Black Org, Open Letter to US Midwifery Association

Willie Grace | 6/9/2015, 7:53 a.m.
The International Center for Traditional Childbearing (ICTC), established in 1991, is a 501(c)(3) professional midwifery and doula association for women ...
International Center For Traditional Childbearing

The International Center for Traditional Childbearing (ICTC), established in 1991, is a 501(c)(3) professional midwifery and doula association for women of color. The ICTC is unique as it represents the voice and needs of Certified Nurse Midwives, Certified Professional Midwives, Licensed Midwives, direct entry midwives, traditional midwives and other midwives who self-identify as a midwife of color, including but not limited to Black, African, African American, Asian, Hispanic, Latina and Native American midwives.

While African American midwives have a long, well-recorded history of serving women and families in the U.S., there remains a real barrier to achieving inclusion in national midwifery organizations. Specifically, we are concerned that ICTC is not an autonomous member of the US MERA. The absence of midwives of color from the US MERA decision-making table demonstrates a lack of cultural humility and contributes to the systemic racism that creates and perpetuates barriers for midwives of color to enter the field and serve their communities.

On October 4, 2014, ICTC petitioned to participate in the US MERA October 21st meeting in St. Louis, MO and though denied, Shafia M. Monroe, ICTC President, and Rita Aparicio and Abigail Aiyepola, ICTC Board members, participated and represented ICTC as a stakeholder organization. The ICTC President argued on the floor for ICTC to be recognized as an autonomous professional midwife of color organization, with the right to participate along with the six professional midwifery organizations listed above whose members and leaders are largely white.

The ICTC agrees with the US MERA core values, particularly the need to work to create a larger, more robust, diverse, high-quality maternity care workforce (2014 US MERA Meeting: A Summary Report). On every level we see the impact of racial inequity and healthcare disparities on birth outcomes in communities of color, and in the underrepresentation of midwives of color in health care institutions and schools. While the research shows that midwives lower the infant mortality rate, there remains a shortage of midwives of color to service their communities in culturally appropriate ways that improve birth outcomes. Currently, the majority of midwives are white women, with less than 2% being black women. Only 13% of black women are being served by Certified Nurse Midwives (CNMs), compared to 57% of white women being served by CNMs (Goode, K.L., 2014).

Given the sufficient evidence to support the need for cultural competency and inclusion to improve birth outcomes and build the workforce, ICTC had expected the US MERA to demonstrate their philosophy of equity and access for women of color to midwifery training and midwifery services through collaboration with the ICTC as a US MERA member.

Thus, we were shocked that once again we were not invited to the US MERA meeting in April 2015. Additionally, we are stunned by the lack of acknowledgement of the resignation from the US MERA Steering Committee of Marinah Farrell, President of the Midwives Alliance of North America (MANA) on Feb.3, 2015, due to the US MERA’s absence of commitment to diversity in the midwifery credentialing discussion with the ICTC. Additionally, we are disappointed by the lack of response to the publication of Keisha Goode’s Dissertation, “Birthing, Blackness, and the Body: Black Midwives and Experiential Continuities of Institutional Racism,” where Goode asked, while attending a US MERA meeting, why the ICTC was not present as an professional midwifery organization representing midwives of color. She documents her concern regarding ICTC’s absence in her dissertation on page 142 (Goode, K.L., 2014).

We know historically, due to systemic racism, that organizations of color receive fewer resources than majority-run entities. However, ICTC continues to succeed in its mission to reach out to communities of color; encouraging them to become midwives and doulas. As an organization we support and advocate for student midwives and midwives of color, work on national and local coalitions to expand the practice of midwifery, and we provide referrals to community members and clients.

With minimal resources the ICTC has responded to the midwifery profession with:

  • A national board in which the majority of members are midwives of color, with other including an OB/GYN; a public affairs vice president; a public health professional, a certified doula and a midwifery student

  • National midwifery membership

  • Creating and implementing strategies for increasing the number of midwives of color

  • Supporting midwifery educational systems

  • Creating and websites to promote collaboration and best practices sharing

  • Sponsoring the biennial International Black Midwives and Healers Conference, a professional midwifery convention; and other state and regional events

  • Participating in the Allied Midwives Organization (AMO)

  • Participating in the Mothers and Midwives Association Campaign (MAMA)

  • Engaging as a steering committee member of the Home Birth Summit

  • Representing midwives of color at the annual MANA and ACNM Meetings

  • Training doulas in the midwifery model of care

  • Engaging in primary research topics that increase awareness of the disparities in quality maternity care for women of color.

With over six months of communication we had hoped that the US MERA would have prioritized and rectified the situation by now, and immediately invited the ICTC to the table, realizing the seriousness of our absence.

The ICTC maintains its position that US MERA is at a disadvantage in reaching its potential and the fulfillment of its mission if the ICTC is not at the table as an independent professional midwifery organization that represents midwives of color. We believe that inclusion is necessary to help meet the charge of a strong and genuinely representative movement to ensure quality midwifery education that meets the criteria of the ICM and the needs of all midwives.

In the interest of strengthening the midwifery movement for midwifery education, we request the following:

  1. A commitment to accept the ICTC as a US MERA member by June 15, 2015.

  2. A commitment by the US MERA organization to formulate a joint statement of solidarity to the principles underlying the International Confederates of Midwives (ICM), recognizing the ICTC as a midwifery association.

  3. A commitment to work closely with the ICTC to increase the number of women of color entering the field of midwifery.

  4. A commitment to those communities who have historically maintained the highest infant and maternal mortality rates and the lowest number of midwives to serve these communities.

  5. A commitment to investigating and addressing how the organizations that comprise US MERA address the systemic racism and lack of cultural humility within their individual organizations and US MERA as a whole.

Based on definitions within ICM Core Documents, ICTC is a midwife association. International Confederates of Midwives (ICM) Core Documents state: "Strengthening individual Midwives Associations enhances the ability of midwives worldwide to achieve the goal of improving the health of women and children. ICM is aware that its members are at different levels of development. Some are just starting with no definite organizational structure, while others are well developed organizations with a clear structure. Some have less than a hundred members. Others have thousands in membership. The associations do not only differ in size, but also in strength."

The ICTC asks the US MERA to open its circle to the ICTC in order to be truly inclusive, so that midwives of color have the opportunity to contribute to the future of midwifery education and regulation in the US; and to the health and welfare of women, children and families of color across the country.

We look forward to hearing from you and moving forward with the strength of our collective effort.