The Legacy of Black Midwives

By Zelie Pollon
Issue 144 - September/October 2007

Later, when Monroe was a student at the University of Massachusetts, she'd stop black women on campus to ask if they were from Africa, and if so, if they were midwives. She was on a mission: to connect with the African midwifery tradition, and to imbue her own midwifery journey with its wisdom.

In 1982, the first of Monroe's seven children was born, with a Jewish midwife in attendance—at that time, there were no black midwives in Boston. It was obvious to Monroe there was a need to be filled, and she decided to create a network for black women. The result, the International Center for Traditional Childbearing (ICTC), was incorporated in 1991, in Portland, Oregon. Since then, the organization has become not only a training center for women in the Portland area, but an information clearinghouse for black women around the country who want to find support and kindred spirits in their areas. ICTC has since branched out across the country and to Africa and South America. And in 2002, the ICTC sponsored the first annual Black Midwives and Healers Conference. Monroe's dream of community—one that includes men and women—was beginning to emerge. "This is not a feminist movement, it's a family movement," she says—white families as well as black.

Part of Monroe's mission is to teach African Americans their history. She wants midwives of all cultures to remember the important position they once held in community health care—a place she feels they should hold again. It was midwives who kept communities together, serving every aspect of health and every member of a family. For Monroe, being a midwife—particularly for the African-American community—means playing a key role in educating black women about their health, reducing infant mortality, and showing women how to raise healthy children with tenderness and attention. These are goals to which Monroe—she won't give her age, but seems to have more dynamism and energy than most teenagers—has dedicated her life. She hopes that, through ICTC, other African-American midwives will carry on the tradition after she's gone.

ICTC is one of the few organizations in the country dedicated to educating and training black midwives. Any doubt about the need for such training is quickly dissipated by a glance at the statistics: Overall, the US has one of the highest rates of infant mortality in the developed world, and the rate for African Americans is almost twice that: 13.6 deaths per 1,000 live births, according to a National Vital Statistics Report.² The reasons for this are intrinsic to the system we live in, says Monroe, who adds that training and supporting midwives is part of the answer.

"We have a legacy, and we should have ownership of this," Monroe says of black midwives. "We need to build up the infrastructure in this society and deal directly with the issues that affect us, including higher levels of poverty, lack of access to quality health care, and higher levels of stress." According to Monroe, the women who enter the ICTC want to be empowered to have the best birth experiences possible, but are subject to health care and societal systems that discriminate against them.

So Monroe sees her job—and the job of any midwife—as also one of making alliances within the black community in the areas of family, work, and education. She makes home visits during which she spends time with each member of the family just celebrating the baby. She makes sure everyone is adjusting well, and may assist with breastfeeding, or show a new dad how to bathe the baby.

ICTC works hard to teach black families about the benefits of doulas, also referred to as sisterfriends and birth companions. In some cases, Monroe invites her clients to attend doula trainings, where they can learn about the labor, postpartum, and breastfeeding support services doulas provide. Last year in Oregon, Monroe helped 200 people, graduated 25 doulas, gave free doula services to 65 low-income women, and taught hundreds of hours of infant-mortality prevention classes.

To Monroe, building a community begins at ground level. ICTC's Sistah Care program gives teenage girls interested in midwifery and women's health care an opportunity to train in these areas for one year. The program includes learning childbirth skills, cultural awareness, and the history of midwifery practice. There's a three-and-a-half-day training workshop for doulas, and a two-year online midwife-training program is being developed.

The ICTC's Black Midwives and Healers Conference is one of the biggest builders of community. Practitioners from around the world gather at this annual event to discuss health, community, and midwifery practice. The fifth conference was held in the fall of 2006 in Phoenix, Arizona, and offered workshops on everything from doulas to dads. But the most important part of the conference is creating a network.

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Cultural awareness and historical awareness are parts of every ICTC program, and figure prominently in Monroe's speaking engagements, weekly meetings, and annual conferences. Slavery affected generations of black families' childrearing practices. "If we yell at our children, 'I'm going to whip you with a switch!,' well, that's from enslavement. We've copied the language of our oppressor," Monroe asserts. ICTC teaches African-centered childrearing practices including extended breastfeeding, babywearing, positive physical contact and affection, and nonviolent discipline methods.

Karen McFee, now a 23-year-old nursing student, is a graduate of Sistah Care. She recalls that it was through the program and Monroe's mentorship that she found her inspiration and her calling. "Seeing someone who is my race doing this encourages me to keep going, and shows me that I can do it too." Through the training, McFee learned details that she never knew, such as the basics of nutrition, particularly for African Americans. Dairy foods, for example, aren't good for the large numbers of black people who are lactose-intolerant. In Africa they had goats, not cows, McFee learned, so many black people do better with goat milk. She learned about other technical aspects—of delivery, drugs, and health—but the more important lessons were about caring for one another and for the community.

Ruth Kaufman, a white woman who runs a small midwifery practice in Albuquerque, New Mexico, joined ICTC last year. She sees the ICTC training—which incorporates all of a community's health issues—as an answer to failing US health systems and the poor health statistics of minorities. Kaufman's work now is to meld ICTC's midwife-training program with larger health issues in New Mexico, such as teen pregnancy and sexual assault.

Kaufman feels that, just as people should be seeking out midwives, midwives should be seeking out new models of caring for their communities. "Shafia is a model for that," she says. As traditional practices in other countries continue to be abandoned, and replaced with what people think are "more advanced" Western methods, Monroe's work is not likely to get any easier. "Now, in some [African] countries, they're doing things we did in the 1950s: holding the baby up [at birth], slapping it on the butt." Countering such cultural shifts requires a lot of awareness and cultural sensitivity—and money. ICTC's budget—mostly from grants, and membership and conference fees—covers only about a third of what Monroe feels the center needs to fully fund its necessary work.

In the coming year, the organization's efforts to get people involved will extend to Internet classes. The ICTC won't hold the Black Midwives and Healers Conference this year, and will focus instead on expanding the number of ICTC chapters and representatives. ICTC will also be cosponsoring this year's Midwives of North America Conference. Monroe believes it's time for midwives, particularly African-American midwives, to own their own legacy and stop being isolated and marginalized. "We want to give women pride. Now black women say, 'Thank you for providing a place for us to learn about our culture and the contributions we have made to midwifery.'"

For the notes to this article, see www.mothering.com/articles...legacy-black-midwives-notes.html [1].

FOR MORE INFORMATION
International Center for Traditional Childbearing (ICTC): 2823 N. Portland Blvd., Portland, OR 97217; 503.460.9324; ictc@blackmidwives.org [2]; www.blackmidwives.org [3]. Sistah Midwife International: PO Box 11303, Portland, OR 97211; 503.281.1688; sistahmidwife@msn.com [4]; www.sistahmidwife.com [5]. Purchase Shafia M. Monroe's Black Midwives and Prenatal Providers Directory: Essential Recipes and Words of Wisdom for Expecting and New Parents from Sistah Midwife International.

Zelie Pollon is a freelance writer based in Santa Fe, New Mexico.