The prevalence of medical racism and bias in the healthcare space presents dangerous challenges for Black expectant mothers across the country. But, where general obstetricians lack the cultural competency to serve Black families with the proper care that they need, Black midwives commonly stand as a viable line of defense against poor maternal and infant health outcomes.
In a time where U.S. hospitals rank high in their quality of obstetrics and gynecology services worldwide, somehow, Black women are still the most likely to die from complications related to childbirth or pregnancy.
“Black women are three times more likely to die from a pregnancy-related cause than white women. Multiple factors contribute to these disparities, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias,” according to the Centers for Disease Control and Prevention (CDC).
Racha Tahani, founder and CEO of Gather Grounded Midwifery, knows about the disparities Black women face all too well.
“The folks that are coming into midwifery care, oftentimes, have been on the receiving end of not being heard, not being respected, mistreated, traumatized, even sometimes, by the health system.”
Tahani, owner of the first Black birthing center of Central Virginia (located in Richmond), serves a dire need in a community of mothers seeking a nurturing escape from the negligence reported in general obstetric practices.
Whether it be amid wellness visits, pap tests, mental health checks, or even searching for therapists who understand what it is to be African American, Tahani noted the perils Black women often face when seeking physicians who can accurately address the myriad of experiences inherent in Blackness.
“[Black women are] going into places where racism is to this day, still being upheld in the teaching of medicine and reproductive health,” Tahani said.
A Long History of Black Midwives
While general obstetrics has become the normalized form of maternal care for expecting mothers, midwifery actually predates medicine. In the United States, Black women in the south and rural areas depended on their midwives to carry out a healthy and successful childbirth.
Tahani contends that once midwifery was seen as a financial to the money-making in reproductive health, it became federally eradicated, largely impacting women and infants in southern states.
“In the South, the majority of Black folks were receiving their care from midwives. They weren’t going to the hospitals. They weren’t going to white doctors, either because they didn’t want to or they didn’t feel safe doing so. And as soon as midwifery was removed from Black communities, we saw a dramatic change in our health disparities, because we were going into places where we were not welcome,” Tahani told the Informer. “Midwifery has always been the answer. It’s just that it has become that midwifery is seen as an alternative or often for those who are well off, when the reality is that midwifery is for every single person.”
Further, research conducted by the National Partnership for Women and Families (NPWF) and other entities have shown that midwifery care, provide equal or better prenatal and postnatal care to expecting mothers in comparison to physician care on numerous indicators, including reduced perinatal mental health concerns, continuity of care, trauma-informed care, early identification and intervention, and higher rates of breastfeeding to name a few.
The magic of midwifery lies in the specific care model that addresses physical and mental health challenges for their patients before the onset of a serious issue that threatens the pregnancy. These preventative measures fill such a critical gap in the maternal health space, especially for those mothers affected by racial and socioeconomic inequities.
“Our maternity care system spectacularly fails communities struggling with the burden of structural inequities due to racism and other forms of disadvantage, including Black, indigenous, and other communities of color; rural communities, and people with low incomes,” NPWF surmised in the report “Improving Our Maternity Care Now Through Midwifery.”
Midwives offer a cultural competency that provides patients with the support they need to feel empowered, as opposed to the fear many feel when sharing their relational, financial, or other personal challenges with general obstetricians out of the fear of judgment.
When considering the Black maternal health crisis, Tahani laments that midwifery has historically offered the necessary long-term care needed to prevent the negative health outcomes that Black women continue to find themselves experiencing from the lack of proper care in general medical spaces.
“Midwives, Black midwives and indigenous, have always known the things that people are now making catchphrases [for]: trauma-informed care, reproductive justice, mental wellness, cultural competency…. We called it care,” Tahani emhasized. “Our model is that we care for our community [and] that we are committed to keeping our community safe, because we know that our communities thrive and grow based upon how people are treated in pregnancy, how those babies are born and then, thus impacting how those babies are raised.”