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Understanding Inequities & Disparities in Healthcare
· Implicit Bias and Health Care Inequities Brian D. Smedley, Joint Center for Political and Economic Studies
· Closing the Gap: Solutions to Race-Based Health Disparities Applied Research center
Perinatal Outcome Health Disparities in the US
The Black Maternal Health Crisis & Midwives of Color
Diversity Matters: What Are Our Challenges, NACPM Webinar (2017), :Dr. Keisha Goode and Dr. Nancy Anderson
Models To Explore
Cultural Appropriation : AORTA (2015
How To Apologize
How Not to Apologize Fakequity (2016)
I’m Sorry If I Caused Offense’: How Not to Apologize, Psychology Today (2017)
The perfect apology Rami Ismail (2017)
How To Be In Community
Five Ways to Center People of Color Fakequity (2018)
What White Midwives Can Do To Be Better Accomplices in Birth Justice (2017)
Asian American Wellness and Midwifery
Susan Smith, Japanese American Midwives: Culture, Community, and Health Politics, 1880-1950 (University of Illinois, 2005).
First Nations Wellness and Midwifery
Joyce Follett, “Interview with Katsi Cook,” Voices of Feminism Oral History Project, Smith College (2005)
The geography of belonging: The experience of birthing at home for First Nations women: J. Kornelsen, et al. Health & Place 16, no. 4:638-645
For All Those Where Were Indian in a Former Life Andy Smith, The Peoples Path
Black Wellness and Midwifery
“My Body, My Pain: Listen to Me and All Black Women,” Vanessa Fabien, The Root (2017)
The Ina May Gaskin Racial Gaffe Heard ‘Round the Midwifery World, Samantha Griffin Rewire.News
"Death by Delivery" (documentary), Fusion (2017)
"Racial Disparities in Birth Outcomes and Racial Discrimination as an Independent Risk Factor Affecting Maternal, Infant, and Child Health" (read executive summary through recommendations), MANA (2015)
Immigrants and Refugees
Understanding the Refugee Experience (Webinar)
Additional Books for Further Reading (Optional)
Patricia Gonzales, Red Medicine: Traditional Indigenous Rites of Birthing and Healing (University of Arizona Press, 2012).
K. Bridges, Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization (Berkeley: University of California Press, 2011).
Sharla Fett, “Consciousness and Calling: African American Midwives at Work in the Antebellum South,” in New Studies in the History of American Slavery Eds. Edward E. Baptist and Stephanie M.H. Camp (Athens: University of Georgia Press, 2006). Article available through Google Books.
J. Fried Stillman, et al. Undivided Rights: Women of Color Organize for Reproductive Justice (Cambridge: South End Press, 2004).
Deirdre Cooper Owens, Medical Bondage: Race, Gender, and the Origins of American Gynecology
Harriet Washington, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (New York: Doubleday, 2006).
NMI Media Library Resources
Access the Media Library HERE
● MA1707: Black Women Birthing Justice - Dr. Sayida Peprah, PsyD
The “Battling Over Birth” research study justice project releases the power of collective knowledge and action. It is the documentation of 100 black women’s birth stories. These stories reveal repeated reports of medical coercion and over-medicalization. They unpack black women’s attitudes toward birth alternatives and set the platform to build a campaign for change.
● MA1710: Plenary 2 - Midwives In Cuba - Geradine Simkins, CNM, MSN; Marina Alzugaray, MS, CNM, ARNP; Diane Holzer, LM, CPM, PA-C ; Yeshi Neumann, CNM, MA, MPH & Ana Ester Rivero, MS, NM
As US and Cuba have reopened embassies in each other’s country, and travel bans have been loosened, the ongoing normalization of relations provides opportunities for meaningful dialog and cultural exchange among women and midwives of two nations. This presentation will share the process of people-to-people educational exchanges that occurred among numerous Cuban women, traditional Cuban healers, Cuban health service providers, and American midwives in 2016 and 2017.
● MA1712: Reclaiming Indigenous Midwifery- Stories Of Honoring Ancestral Knowledge, Resisting Medical Colonization And Returning Birth To Native American Communities - Rhonda Lee Grantham, Midwife & Autumn Cavender-Wilson
Midwives & healers have forever served their communities throughout the journey of pregnancy & childbirth. But for many of today’s Native American families the realities of intergenerational trauma, forced relocation, and Indian Health Services policy have resulted in both disconnection and undeniable health disparities. But the resistance is growing and indigenous communities are demanding to keep their families together and their communities whole. As we honor the truth that birth is both a physical experience and a sacred ceremony, we are restoring family traditions while healing generations. From community- based doula programs to birth centers to midwifery at Standing Rock, the movement to Reclaim Indigenous Midwifery is here.
