• In the beginning, you were revered. You were wise women and assets to your communities. Your power was immeasurable. You became a target. They called you UGLY, IGNORANT, and DIRTY. They blamed deaths on you. They tried to manipulate you and to turn your people against you. They tried to exterminate and to replace you. You are still here. You are still fighting. Please come forward and make yourself known. You are needed.

    images found in AJN, Vol 100(10), Oct 2001, pp 50-56

For Immediate Release - New Collaboration between CCSM and SWTC Midwifery Program

December 23, 2011. Fennimore, Wisconsin. We are pleased to announce a collaboration between Jennie Joseph’s Commonsense Childbirth School of Midwifery (CCSM) and Southwest Wisconsin Technical College (SWTC) in providing student midwives an opportunity to obtain an Associate degree in Direct Entry Midwifery. Applications for this upcoming spring semester (2012) are available online at www.swtc.edu. Application fee is $30 and can be paid by credit or debit card. Tuition for Wisconsin residents is $113 per credit hour and for out of state students $165 per credit hour. Scholarships are available for program students. Once application is made and completed, questions can be directed to the program’s lead instructor Sherry DeVries at sdevries@swtc.edu or 800-362-3322 ext. 2624. For financial aid questions please contact Joy Kite at jkite@swtc.edu or 800-362-3322 ext. 2319.

Winter Garden, Florida. Commonsense Childbirth School of Midwifery (CCSM) is offering clinical externship training for students already enrolled in midwifery training programs elsewhere. Under the direct tutelage of Jennie Joseph and her staff midwives at The Birth Place, you will experience observational and hands on experience in prenatal, intrapartal, postpartal and newborn care. Each module will culminate in skills testing and sign off. On-site training at The Birth Place facility in Winter Garden (Orlando), Florida will be arranged and facilitated through your current school/ preceptor and time frames can be customized to suit your availability. Students will be expected to attend clinic during the week and also labor and deliveries as and when they happen and to complete a skills assessment at the end of each session. Program costs are calculated per clock hour of externship at $10.65 per hour with a minimum 120 hours per session, and scholarships are offered to eligible students. Institutions or preceptors may direct questions to Jennie Joseph at ccsmidwifery@gmail.com.
*CCSM is not accepting applications for the Three Year Midwifery program for Florida licensure for the 2012 session.

Today, May 5th, is the International Day of the Midwife (and also Cinco de Mayo). Let us review some of the information that has been reported in Deadly Delivery: The Maternal Health Care Crisis in the USA, One Year Update, Spring 2011:

(all emphasis added)

Previous UN reports showed that women in the US have a greater risk of dying of pregnancy related causes than in 40 other countries. In 2010, UN data showed that the United States had slipped from 41st to 50th, with a higher maternal mortality ratio than 49 other countries.

Despite the 34% decrease in global maternal mortality between 1990 and 2008, with 147 countries experiencing a decline in maternal death rates, the US was among just 23 countries to see an increase in maternal mortality.


With over 4 million women giving birth each year in the US, at a total cost of $98 billion, childbirth and newborn care is by far the most common, and most expensive, reason for hospitalization.

Keep this in mind when you hear organizations arguing against birth out of the hospital.

...the US spends twice as much as any other country surveyed on the fees charged by maternal health care providers.

Keep this in mind when you hear about insurance companies.  When providers raise their fees it makes it more difficult for clients to self-pay (when desired, or when necessary). But fees are raised so that the provider gets better reimbursed by the insurance company (who tries to undercut the provider). This, in turn, creates a reliance on insurance companies to foot the bill for health care. Who is the real winner here?

Having a baby is the most costly health even families are likely to encounter during their childbearing years.

Approximately 99% of women give birth in hospitals where facility fees alone average between $8900 and $11,400 for a vaginal delivery, and between $14,900 and $20,100 for a cesarean...

Around the US, out of hospital births range from $2000-$4500 for a normal, uncomplicated vaginal birth. Why is out of hospital birth only 1% of the total births if it can reduce costs by half?

Many physicians do no accept payment by Medicaid because of low reimbursement rates, which has created a shortage of providers for women paying with Medicaid.

There may be a shortage of physicians, but we have midwives, ready and waiting to fill in the gaps. What is preventing the midwives from doing so?

Written practice agreements requiring physician back ups.
Physicians not wanting to provide back up.
Physicians not being able to (insurance-wise, peer-condemnation-wise) to provide back up.
Midwives without prescriptive authority.

Medicaid pays for over 40% of births in the US, and costs related to pregnancy and birth account for over one quarter of all hospital charges billed to Medicaid

Knowing the history of obstetrics in the US creates some context for this information. Obstetricians generally did not want to serve low-income women, who were mostly people of color and/or immigrants. This space was reserved for midwives. However, when OBs discovered that they didn't have enough patients to learn obstetrics on (and thus sustain a living), a collaborative effort with the government was created. Offering poor women care at the health departments and teaching hospitals brought patients to obstetrics and to research universities.

Many midwives have a hard time earning a living from having a large clientele of women on Medicaid.  Medicaid reimburses providers at the lowest rate, often times below 50% of the provider's fee. A midwife in a private practice must utilize women with private insurance, seemingly, to subsidize care for all.

