Talking Midwives in Midtown: an Aha! Moment

Yesterday, I met an old friend for breakfast. We met at Norma's in Le Parker Meridien hotel. As we noshed on a delicious breakfast, pondered who has actually ordered the $1,000 caviar breakfast item, we had a ground shaking conversation about the role of midwives in changing the landscape for maternal health.

My fellow diner was my good friend Shirley McAlpine, a beautifully statuesque British woman. She became my friend when I lived in London and is now doing some amazing work in the U.K and U.S. about prenatal education and natural childbirth through her popular Birthwise DVD http://birthwisedvd.com/us/ and consulting work. The tagline for Birthwise is "Your Creation. Your Choice." I love that.

Shirley had just returned from the Midwives Alliance of North American conference in the Nashville, Tenn., area and she was buzzing. Her energy was infectious. And while we are both involved with maternal health issues across the board, as two black women we are also particularly concerned about the issues in our community. So the questions began to roll. Could midwives be key to helping reduce the high pre-term birth and low birth-weight baby rate that continue to plague black women of all socioeconomic levels? Could midwives help reverse the high exceptionally C-section rates among black women and reduce the shamefully rising maternal mortality rates among black women?

Shirley and I are convinced, yes. And birth center models like The Birth Place, http://thebirthplace.org an unique midwifery and women's health center in Winter Garden, Florida run by Jenni Joseph, show impressive results in reducing pre –term births.

But, why? The answer, as it unfolded before us, was in the education that midwives provide. Expecting moms who work with midwives are more informed about the birth process than women who work with doctors only. We all know that most doctors prefer that you know less, and trust them more, so that they can do what works best for them and not deal with any pesky little questions about your own life that you may have.

After all knowledge is power.

So when a woman who has had a midwife is told she needs to be induced. She knows she can ask why, if the baby's heart rate is fine and other measures she's been educated on are still ok.

When a woman whose water has broken is told that she must be induced, a woman with a midwife may have been taught that actually unless other indicators show otherwise a baby can be fine for up to 24 hours after the water breaks. It is Hollywood that has told us otherwise, and turned the water breaking into the mad dash to the hospital event that makes for great cinema but woefully misinformed moms to be.

And when a woman has a true (not Hollywood or doctor-friendly) understanding of how long the labor process can be, she won't stand for being told that a C section is necessary because it's been five hours and she hasn't dilated. She will also have been educated on the real signs of labor, so she won't go the hospital too soon where labor can be stunted by laying in a bed and you are more likely to be given unnecessary medical interventions.

These are key pieces to the puzzle. As we know, the answer is not in the prenatal care. Women are getting that. But that hasn't improved matters. The key is in the education--an education that often does not happen in its full measure at a traditional doctor's office. And that midwives can provide.

And that nuanced understanding of how black women end up on the operating table more and remain six times more likely to die from pregnancy-related complication is worth more the $1,000 caviar.

Breastfeeding On My Time

By Tangela Walker-Craft
WeNews guest blogger

I decided to breastfeed my daughter until she was 2 years old. I was the first person in my family to practice what is called extended breastfeeding since the introduction of baby formula.

I thought this was a personal decision, between me and my husband and my child, but boy was I wrong.

I taught her a few baby signs by the time she was about 9 months old, so she knew how to tell me when she wanted to be nursed. During the first year she was exclusively breastfed. By the second year she had a diet consisting of breast milk and toddler appropriate foods. During her second year, she breastfed less than the year before.

Unfortunately, unwanted and unwelcomed advice on when I should wean her came from everywhere. People that have never breastfed a day in their lives will offer their advice about when's the best time to wean YOUR baby. Even people that have never had a child will somehow know when you've breastfed long enough. Unbelievable!

If you resist their unsolicited advice, people may even switch from asking when you plan to wean to trying to scare you into weaning.

You'll likely hear, "If you don't wean her soon, you won't be able to do it." You may even get the, "She's going to start biting you when she gets teeth," threat. It's funny how most people accept that a baby will start to walk when he or she is ready, and talk when he or she is ready, but they think that there is a magic age when all babies should stop being breastfed.

Once threats don't manage to scare you into submission, the attempts to shame you into weaning may begin. You'll get the loaded, "You STILL breastfeeding that child? How old is she?"