● MA1713: How To Use A Racial Equity Toolkit For Decisionmaking In A Predominantly White Organization - Wendy Gordon, LM, CPM, MPH
This session is geared primarily toward leaders in predominantly white midwifery organizations. Decisions are often made by white leadership without being aware of the white-dominant context of those decisions. Incorporation of a racial equity toolkit can help to create an intentional pause in the decision making process to consider all policies, initiatives, and actions with a racial equity lens. Examples of the components of a midwifery- specific racial equity toolkit are included.
● MA1722: Whiteness And Racism In Birth In The US - Heather Thompson, MS, PhD & Zoë Williams
This session will provide an overview of how racism emerges personally and systemically in general, and especially in birth. A discussion of the history of race in the US will provide a backdrop for the de nitions of important terms, historical review of race and birth in the US. Participants will learn about how race a ects birth outcomes through both physiologic factors and healthcare system inequities. This session will end with a discussion of the racial factors at work in the current “natural” birth movement and what participants can do to begin to incorporate racial awareness into their practice.
● MA1738: The Giving Voice To Mothers Study - Communities Of Color Speak Of Disrespect And Inequity In Access To Birth Options - Saraswathi Vedam, RM FACNM MSN SciD
The Lead Investigator of the Birth Place Lab and convenor of the Home Birth Summits speaks on new research and tools and the landscape of patient oriented research so we can better understand the discrepancies in women’s experiences of maternity care and treatment by care providers, based on race and socio-economic status. We will learn about global initiatives to address respectful maternity care and ways to increase equitable access to choice of birth place and autonomy in decision making for all women in the US.
● MA1739: Plenary 8 Birth Justice 101 - Jamarah Amani, LM, CLC, Community Midwife
Black low income women have a higher primary c-section rate than any other group. In the United States, Black women are almost four times more likely to die from pregnancy- related causes than white women and black babies are more than twice as likely to die in the first year of life as white babies. How do interpersonal, institutional and internalized racism impact life and death in our communities? How do poverty, immigration status, economic disparity and various forms of discrimination ffect an individual’s ability to receive quality reproductive health care? What is the responsibility of midwives who have historically been advocates for and caretakers of people from marginalized communities?
● MA1634: Transgender Cultural Competency 101
As the USA becomes a more diverse nation, health care systems and providers need to respond to patients’ varied perspective around health and well-being. Providers will explore skills to develop more inclusive practices.
● MA1636: Strengthening Midwifery in The Caribbean - Debrah Lewis
In 2012 a group of 30 midwives representing 13 Caribbean nations met with the goal of launching a regional midwifery association. The goal of the fledgling organization was to provide a forum for a united voice for midwifery and a way to share and knowledge across multiple governments and regulatory bodies. In two years, the CRMA has become a strong voice for midwifery in the region as well as a sponsor of educational opportunities for member countries. This presentation will describe the development of the CRMA, its progress toward representation at regional and global levels, and the active work to strengthen midwifery education. CRMA presenters will address the challenges of working across 13 nations, a variety of regulatory and educational systems and small budgets. The achievements of the regional association can offer important global lessons for development of strong collaborative midwifery networks.
● MA1638: Plenary 9 - North American Midwifery - MANA, CAM, and Mexico Association alliance - Cristina Alonso
This panel discussion will explore the current state of midwifery in North America. Examination of new developments in the Mexican midwifery system, education and regulation of Native American/Aboriginal midwives in Canada and common trends in North American Midwifery in 2016.
● MA1506: Beyond White Bellies: Reflecting Families of Color in Birth Imagery - Carrie Murphy; Esperanza Dodge
This session will present an analysis of the imagery of pregnancy and birth as seen in pregnancy manuals (books, pamphlets, etc) as well as birthing websites, both mainstream and those geared towards unmedicated birth. Participants will be able to identify why and how the majority depiction of white women is dangerous and problematic for pregnant people both emotionally and mentally, and come away with a greater awareness of systemic racial and socioeconomic inequities in maternity care today.