Maternal mortality ratios for American Indian/Alaska Native women and non-Hispanic black women were 4 and 8 times higher than the 2010 target, respectively.

...(deaths per 100,000 live births)...non-Hispanic black women (34)...American Indian/Alaska Native women (16.9), Asian/Pacific Islanders (11.), non-Hispanic whites (10.4, and Hispanics (9.6).

The risk of maternal mortality has remained 3 to 4 times higher among black women than white women during the past 6 decades. Racial disparities were also seen in all income groups...

There has been much research on Black infant and maternal mortality. Organizations have been created. We continue to put out a call for more and more research, instead of putting that money into the communities and into midwives like Jennie Joseph who are a part of the community, who work within the community and produce results.

Higher poverty rates increased the risk of maternal mortality for both white and black women.

Not to mention that the racial disparities in both infant and maternal mortality that are seen in all income levels in the Black community, may not only be related to stress from racism, but also to generational poverty (because income status reflected in the present gives no information about historical economics).

New analysis shows that states with high cesarean rates (over 33%) were associated with a 21% higher maternal mortality risk.

If you are a woman in any of the following states, this information should be quite frightening:

Percent of babies born by cesarean delivery, each state: preliminary 2009
1 Louisiana 39.6
2t New Jersey 39.4
2t New York 39.4
4 Florida 38.1
5 Mississippi 37.8

Thank you, Jill. See the rest here.

Uninsured women are less likely to be in good health when becoming pregnant, and if they have chronic health conditions, they are less likely to have obtained treatment, which increases their risks during pregnancy.

...cost was a significant barrier preventing women from accessing health care, with consequences including women entering pregnancy with untreated health conditions, facing delays receiving prenatal care and inadequate post-partum care.

On 23 March 2010, President Obama signed into law the Patient Protection and Affordable Care Act of 2010, the most sweeping health care reform to be enacted in the US in decades, which promises to substantially improve health coverage...These expected improvement are a risk of ever being fully implemented due to legal, legislative, and financial challenges.

Remember this information when you are listening to the news, voting in local and national elections, choosing to have a baby, or rather, not having the choice on whether you want to continue with your pregnancy. The debate should never be about whether you are pro-choice or pro-life. It is a purposeful distraction.  As women we need to be able to act in our own best interest, therefore allowing other women to do the same. If we cannot...if we do not...someone will gladly make decisions for us.

Women, we must take back our rights. They have never been given to us.

7th International Black Midwives & Healers Conference
“Weaving the Cultural Traditions of Midwifery”

Pre-conference October 7, 2010
Conference October 8-10, 2010

Hilton Long Beach & Executive Meeting Center
701 West Ocean Boulevard
Long Beach, CA 90831-3102

Find out more here.

Shafia M. Monroe is the Founder and President of International Center for Traditional Childbearing (ICTC) and community activist devoted to infant mortality prevention, breastfeeding promotion, and increasing the number of midwives of color.

Miss Shafia's approach is rooted in African Midwifery Traditions, where the midwife educated the community, and focused on holistic practices to bring families together in order to ensure the health of the mother and child. Miss Shafia serves in the legacy of midwives that come out of the old South...>>read more and vote here<<

Get Rid of the Midwives

posted by da midwif on 0 comments

Thank you to midwife Katy Dawley for her research article, The Campaign to Eliminate the Midwife, published in the American Journal of Nursing in 2000.

We begin with this article because it highlights the contributions of nurses to the attempted extermination of Black midwives in the United States.  The medical establishment, which consisted of budding, White, male obstetricians and gynecologists, was not able to achieve it's domination alone.  It is important to understand this collaboration between nursing and medicine in order to put the current dynamics of midwifery into proper context.

Giving birth the early 20th century in the U.S. was perilous, particularly for people of color and the poor. Black midwives served these communities, just as they had served on slave plantations for White and Black women alike. Doctors needed to blame the high mortality rate on the practices of the Black midwives in order to elevate their own status as authorities in the field. They utilized nurses who described these midwives as unclean, uneducated and incompetent. This characterization was not based on actual practical skills or results because, factually, the outcomes of the midwives were comparable to, or more favorable than the doctors'. It was a deliberate attempt to discredit Black midwives so that the women that they served would choose doctors and hospital birth, as the White privileged women had already done. The more women doctors had at their disposal the more "research" could be carried out on disadvantaged populations. And this profit was for the medical establishment--not for mothers, babies, communities of color, or the poor.

    Hospitals to Avoid

    St. Barnabas Medical Center (NJ)
    Kendall Regional Medical Center (FL)
    South Miami Hospital (FL) Mercy Hospital (FL)
    Hileah Hospital (FL)
    Baptist Hospital (FL)
    Jackson Memorial (FL)
    Holy Cross Hospital (FL)
    Mid-Valley Hospital (WA)
    Iroquois Memorial Hospital (IL)
    Rush University Medical Center (IL)
    Gateway Regional Medical CenterAdvocate Good Shepherd Hospital (IL)
    Delnor Community Hospital (IL)
    Crawford Memorial Hospital (IL)