Family members and people that feel that they can will make snide remarks about how your
child might be driving, married, or doing something else that's totally ridiculous before you wean him or her.

Things were particularly challenging because breastfeeding, especially extended breastfeeding, is not necessarily encouraged in Black families.

Like many breastfed babies, my daughter lacked the "baby bloat" that frequently occurs in formula fed babies. My well-meaning grandmother asked me dozens of times if I was sure my baby was getting enough to eat. She'd ask me, "Are you sure you're making enough milk?"

She and other members of my family refused to believe that my baby could survive on just breast milk. I was constantly guarding against my family's threats to give my daughter "real food". formula.

After breastfeeding six children of her own out of necessity, my 85-year-old grandmother seemed to view my decision to voluntarily breast feed as something out-dated or odd.

I think that moms that do not practice extended breastfeeding sometimes secretly resent moms that do. There is a competitive spirit that makes women want other women to make the same child care decisions that they've made. Women that do not, or did not practice extended breastfeeding, may feel that moms that do are judging them for their choice.

Contrary to the warnings, weaning for me was easy. Taking natural cues from my daughter during that second year, I breast fed less and less during the day time. Breastfeeding became more of a bonding and comfort activity for us at night. When I sensed that she was ready, I began telling her that mommy wouldn't have any more milk soon. My breast naturally responded by producing less milk because of the less frequent feedings.

My daughter's nursing slowed down to a few minutes only at bed time.

Over a three day period I cut the feedings down to quick bouts, which culminated in the end of what was one of the best experiences of my life. I am glad I never succumbed to the pressure to wean before we were ready, but it bothers me that such pressure exists.

Why are we so uncomfortable with extended breastfeeding?

Tanglela Walker-Craft is the creator of Go Pillow! a patented, multipurpose childcare item that allows moms hands-free breastfeeding with comfort and president of Simply Necessary Inc. After nursing her own daughter for two years, Walker-Craft, realized that there was not a product on the market that allowed mothers to have nursing privacy and cradling comfort when others were present. Existing nursing pillows were too bulky and cumbersome for travel and cover-ups on the market required too much manipulation. The GoPillow! satisfies the needs of both breast feeding and bottle feeding mothers and caregivers.


Learn more at:
http://www.simplynecessary.com/

New Study Links Race and Delayed Breast Cancer Diagnosis

It's breast cancer awareness month. And for all the much-needed talk and fundraising done to help raise awareness about this important women's issues, a new study shows a troubling link between race and breast cancer diagnosis.

African American women are more likely than white women to be diagnosed at later stages of the disease and are more likely to die from it. Researchers have long wondered why and considered lack of health insurance as a likely factor. Yet, a troubling new study says that race and/or ethnicity -- rather than insurance status – is the leading cause in these delays in breast cancer diagnosis in minority women.

Researchers at George Washington University in Washington say they were surprised to find among women with health insurance, African-American and Hispanic women experienced greater delays in diagnosing breast cancer than Caucasian women.

The number of days from abnormal screening to definitive diagnosis for those with private insurance was 15.9 days for white women, 27.1 days for black women and 51.4 days for Hispanic women.

The most staggering and disturbing disparity was among women with government insurance. In that group, delay times were 11.9 days for white, 39.4 days for black and 70.8 days for Hispanics. Among women without insurance, times were 44.5 days for white, 59.7 days for black women and 66.5 days for Hispanic women.

"We thought having health insurance would even the field among all women," researcher Heather Hoffman said in a statement. "Insured women should have had the same rapid evaluation regardless of race and ethnicity."

The study shows even further, the effects of race and ethnicity on a woman's health outcomes. And while researchers probe medical causes, there must be a deeper dive into the systemic bias and racism that exists among medical professionals and healthcare providers.

Far from a level playing field, women of color are battling against forces they can't see or control to have equitable healthcare.

So, now what?

For Our Sons Police Stops Are Part of Growing Up

Guest Blog by Dionne Grayman

My son was small for his age, having a birthday late in the year and always looked younger than he was. We all do. It's the family "curse".

