I became a midwife after working as a doula for 10 years. I came into the work with the knowledge and concern for the lack of safety that is espoused to Black women and birthing people that I witnessed while attending births within institutions that have and continue to perpetuate harm in birthing spaces.
I have witnessed disregard, distrust, and racialized obstetric trauma that leaves Black birthing people feeling unheard, helpless, enraged, and physically and emotionally violated. In the years since I began this work, the outcomes for Black birthing people are continually worse all while garnering more and more attention in the public but without focus on solutions – community birth and Black midwives.
The staggering black maternal mortality rate in the United States, in which Black women are three times more likely to die from a pregnancy-related cause than White women, highlights the deeply entrenched racial disparities within our healthcare system. In Chicago, the place I reside, that rate is doubled: Black women are six times more likely to die from pregnancy-related causes.
How do we get better care for Black birthing people?
The pursuit of birth equity, the promise of optimal conditions for birthing individuals, remains an unattained goal for Black women and birthing people across the nation. The recent closure of the sole birth center in Illinois with a Black midwife on staff serves as a stark reminder of the urgent need to address this crisis. As we grapple with these challenges, it prompts a larger question: In a landscape lacking accessible birth centers and Black midwives, how can we ensure essential care for Black women and birthing individuals nationwide?
Doctors must stop ignoring Black women.It happened to me, as a pregnant OB-GYN.
This issue’s significance reverberates beyond a single city. Every year, numerous Black women across both metropolitan and rural areas throughout the country face the complexities of pregnancy, desperately seeking safe and equitable maternal health care.
According to a study from the National Bureau of Economic Research, the wealthiest Black woman in California is at a higher risk of maternal mortality than the least wealthy white woman.
While the term “birth equity” echoes in our discourse, its true implementation remains distant. Progress has eluded us; instead, we find ourselves regressing. Since 2019, multiple regions in the United States have witnessed alarming declines in maternal health care options.
These include reductions in hospital labor and delivery units, as well as diminished access to out-of-hospital midwifery care. The disparities in health care for Black and brown communities are a testament to systemic discrimination.
We need more Black midwives
The shortage of Black midwives nationwide – a 2021 report found that only 7% of certified nurse-midwives and certified midwives identified as Black or African American – is an affront to the Black birthing community. This persists despite the fact that Black midwives have been shown to improve maternal health outcomes and the quality of health care that people of color receive.
Black patients deserve better care:Why are so many Black patients dying from heart failure?
This is not birth equity; it is a systemic disregard for Black lives. Black women and birthing individuals are enduring exploitation, negligence and systemic harm, an injustice that demands our immediate attention and concerted action.
In the face of this crisis, I stand as a Black midwife who continues to bear witness to countless stories of needless Black maternal and infant deaths. My own experience has fueled my commitment to rectify this disparity by starting the Chicago South Side Birth Center, a nonprofit, community focused, Black midwife led birth center on Chicago’s south side.
The Chicago South Side Birth Center will help address inequities in birth outcomes by providing culturally centered midwifery care alongside families and within the community to promote wellness and abundance in whole health. It is our commitment to disrupt these maternal health outcomes for Black birthing people and their families.
Funding and activism can change the Black maternal health landscape
This important systemic change work has led me to partner with Chicago Beyond, an organization dedicated to transforming the lives of young individuals through holistic investments in education, safety, community development and health.
Recently, at the Clinton Global Initiative 2023 Meeting, Chicago Beyond announced a $2 million investment in a new Black Maternal Health Fellows program to spearhead transformative change in maternal health care across America. Chicago Beyond is actively seeking partners to join the program and help catalyze a total of $5 million in funding for Black maternal health leaders over the course of four years.
Together, we are changing the landscape of Black maternal health and birth justice, starting with Chicago’s South Side, with an initiative aimed at delivering community-oriented solutions to the historical disinvestment in the well-being of Black families and community members.
Support, through funding and activism, of Black-led maternal health organizations such as the Chicago South Side Birth Center will play a pivotal role in establishing and sustaining community-centered birth centers. Additionally, advocating for a legislative increase in Medicaid or state reimbursement specifically designated for Black, Indigenous and people of color-led birth centers is essential to ensure equitable access to quality care for all, especially for Black women and birthing individuals.
The time for action is now. We demand change and accountability from the institutions that have neglected us for far too long. It is our collective duty to transform the rhetoric of birth equity into a tangible reality where every Black woman and birthing individual receive the care they need and deserve.
Jeanine Valrie Logan is leader in residence at Chicago Beyond and a birth-equity champion who works to address inequities in Black maternal health. She received a Bachelor of Arts from Fisk University and a Master of Science in nursing from DePaul University. She also received a Master of Public Health with a concentration in global reproductive health from George Washington University.
