January 23, 2009
Born and raised on the ocean in Santa Barbara, California, I now make my home in Washington, DC. Since leaving California seven years ago, I've been blessed with opportunities to travel and live in Central America and Africa, alternately finding homes in Washington, Ghana, Guatemala, Uganda and Kenya. It was through my travels and interludes in the lives and worlds of other women that I settled onto the professional path of maternal and child health. In Africa I became especially interested in reproduction. I came to feel that reproduction had to be at the center of any discussion of women's rights and empowerment. If we care about emotional, spiritual and political empowerment, we must also think more practically about physical empowerment. In my mind, at the most basic level, this is about being able to choose when and how we have sex, become pregnant, give birth and raise children. While working in a very rural maternity ward in Eastern Kenya, I saw pregnancy and birth in many contrasting lights. I saw a young twenty one year old woman labor patiently to deliver her first baby boy, her partner tender and encouraging her to breastfeed immediately after the birth. I saw an emergency cesarean performed without oxygen, blood, or proper anesthetic deliver forth two tiny but healthy twin boys. I arrived in the morning to hear of two women who had come in the night with their anemic uteruses ruptured, both babies and one mother lost, the other in uncertain recovery. And so I came to see birth, particularly in Africa, as both a curse and a possibility, as both terrifying and beautiful. Maternal mortality rates in parts of sub-Saharan Africa are estimated at 40%- how depressing, and yet, what an obvious target for change and improvement.
I was delivered into this world by my mother, and by a midwife named Middie. And midwifery, I am convinced, offers one piece of the solution to maternal and child health disparities both here in my home country of the United States, and also throughout the world. The US, despite being one of the wealthiest, most developed nations in the world, has comparably poor maternal and infant outcomes. In many countries, France and England included, midwives care for the majority of normal pregnancies, providing prenatal care and attending deliveries. I imagine a future in which the US model of care looks more like this, and in which midwifery is cultivated on a grass-roots level throughout Africa, embracing the best aspects of traditional birth attendants and increasing local capacity for the provision of high-quality maternity care.
For now though, I work in a wonderful birth center in NE DC. I work with a committed group of midwives who are doing their part to put a dent in the health disparities in our nation's capital (in DC, infant deaths for African American women occur at five times the rate of white women). I attend births as a volunteer doula and work full-time in the center, while taking classes at night to get my BSN and eventually my masters in midwifery. Attending births here, I often see the faces of laboring mothers in Africa. Birth is truly a universal experience among women, we all are birthed or give birth at some point in our lives. And that moment of birth, when a tiny new person slides into the world, is universally beautiful and momentous, regardless of location. Wouldn't it be nice if it was also universally safe and if the quality of care a woman received in that moment did not vary so greatly along the lines of race, income and region of the world?