When he began high school at the age of 13, I insisted upon driving him. He insisted upon taking public transportation. Living in New York City, part of the rites of passage for most of our children includes independent travel through the hundreds of miles of subway tunnels, elevated train tracks and bus routes. Daunting to tourists and suburbanites in for a show but not to the savvy city kid raised on pre-paid MetroCards and sightings of rabbit-sized rats. I won the battle the first day; he, the second. Sort of. I made him ride the bus, which was about a 90 minute ride; the train would have saved him half an hour. I gave him money to call me when he got there and he was supposed to call me when he was leaving. This was before cell phones became the mandatory kid-accessory. That would come on his third day of school, September 11, 2001.

I wanted him to ride the bus because I figured he would be safer on the bus, more protected. He had made the football team and became friends with other kids on the team who lived in our neighborhood and rode the train. Friends with names like Big Lou and Tall Mike. For a month he begged to be allowed to take the train, assured me that he would be fine, introduced me to his "bodyguards" and I relented.

And it happened, shortly after.

But we had had the conversations. I gave him pop quizzes when he came out of the shower, at dinner, in between his second and third helpings, because you never approach a hungry male asking anything-and after I had hosed him awake. And he went to private school, had his whole life. Wore a uniform which was known to every transit employee between here and there. He was articulate, bilingual, could speak "adult" as well as he spoke "teenager". He was clean cut, no earrings, no tattoos, no saggy pants, no gaudy chains. In the fall and spring, he wore the hoodie of the moment, in the winter a black Northface and black Timberlands with his oxford and khakis, just like every other young man at the all-boy school he attended-Pinero, Caluccio, Feist, Harden, Schwartz. It would be hard to tell them apart if they were all on the school steps with their faces turned away from the street parents used for pickup.

And it happened anyway.

One day, he was stopped by the police on his way home. Asked to present identification, asked where he was headed. That was the first time. The second time, he was asked for identification and frisked. Then the third time, the fourth, and the fifth. And he was patted down, had his backpack gone through, returned to him, sometimes gently, most times not.

My brother-in-law is a New York City police officer, a detective within a homicide division. New York's Finest, they're called. He gave him a courtesy card issued to officers to give to their relatives in the event they have an interaction with a fellow cop. I have used the card and received a warning instead of an expensive fine. My son has had the card thrown into his face and onto the ground. His "dealings" with the police did not end with his graduation from high school-with honors. Did not end despite his admission into nine of the ten colleges he applied to. It has not ended with his being a college senior with 3.5 GPA in a dual major. My son is no angel; he can be surly, argumentative and obstinate. He has experimented with alcohol and marijuana. He listens to rap music, I have heard him curse and I'm pretty sure he's no longer a virgin. Your typical all-American boy. Except it's only typical for African American young men and other men of color to be subjected to this kind of police treatment.

In addition to the coming-of-age conversations parents have with their children, black parents have to add the "What to Do WHEN You Are Stopped By the Police" talk to the list of ones they have with their sons. We have to, for their safety and our sanity. Because in our collective memory, there's the horrifically mutilated body of Emmet Till. There's Amadou Diallo and Sean Bell. My son's name is Sean. And every single time he's stopped, I feel I have failed him and I have failed in the God given responsibility of protecting my child.

The saddest part of all of this is he'd begun to become "immune" to being stopped. He, like too many other men of color in this city, had become desensitized to being treated criminally. They take it as par for the course; they shrug it off and most will laughingly share their war stories. But listen closely and you can hear anger comingled with humiliation and a weary, reluctant acceptance.

Not exactly the stuff that dreams are made of.

Dionne Grayman is the founder of Mothers Empowered, a coalition of mothers who are in search of their best selves and committed to the business of making this world a better place for our children. At Mothers Empowered the mission is ME! A former high school English teacher, Dionne has taught the full spectrum of New York City's children ranging from incarcerated juveniles on Riker's Island to gifted students at one of the city's most prestigious high schools. She has also served on the executive board of the Community Education Council in District 13 in Brooklyn and is the co-vice president of the PS/MS 282 PTA Executive Board. Grayman holds a bachelor's degree in English and journalism, a graduate degree in special education, and has completed CCC's Community Leadership Course. Learn more about Mothers Empowered at www.mothersempowered.org