I’ve been thinking a lot lately about inclusion in the midwifery profession. Of course, this is not the first time I’ve written about this. Those of you who know me know that I think about issues of inclusion and diversity all the time.
For me, midwifery has never been simply a matter of supporting individual choices in birth, although certainly that is one aspect of it. In fact, I often hesitate to blindly associate the concept of “choice” with birth, as it assumes that we all have equal access to knowledge, support and empowerment to advocate for our preferences. It doesn’t take long to realize that the illusion of choice in birth doesn’t extend very far when we’re still privileging some people as parents over others.
On a broader level, I see midwifery as a public health tool to address major disparities in birth outcomes and family health in our country. However, one big stumbling block is that the midwifery community currently does not reflect the broader community of those we seek to serve. While race is only one of many components of diversity, I do believe it is an important one. As an Asian-American woman, I rarely see myself reflected in either the general media covering empowered birth choices, or in my chosen profession. Some days I can be lulled into thinking that something as simple as seeing other Asian midwives is almost trivial, and yet, there is a substantial body of research on ways in which people of color, especially Asian-Americans, are made invisible in the Black-White racial paradigm of the United States.
In 2011, 6.6% of CNM’s who responded to ACNM’s triennial membership survey identified as people of color. Out of 2,230 total respondents (about a third of the membership that year), a whopping 4 midwives identified as Asian or Pacific Islander. Granted, a total 4% of midwives did not answer the question at all or had missing info. However, 91% (2,034 respondents) identified as white. Only 2.6% of CNM’s who responded identified as Hispanic. The last census placed the Hispanic population of the U.S. at 16.9%. The report notes that these numbers have not changed much between 2009 and 2011. Looking at the 2006-2008 report yields similar results.
So, what are some solutions?
As in any of the health care professions, addressing pipeline issues and lack of funding support are key.
How are we supporting the development of a strong, qualified applicant pool? What programs are being put in place to connect potential midwives with good mentors? How are midwifery organizations connecting with young students to introduce them to the option of midwifery as a career path? What financial supports are in place to support students who come from disadvantaged backgrounds?
This is why I’m so excited to see leaders within the CPM community take it upon themselves to make concrete changes that will support more midwifery students of color. Spearheaded by CPMs Vicki Penwell, Claudia Booker, and Jennie Joseph, they have created an opportunity for midwifery programs to commit to providing a full scholarship each year to a student of color.
And so, our Grand Challenge is this: What if every midwifery program in America, big or small, non-profit or for-profit, were to offer one FULL scholarship per year to a qualified candidate who was a woman of color?
If every school or program now in existence were to offer one full scholarship per year, the burden will not be too much on any one school’s budget. We will all share the responsibility and privilege of addressing a grave injustice in our own time and country. Within a few years we could see this imbalance shift and begin to see many women of color serving their own populations with quality midwifery model care.
It’s one step towards making our community more inclusive. What other ideas do you have? I’d love to hear them! Let’s keep this conversation flowing!