How can midwifery truly be made accessible to communities of color?

Right as 2011 was wrapping up two articles were posted about home birth and midwifery revivals in communities of color. Having written about the question of race in the home birth movement back in 2009 for RH Reality Check in these two articles, I’m excited when new outlets pick up the story. There is much movement in this arena, and also much more than can be done to make sure US midwifery is accessible to people of color.

In New America Media, Valeria Fernandez writes about efforts to revive Mexican midwifery in Arizona:

Marinah Valenzuela Farrell is one of only a few licensed midwives in Arizona. Though it isn’t a profitable venture, helping mothers bring their newborn children into this world is for Farrell a calling deeply rooted in her native Mexican tradition.

“It is really hard to be a midwife,” said the 41-year-old. “You don’t sleep, and you don’t make money. People think you’re crazy because you’re doing homebirths.”

A majority of Farrell’s clients are middle class and white, though as a Latina she aims to make midwifery accessible to low-income women in dire need of prenatal services but too afraid to seek them out in a state virulently hostile to undocumented immigrants.

“I think they don’t know that we exist,” she said. “I think the more the community knows that there’s a midwife who will come and visit them at home and do a homebirth… [attitudes] will change and shift.”

I spoke to the author while she was working on the piece, and a quote of mine is included toward the end.

In The Grio, Chika Oduah writes about black women and home birth. The article includes a video, which is a good primer of the issues at hand with home birth. It also references my Colorlines article about the possible connection between maternal health in communities of color and access to midwifery care.

What is clear from the research about this issue is that women of color are less likely to receive midwifery care, and that disparity is larger than the population numbers would suggest. I think this dynamic is complicated by global sociopolitical historical factors. For example I experienced resistance from Latina immigrant women to midwifery care because of the stigma toward parteras (midwives) in their home countries. In many places in Latin America, midwives and home birth are seen as the option used by women who can’t afford to go to hospital for birth–basically an option only for those who have no other option.

That creates class and race stigma on home birth and midwifery care.

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