MOM Art Annex: Exhibition & Education Center

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Diversifying Visibility to Decrease Mortality Rates

The American Medical Association says that women of color are 2- 6 times more likely to die from pregnancy complications than white woman depending on where they live. There are many factors that can contribute to this disproportionality, including quality of prenatal delivery and postpartum care. This mortality rate has significant detrimental effects on the black community as countless mothers are lost to this vicious cycle.

Chinelle Rojas, Dear Little One Birth Photography

Likewise, economically disadvantaged women are less likely to receive quality healthcare and are thus also less likely to receive prenatal care. This leaves black mothers more likely than white mothers to have hypertension, blood disorders, and other medical conditions that complicate their pregnancies. A recent article by USA Today explores the surprisingly high rates of hospitals blaming mothers’ preexisting conditions for high maternal mortality rates among women of color, especially black women. Before USA Today conducted a study and critically examined these shocking maternal mortality rates, these numbers have been overlooked because hospitals are allowed to keep this information private. By keeping this information away from the public, many hospitals have been excusing their poor outcomes by blaming the health of the mother.

Apart from the legal actions that can be taken to decrease mortality rates of women of color, there are organizations and individuals who, through means of advocacy, let this information come to the light and make a conscious effort to put a stop to it. Employing advocacy through visibility, Kimberly Seals Allers, is an international speaker, author, and the founder and organizer of Black Breastfeeding Week among other things. Kimberly is on a mission to “shift the paradigm, shift the discourse, shift the infrastructure, and shift the experience of womankind and motherhood for all”.

In the Tampa Bay area, Chinelle Rojas is working hard to shift the narrative. Chinelle is the birth photographer behind Dear Little One Birth Photography and is the founder of The Melanated Birth, in which she uses photography to represent women of color in birth. She believes that photography is a powerful tool, especially when u towards a powerful cause. Chinelle has observed the lack of diversity in the birth photography community and is taking steps towards solving this problem. She advocates that ultimately visibility can be an important step in reducing mortality rates for women. Photographing the births of women of color outside a hospital setting increases awareness of different birth options available apart from the standard hospital epidural birth. She is hoping to spread a message about the possibility of giving birth in alternative settings. She argues that many mothers-to-be, only know of other women who gave birth in a hospital. Seeing photographs of black women giving birth with the help of doulas and midwives in a comfortable setting can be the start of another woman’s successful journey into motherhood.

Chinelle Rojas, Dear Little One Birth Photography

“‘Imagine a world where our little pebble of documenting births can make waves on the mortality rate of mothers across the country or the world.’” –Chinelle Rojas

http://www.tampabirthphotographer.com/

http://themelanatedbirth.com/

Additional Resources:

http://blackbreastfeedingweek.org

http://www.kimberlysealsallers.com

Article sources:

American Medical Association. State-specific maternal mortality among black and white women: United States, 1987–1996. The Journal of the American Medical Association. 1999;282(13):1220–1222.

Young, Alison, et al. “Hospitals Blame Moms When Childbirth Goes Wrong. Secret Data Suggest It’s Not That Simple.” USA Today, Gannett Satellite Information Network, 9 Mar. 2019, http://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2019/03/07/maternal-death-rates-secret-hospital-safety-records-childbirth-deaths/2953224002/.

This article was researched and made possible by Vana Madhu as part of a service-learning internship with USF. Read more below or click the image to find out more about our student authors:

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Why Jenny Wants To Be A Birth Doula

 This blog contribution is by MOM Social Media Intern, Jenny Nigro

I have been on a path toward pursuing a doula certification for some time now.  The beauty of the timeline for certification is that it is a go-at-your-own-pace kind of thing.  As it turns out, this also happens to be a curse for me.  Admittedly, it’s taken me longer than it should to keep up.  Part of the reason, though, is that without any real rhyme or reason, I convinced myself that I should be a birth doula.  A birth doula is someone who attends the birth and offers support to the laboring mama in any way that is needed — in offering kind words, in reminding parents of breathing techniques, in running any water/ice chips that are needed, in massaging sore parts of the mother’s body, in taking photos or video of the birth so that other labor partners can be more actively involved, or in communicating aspects of the labor plan to medical personnel on the mother’s behalf if requested.  Even as I write this list, I am filled with a sense of caring and warmth in thinking about the role that this plays in a birth.  Perhaps this is what initially drew me to the field.  But the deeper I went into fulfilling a certification, the more I realized that what I truly wanted to do was become a postpartum doula rather than a birth doula.

Doula_StoryAs the name suggests, postpartum doulas become involved in a family’s life post-Baby.  The doula offers support to the family in a variety of ways — they may offer insight into breastfeeding technique, offer general breastfeeding or parenting support, maintain the household while parents and Baby rest/spend time bonding, cook healthy and nutritious meals for the family, or assist in care-giving to other children in the household so that the parents may have time to bond with their baby individually.  A huge part of why I wanted to become a doula is because of the outcome of most safe, healthy deliveries: the welcoming of new life into a family.  As a birth doula, I would only get to witness a small piece of that process.  But as a postpartum doula, I could assist in the most crucial moments of that baby’s growth and development: as they bond with their family, expand their awareness, perform life’s first milestones, and interact with their environment.  And for the family, I could ensure that the time that they have with their baby following delivery is precious and undivided by mitigating the demands of everyday life so that they can focus on the new member of their family.  As a nanny, I perform many of these duties already: I cook nutritious meals for the family, I engage in light housekeeping duties, and I help supervise, instruct, and engage the children in the home to help the household run smoothly.  It would be a natural transition, I feel.

