Monday, July 30, 2012

Midwife Continues to Deliver Quality Maternal Care


By Malena Amusa
WeNews correspondent


Internationally renowned midwife Jennie Joseph cradles the baby of one of her satisfied patients.
Internationally renowned midwife Jennie Joseph 
cradles the baby of one of her satisfied patients.
Credit: Jennie Joseph.
When you mention the rising rates of maternal deaths in America to an active doula or midwife, get ready for the unvarnished truth.

“This is a national health crisis that too many people are ignoring,” said Miriam Perez, a New York Based- doula, activist, and founder of the Radical Doula blog.  “Not enough people know that black women are four times more likely to die during pregnancy than white women. Other women of color have higher rates as well.

Perez thinks it's time to shake things up. “There’s greater attention to the problem of maternal mortality,” she said. “But I don’t know if the solutions are greater. We definitely need new models.”

In 2009, there were 16.1 maternal deaths for every 100,000 live births, according to unpublished data provided by the Health Resources and Services Administration - -that’s up from 12.7 in 2007. At a time when dozens of countries are decreasing their rates, conditions are worsening in America. In New York City where Perez is based, there were 69.3 black maternal deaths per 100,000 live births in 2009, the city’s vital statistics revealed. Although America spends more on health care than any another nation, being black and pregnant in New York City spells greater risks than being pregnant in Costa Rica, Iraq, or Kazakhstan. Nationally black women continue to be at a higher risk of maternal mortality and that’s despite the mother’s income or education-level. 

Perez said the hospital it not always a safe zone for mothers.  Maternity ward doctors may not treat patients in a holistic manner and insurance companies are reluctant to pay for midwives and doulas.

In Winter Garden, Fla., outside Orlando, Jennie Joseph runs a community-based midwifery clinic called the Easy Access Prenatal Care Clinic. A one-day free clinic occurring every week, this service provides a vision of how different things could be.

It caters to low-income women regardless if they can pay or not. The Easy Access clinic is funded by Joseph’s midwife practice The Birth Place -- and takes care of any woman who walks through the door.

“If you’re pregnant we’ll take care of you," said Joseph, a pioneering midwife. "We’ll get you maternal care and educational info, examine your belly and listen to the baby’s  [JJ1] heart beat. If you need a proof of pregnancy or the fax number for a birth certificate – it can be financial, medical, or social, we cover all these angles.”

These components make up “The JJ Way” which in a 2006 study of 100 women in the Easy Access program was correlated to dramatically reduced rates of pre-term births and infant morbidity.  The JJ Way Maternal Child Health Care System is specifically designed to address the perinatal health woes experienced by African American pregnant women and their infants – and has been recognized nationally as a best practice for maternal and child health. In 2010, Joseph opened her own school called the Commonsense Childbirth School of Midwifery in January 2010. The following year, Joseph’s work was featured in super model’s Christy Turlington Burns’ documentary “No Woman, No Cry,” which examined global pregnancy issues and aired on the The Oprah Winfrey Network.

“One woman came in for her first visit and her blood pressure was 210 over 110," Joseph said, explaining one patient’s struggle. "She was 21, already had two children, and was pregnant.

“That same morning we referred her to the hospital, which gave her medicine and sent her home. She had no insurance. So when she went for a follow-up visit and her blood pressure was still high, the hospital told her to see her Ob-Gyn tomorrow, but she didn’t have an Ob-Gyn because she had no Medicaid. With no one to fill that gap, she came back to me because she could. With our lab work and records, we were able to send her to a perinatologist who accepted her without insurance. Later, her Medicaid kicked in, and her blood pressure went down after getting the right kind of medicine.”

The opportunity for this highly-accessible, resources-driven, and midwife-assisted care to help women is tremendous.  Women who participated in Joseph’s internal study tracking infant outcomes lauded the clinic’s for being “really nice and personable”, “very informative” and helping women “make your own experiences.” “[I] wish there were 100 Jennie’s”, one mother reported. 

It’s not certain if this level of care will be replicated in hospitals and clinics across America, but as time goes on, it’s evident that The JJ Way is needed for mothers and their babies.

“Our health care is so compartmentalized,” Perez said. “You go to this provider for this problem and another for that problem. Providers don't have the time and framework to treat patients in a holistic manner. But you really need a provider who can see the big picture of your life. And that’s where midwifery comes in. It brings the holistic perspective to your care and is patient- centered. The patient’s needs and community are the center of it.”

Malena Amusa is a freelance reporter based in St. Louis.


To see the Malena Amusa's full story go to:  http://womensenews.org/story/reproductive-health/120729/us-health-law-may-curb-rising-maternal-deaths




 [JJ1]…and here, may ‘listen to the baby’s….’ or ‘hear the baby’s heart beat’

1 comment:

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