Home birth for women of color/low income women to solve health care disparities - Page 2

[amlikam]

I wanted to reply to this, even though the original post is from quiet some time ago. However OP I am encouraged by your voice and want to encourage you to use it more. I live between worlds as a woman of color who looks white and married into a "white" last name. So for all intents and purposes to the system I am white. HOWEVER my sisters kept their maiden name and have a darker skin than I (genetics is funny). I noticed a significant differnce it the way my own perinatal care was managed to how my sisters care was managed (one of them had care with the same practice of providers.)

I believe the number one way for helping to change disparencies is to speak about it more. I believe culturally women of color are taught to respect the person of power in systems relationships (ie: their parents, Drs, teachers, ect.) and are significantly unlikely to speak up for their own care. Resigning themselves to what they get. I think of my own father who was in the hospital this past summer for major surgery. When he told the Dr he didn't feel right they dismissed his requests for tests/followup. Later we learned the surgery went seriously wrong. It took me talking with the Dr's to take his claims seriously!

I do believe there are ways to help the community without investing in education to be a professional. It is equally helpful for women to hear stories of what it is like to have empowering births with providers who honor and value the mothers/families. One way to do this is to start a birth circle, postpartum support circle or red tent in your community, where you can begin to look at how the women of your own community are treated and that ways you can work together to change the kind of care you are willing to accept. 

This journey can be incredibly isolating for mothers in general, but especially women of color who meet a variety of barriers to care.
 

ETA: May birth professionals like CPM's and Doulas believe in offering support to women of color/low income/ otherwise underserved populations at deeply reduced fees/arrangements. I believe that if a woman wants a more holistic model of care she should have access to that care and know many others who feel the same. From my research I believe a homebirth can be sometimes a safer alternative to hospital births, but do believe it is dependent on many factors (no one size fits all here)... the main factor being diet, which can be a barrier to care for many low income families.

Thank you so much for voicing this and allowing us to support you here. Please PM me if you would like to talk more.  

[Susan Jenkins]

One of the provisions of the health care reform law requires all state Medicaid plans to pay services provided by freestanding birth centers and the midwives who practice in freestanding birth centers, so long as the birth center and midwife are licensed in that state, the state Medicaid plan must offer women who are enrolled in Medicaid the option of giving birth in a birth center with a midwife.  This law is beginning to be implemented in each of the states, so please send me a private message if anyone experiences any problems getting Medicaid in her state to provide this option.  Check out information about this law at the American Association of Birth Centers website at www.birthcenters.org

  Also, the national midwife organizations MANA, ICTC, NACPM, NARM, and Citizens for Midwifery (who together are calling themselves the MAMA Campaign or Midwives and Mothers in Action), have a bill that will be re-introduced in this new Congressional session that will also require all state Medicaid plans to pay for home birth with licensed Certified Professional Midwives (CPMs).  See their website at http://www.mamacampaign.org/

We need to all support this bill, which will extend the same option of home birth and the woman-centered model of maternity care offered by midwives as an alternative to hospital birth to low income women.

Take action for women's health, for the health of all women, become an activist for equal access to home birth, birth centers, and midwives for all women.

Susan

[phathui5]

OP, I don't think that you should feel obligated to subject yourself to another hospital birth in the interest of improving care for other women. If anything, perhaps you could meet with the charge nurse and the head of OB at the hospital where you delivered and tell them about your experience.

[LaotianMama]

I'm so sorry with your experiences with the medical model of care. :(

As a mother of color *and* low-income, I can say that it's so very important to know plenty of information and arm yourself with resources against all the odds stacked against our demographic. I had a hospital birth with paid insurance with my first-born and it was a great experience. I had a doula, a midwife, and a great confidence I got from research and information. I am now on state medical insurance and planning a home birth with midwives and a doula. So, while I know I have greater chances of medical issues due to my race, I am very low-risk and healthy in other persepectives. So, I know it can be done but it starts with confidence within yourself and arming yourself with information and positive support to achieve what many circumstances are set against.

Good luck. :)
 

[Vaquitita]

I can't comment on being a woman of color thing, but I do think the clinics for low income women are horrible! In my last pregnancy, I was on medi-cal and went to the clinic for most of my pregnancy. They just expect you to be ignorant and stupid. I eventually switched to a private doctor and even though I still was on medi-cal, nothing had changed there, the treatment I received was very different. At the hospital too my treatment was fine, very different than what I experienced at the clinic. I suppose if the women going to the clinics stood up for themselves and informed choices, maybe, eventually, it would improve. But I would not subject myself to that again. If women on medi-cal were to only use the other options, never choosing the clinic, that might eventually make a difference too. And that would be less traumatic.

i can imagine if they treated me, a 30 year old married white woman, who was raised middle class even if I'm now low income, like I am ignorant and stupid I bet the way they treat women of color is much worse...

[mwherbs]

I think that the demographic of home birth says alot . You consider the older white,married college educated multip to be able to advlocate for herself and yet those are the women giving up on trying to fight with the hospital providers. That group of women are not the only ones we serve but the biggest portion- and the studies on older moms put them at higer risk of term stillbirth and other things not as high as women of color but higher than the 18-30 yo white moms. I am not sure how well it would work out for all moms of color but it would be a consideration if you have a good midwife,

[GISDiva]

This doesn't address the homebirth aspect per se, but I recently heard of a program in my city that targets low-income women (and in this city, that often means minority women).  It's run out of a community health clinic to gather groups of women of similar gestational age as a support network for each other.  It's run by two CNMs and aims to give them the information they probably aren't getting from their (as mentioned above) lackluster regular prenatal appointments and to give them space to talk and discuss.  I know a lot of people are distrustful of CNMs too, but i have to think this is better than what they were getting before.

Here's the podcast link if you're interested:  http://www.radiomilwaukee.org/initiatives/make-difference/centeringpregnancy-sixteenth-street-community-health-centermake-differen

Where that tied in for me in your post is the simple idea that knowledge is power.  If more and more women of color can feel confident in their own knowledge and supported by their own community network rather than relying on what is given to them by the resident du jour, then perhaps the tide will shift.  (Yes, rose-colored glasses perhaps...)  You mentioned that one of the things upper-class women can do more easily is advocate for themselves.  We can't fix some of those other things, but we can fix that perhaps.  And honestly?  The homebirth midwives in our area are already quite overworked, we need more of them and we need them in those communities.  But a good start would be to plant good information, no matter where the birth takes place.

And good for you.  :)  It kind of makes me wonder how our local free standing birth center could reach out to a broader group of people...