As part of my postpartum doula certification requirements, I am expected to read several books about “mothering the new mother,” breastfeeding, and infant care.  In one of my required reading books, I came across a quote/concept that sealed my decision to shift from birth to postpartum doula-ing.  Deep down, I suspect that I’ve felt this way all along, but seeing it in print was sort of an awakening.  The book quotes Suzanne Arms, holistic birth and parenting advocate, who once asked, “Is ours not a strange culture that focuses so much attention on childbirth — virtually all of it based on anxiety and fear — and so little on the crucial time after birth, where patterns are established that will affect the individual and the family for decades?” (Mohrbacher & Kendall Tackett: 2010, 106).  The book also cites a cross-cultural review of postpartum practices which found that postpartum depression is virtually nonexistent in societies where families had a reserved time set aside for spending time alone with their baby, where mothers were cared for and allowed to rest in privacy, where parents were relieved of their household duties during this time, and where women’s status new mothers was recognized (2010, 106-107).  In Rigoberta Menchu’s memoir, I Rigoberta Menchu, she devotes a section to describing the postpartum practices of the Quiche, where this sort of designation for new mothers is honored.  She describes this as one of very few times in women’s lives when they are exempt from labor so that they may remain with their babies in seclusion for these important moments of their lives.

This feels so inherently different from the way we treat new mothers in our society.  We shower expecting moms with attention — literally and figuratively — by throwing them parties, buying them everything they need for their babies before they come, and catering to their aches/pains/cravings while they are carrying.  But once the baby comes, new mothers are somewhat forgotten.  While some thoughtful friends and neighbors may contribute a dish or two and grandparents may come to stay with the family for a short while, once that time ends, new moms are expected to 1) automatically “get it” — get the hang of everything that taking care of a newborn entails, 2) bounce back from their pregnancy and any trauma inflicted on their bodies in terms of medical interventions used in birth, 3) not ask for anything and instead give everything to their newborn.  Any attention offered the new family is more in adoration of the new baby.  Brises, christenings, and naming ceremonies all celebrate the child.

I’m not saying that this attention and focus on the new baby is misplaced.  But imagine a society in which the time followed the birth of new baby is cherished and sacred.  Think about the ease of transitioning for the family if friends, family members, and neighbors eased the burden of normal household routines so that the new parents could have the first two weeks with their babies, chore-free to simply enjoy getting to know their little one.  Picture a world in which a family’s decision to engage the services of a postpartum doula is expected, not a rarity.  It is conceivable to think that a culture of postpartum depression or baby blues could be alleviated, even just a little bit.  If this were the norm, perhaps our entire construction of maternity/paternity leave would shift.  In reality, the way we do maternity and paternity leave in America reflects the reality that we simply do not value the time following births.  Policies that do not include paid parental leave or offer inadequate time periods of full or partial pay speak to this idea that we expect parents to immediately bounce back from giving birth.  Parents are expected to return to work in tip-top shape, despite having gone through a major life change.  They are criticized when they fall short and admonished for taking additional time off.  But if we were to reserve special time for families following the birth of a new baby, undoubtedly we would begin to see parental leave policies that respect this convention.

And that is a world that I would like to raise a child in.

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“The Business of Being Born”, British-Style

A_seated_Greek_woman_on_an_obstetrical_stool_being_held_in_p_Wellcome_V0014911Recently, the New York Times reported on a study unveiled in Great Britain, which revealed an interesting find in the field of childbirth. According to the study conducted by Britain’s National Institute for Health and Care Excellence, it is safer for women with no complications during their pregnancies to give birth under the supervision of midwives, rather than ob-gyns. (Women with no pregnancy complications are defined as those who have not had high-risk pregnancies in the past, are expected to carry the fetus to full-term, and for whom the baby is presenting head-first). The study found that obstetricians are more likely to use unnecessary medical interventions among low-risk pregnancies — including spinal anesthesia, cesarean section, forceps delivery, and episiotomies — which pose greater threats of infection and surgical accidents.
Of course, this is not new news within the natural pregnancy movement. Ricki Lake’s famous documentary, The Business of Being Born, made this argument years ago. Restricted by looming warnings of malpractice, obstetricians – surgeons by training – are more likely to impose medical interventions on delivering moms. This means ordering C-sections and performing episiotomies in cases where these may not always be needed. Midwives, however, rely on mother’s advocacy and self-awareness to guide decisions in the delivery room. They will defer to doctors when a complication surfaces that could pose a risk to Mom or Baby.

The Times notes that in the US, only 9% of the 3.9 million births that occurred last year were attended by midwives. This has not always been the case, however. At the turn of the century, midwives attended approximately half of all births. However, notable shifts in medical knowledge, which stigmatized childbirth as a pathology to mother and child, and positioned midwives as lacking in education/training and a resource for the lower classes, contributed to the decline of midwives and home births (read more here). Eventually, years later, the rise of the nurse-midwife helped to ease the public’s mind about the training and licensing for midwives. The nurse-midwives brought great changes to the birthing field, including the inclusion of fathers in the delivery room, a push for breastfeeding, and the allowance of babies and mothers to remain in the same room post-birth. Fast forward fifty years to now, when 75% of certified nurse midwives work in physician practices or hospitals, and either interact with or are under the supervision of doctors. Strict standard and licensing requirements for midwives have long assured expecting parents of their capabilities in the delivery room, and now it seems, they may even be a safer option? Perhaps the implications of the British study will have a ripple effect on the American healthcare system to push for greater autonomy among midwives.

By Jenny Nigro, online intern

Photo source: Wikimedia Commons