In the early 1900s, home births and midwives were pushed out as options by the incoming wave of hospitals and the health care system being established. But even up until the 1930s, home births and midwives were still considered safer than hospitals. So, what’s changed? Actually, maybe nothing. The 2020 global pandemic has simply brought a new awareness to the many cracks within our health care system — including the fact that the United States has one of the worst infant mortality rates in the world, and Black and brown mothers and babies die at disproportionate and alarming rates.
Current abuses against WOC within our health care system during pregnancy are shocking and traumatic. They follow generations of medical traumas already acted out against Black women by medical professionals. The risks of hospitals to mothers and babies aren’t always documented by report findings (that have taken decades to publish). Black mothers enter a predominately white arena and experience unenthusiastic doctors and health care providers from the get-go, as well as inattentive and unsupportive care throughout the way. These risks in “care” are trauma inflicted upon the parents and/or baby, and inadvertent violations can be devastating, too.
Too often Black families come across an outright disregard for their experience and life. This institutionalized racism includes the widespread overuse of cesarean sections among Black mothers, as well as surgical procedures performed during the birthing process without consent; ignores of cries for help; and babies being taken away for hours immediately after birth. The list of violations of patient trust goes painstakingly on.
The 2020 Colorado Trust article “For People of Color, Could Home Births Be Safer Than Hospitals?” explains that some researchers and advocates have begun to call what Black and brown mothers experience in the birthing process throughout our health care system as “obstetric violence.” In light of this, what can we do now to aid Black and brown birthing families in Colorado?
Many steps and choices can be taken throughout the birthing process that may differ from what the health care system offers, but that doesn’t make them wrong. WOC are finding comfort in natural options that women used successfully for thousands of years. The midwifery experience is a collaborative and parent-centered approach, as opposed to being OB-GYN- or practitioner-centered. Providing relationship-based care and empowering families through not only telling them about but showing them autonomy may be some of the ways midwifery is saving lives.
As discussed in a Colorado Springs-based episode of NATAL (“Six: Brittany’s Story”), a podcast about having a baby while Black in U.S.:
“In 2018, researchers confirmed what many birth workers already knew to be true, which is that integrating midwifery care into regional health systems is strongly associated with lower rates of c-sections, preterm births and maternal and infant death.”
Unfortunately, the laws created to force midwives out of the health care system can now make collaboration between midwives and hospitals during the birthing process more complicated. Nonetheless, today home births are regarded by some doctors to be a viable option for low-risk pregnancies — simply because many doctors are fed up with a system that’s racially biased and underperforming.
The reintegration of midwifery care since the early 1990s in Colorado is a success story to back these notions. Home birth for some mothers is not an option, but midwifery care can still support a mother through her birthing process. Teams of doctors and midwives are working hard to ensure client autonomy by preparing the client well beforehand and using innovative, collaborative practices like birth plans. And when it comes to considering options for a WOC as she creates a birth plan, home birth and/or midwifery may actually be a preferred or necessary part of the plan.
In the NATAL podcast episode, Brittany’s midwife is Demetra Seriki (called Mimi by her clients) who operates A Mother’s Choice in eastern Colorado Springs. Seriki and midwifery can be seen as a light at the end of the tunnel for WOC birthing in Colorado.
Seriki, the only Black home-birth midwife in Colorado, really just wants more people to know midwives exist — and to know everyone should feel supported throughout the birthing process by their health care providers. She wants mothers to understand they have options and rights when it comes to their birthing experience in Colorado, and at-large. (Seriki has collaborated with the National Advocates for Pregnant Women and parents can access a “Rights Over My Birth” card on their website.)
Knowing what you want, knowing your rights and having a birth plan can be essential to an empowering birthing experience. Birthing mothers, families and partners should know they have options and rights as they demand justice in and outside the birthing room.
Mothers who are considering if home births could be safer should know they can be an affordable option, too. Colorado is not among the 11 states where Medicaid covers the services of certified professional midwives like Seriki, but she and her partner, Stephanie Sibert, at A Mother’s Choice offer discounted services to families with Medicaid or Tricare, or families who are uninsured or experiencing homelessness. They also offer payment plans because they believe it is truly an ethical issue to deny health care based on financial qualifications. Midwifery care through A Mother’s Choice is $40 per visit, but goes down in price after 36 weeks. After birth, visits are $20.
Seriki’s midwifery care includes both home birth services (which includes prenatal, midwifery, birth and face-to-face visits after birth) as well as prenatal open access. These two options of prenatal or home birth are designed with the client in mind. Every woman knows her body best, says Seriki, and options can show them what they may not have known they wanted.
Of course, WOC are not the only ones wondering if the health care system is the best place for a birth — only half of white mothers found their maternity care provider to be “completely trustworthy.” But for WOC in Colorado, knowing they have options and the possibility of autonomy can make all the difference.