare. There is no other explanation for this turn of events – American women do not collectively have smaller pelvises than the rest of the world! Our system is broken and our women are dying. Yes, let’s keep talking.

We can talk about what to do now. Today, May 5th is International Day of the Midwife. There are celebrations, walks and rallies going on around the world and throughout the United States.  The International Confederation of Midwives is holding its 29th Triennial Congress in Durban, South Africa in June this year with an anticipated 3000 midwives attending. Today’s walks are the beginning of a symbolic ‘Walk to Durban’ in solidarity with all the worlds’ midwives and will culminate in the actual 5k walk into Durban that will open this historic conference. American midwifery is strengthening and we are here to serve. I salute all the practitioners, provider agencies, consultants, policy makers, professional organizations and consumer organizations that care enough to stand for change.  And as the informed and empowered grass roots supporters of American midwifery mobilize today and reflect on this unnecessary life and death struggle I simply have one question – CAN WE TALK?

Jennie is hosting an Amnesty International watch party for the premiere of No Woman No Cry on the Oprah Winfrey Network this Saturday, May 7 (the night before Mother’s Day), at 9:30 ET/PT and again on Sunday, May 8 at 1pm ET/PT. You can too! Register today. This Mother’s Day, Amnesty International is helping drive the conversation around maternal health with Mother’s Day action cards, lobby visits to members of Congress, and more. Find out more at amnestyusa.org/mothersday.