● MA1508: Plenary: Umbilical Cord Stories - Navajo Perspective - Ursula Knoki-Wilson, CNM, MSN,MPH
An exploration of Navajo cultural views and meanings of the umbilical cord, the importance of keeping the sacred in Navajo birth practices and the human experience of umbilical cord stories and connection to other cultures.
● MA1511: AME Presents: Forgotten Midwives: A Better Look at the History of Midwifery - Neve Gerke, LM, CPM, MSM; Eve German, LM, CPM, MSM
Most history written about United States midwifery focuses only on the political side of midwifery's demise and the medicalization of birth, making no acknowledgement or analysis of ways the issues of race, class, and privilege contributed to midwifery's mid-century disappearance from the U.S. healthcare system. Our research utilizes the specific lens of Native American, African American, and Japanese American midwives in Washington State to show through their stories and history how the loss of midwifery was not only the result of a choice to uphold the rising medical field and extinguish traditional healthcare systems, but was also the result of social and racial discrimination. We draw direct parallels to the effects of both medicalization and racism on midwifery nationally then and now, but more importantly to how these same events are directly connected to today's devastating health disparities. We feel strongly that this in-depth study of midwifery history brings clarity and insight into the events that created these disparities in the first place, and therefore instructs us as a profession in how we might work to resolve health inequities today. Identifying specific ways that racism shaped the midwifery of the past—and our current system—is deeply relevant to today's activism, bringing important clarity to the complex problems our profession faces today, empowering us to gain vital insight as midwives and leaders in our efforts to help midwifery fully thrive in our current healthcare system, and to overcome barriers to both midwifery education and midwifery care.
● MA1524: Bringing Cultural Diversity to Midwifery - Tamara Joy Littles, RN, BSN, SNM; Nandi Andrea M. Hill LM, CPM; Felina Ortiz, CNM, DNP; Michelle Pino, CNM, MSN; Nichele R. Salazar, CNM, MSN; Brittany K. Simplicio, CNM, MSN; Hien Tran, SNM, RN
We will examine health disparities and the growing field of epigenetics, or how racism affects the health of women and their children. The discussion will include the importance of increasing the number of midwives of color, in order to address these issues. The rich history of midwifery, including the Partera and Curandera in New Mexico will be examined as well as an overview of the pathways and challenges for culturally diverse students of midwifery. We will also identify the strengths and assets women of color bring to midwifery.
● MA1533: Fostering the Future of Latina Midwifery Care - Vanessa Caldari, Melissa Cheyney, PhD, CPM, LDM
International midwifery is in the early phases of acknowledging and attempting to rectify its underlying "white savior complex", where midwives have historically used international midwifery practices and schools to meet their clinical requirement for their education, while often simultaneously (and inadvertently) undercutting local and traditional midwifery practices. As a labor of love and with an emphasis on maternal, infant, and family well-being, midwifery has the potential to de-colonize practice through the engagement of community-led research, collaborative midwifery practice and service-learning. Community-led collaboration requires that the local community determine their own needs for research, resources, and support and that the researchers function within the parameters of these locally-identified needs, bolstering the support system and providing assistance and access to resources as requested by the community. The importance of community-led collaboration may be widely acknowledged, yet the pragmatics of decolonizing midwifery on the ground and in practice is still largely uncharted territory. On this panel, we talk about our experiences of wading through the "how to's" of a community-led collaboration between Puerto Rican parteras and activists, birth professionals and academics at Oregon State University (OSU), and the Midwives Alliance Division of Research. We share lessons learned in this evolving collaboration as we work to improve maternal and infant health within a middle-income, colonized nation.
● MA1403: Saving Ourselves - Black Midwives and Doulas Impacting Inequities—Sherry Lenore Payne RN MSN CNE IBCLC
This session examines the state of childbearing and maternity care in the African-American community, with a review of the literature, and a subsequent look at successful community-led models around the country driven by the resurgence of Black midwives and doulas and their impact on birth outcomes and breastfeeding rates.
● MA1409: What You Don’t Know Hurts Us: Racism, White Privilege, and Perinatal Health Inequities—Sherry Lenore Payne RN MSN CNE IBCLC
This workshop examines the issue of health inequities in the African-American community and how why white privilege promotes those inequities. We will discuss common barriers to care and health promotion and how practitioners can increase their own awareness of the problem. Finally, we will look at strategies for eliminating disparities through purposeful assessment and examination of beliefs and attitudes and the policies that proceed from them. This workshop offers practical steps that anyone can take to begin to rid themselves of bias in the provision of care.
● MA1416: AME Presents - Out of Country Clinical Placements - Calling the Question for MEAC Schools—Wendy M. Gordon CPM LM MPH, Mary Yglesia AND Ida Darragh CPM
Stating it is beyond NARM’s capacity to oversee or assure the quality of clinical training in dozens of world-wide sites, NARM will not accept clinical experiences for PEP applicants in out-of-country clinical sites after June 1, 2014. In light of NARM’s position, MEAC has convened a committee to study clinical placements in out-of-country settings for students in MEAC accredited midwifery programs. Informing this work is a history of participation by students and apprentices in maternity sites, specifically in Africa, Asia and Latin America, where European hegemony created historical, unequal long-standing relationships that have existed for centuries. Coupled with lack of diversity in the CPM community, this fostered a climate where programs which arrange clinical placements for CPM students have been criticized for inappropriate or naïve abuse of power over childbearing women to obtain clinical experiences for certification. These foreign clinical placements may jeopardize human dignity through cultural arrogance and ignorance. The MEAC committee is looking at all facets of out-of-country clinical placements for students in MEAC accredited programs. We will report the committee’s findings and create an opportunity for educators to bring forward important issues for discussion on this topic. For example: Is there value in out-of-country clinical placements for student midwives and birthing women, their families and communities? What is the risk to the women and babies by having students provide their care? What is the risk to students who are ill prepared and possibly inadequately supervised? Can systems be put in place to protect and benefit all involved?
● MA1418: Supporting Muslim Families in the Childbearing Year: A Guide for Midwives—Shannon Staloch LM CPM IBCLC and Krystina Friedlander
Like other Americans, Muslim families are increasingly seeking out midwifery care. This session is designed to sensitize midwives to the incredible diversity of religious and cultural preferences that color the childbearing experiences of Muslim women, thus giving midwives the tools to better navigate issues related to working with Muslim families. The session will cover a range of topics, including varying definitions of modesty, the relevance of gender roles, the complex relationship between culture and religion, Muslim comfort with birth control, expectations about circumcision, Islamic traditions around birth and babies, fasting in Ramadan for pregnant and breastfeeding mothers, and more. We also plan to share the results of the first-ever American Muslim Birth Survey. We anticipate that the results will show a community of women who have larger families than average American women as well as higher rates of natural birth and extended breastfeeding. These results, we hope, will inspire midwives to reach out to Muslim women, part of a community that numbers anywhere between 2.5 to 7 million people in the United States. We will share strategies that midwives can use to promote midwifery care to the Muslim families in their local communities. Midwives will leave this session with an increased and more nuanced understanding of Muslim traditions and practices around birth and their implications in midwifery care.
● MA1427: HOW Equity?—Sam Killermann
Gender is one of those things everyone thinks they understand, but most don’t really understand at all. Kind of like the usage of the word “irony” (isn’t that ironic?) Sam will explain the complexities of gender, highlighting the obstacles with healthcare. He’ll follow up with a discussion to brainstorm strategies for dismantling these barriers. 1CEUs will be applied for from MEAC for this session.
● MA1429: Panel - Midwifery in Native American Communities - The Challenge
● MAX05: African-American Mothers and Prematurity and LBW in the US - A Qualitative Analysis of CPM Prevention Narratives—Melissa Cheyney PhD, CPM, LDM and Arika Makena Bridgeman-Bunyoli MPH
● MAX09: Ethics and Social Justice in Midwifery Education—Wendy Gordon CPM, LM, MPH and Illysa Foster CPM, LM, M.Ed
● MAX12: The Stories We Tell - Addressing Racism and Inequity in Midwifery— Sheila Capestany MPH, MSW
● MAX14: Birthing Social Change in Midwifery Education—Wendy Gordon CPM, LM, MPH
● MAX24: Religious and Cultural Considerations When Serving Muslim Families—Aisha Al Hajjar AMANI
● MAU06: Teaching Cultural Competency To Midwifery Students
● MAU21: Keynote Address - Makeda Kamara
● MAU37: Trauma, Discrimination & What Makes People Choose