Graduates of Penn’s nursing-midwifery program are working to crowdfund full-tuition scholarships for future students of color in the midwife program.
The use of midwives during childbirth — as opposed to or in conjunction with a traditional OBGYN — is currently more common than it’s been in decades. Three times the number of pregnant people in the United States opted for midwifery care in 2013 versus in 1989.
Historically, midwives were popular among black and immigrant populations in the U.S. As the 20th century progressed, home births became stigmatized, according to the Columbia Journal of Race and Law, and people from communities of color stopped (or were kept from) going into the field. But midwifery saw a resurgence with the “natural birth” movement at the turn of the millennium — and now, more than 95 percent of practicing nurse-midwives are white.
Philly resident Nicole Chaney wants to change that.
Getting to endowment
A December 2017 alumna of Penn’s nurse-midwife program, Chaney recommended her entire graduating class give back by paying it forward to people of color. And they stepped up, pitching in to the crowdfunding and working to raise awareness of the campaign.
So far, just under $11,000 has been raised toward the final goal of $125,000.
The University of Pennsylvania has pledged to match $25,000, Chaney said. With that donation, she believes the fund will end up being enough money to get the scholarship endowed, and turn it into a gift that can be repeated year after year.
To make it happen, all of the 22 students who graduated in December will help — each has agreed to donate a percentage of their salaries to the cause, every month.
Chaney stresses the importance of bringing more people of color into the field by noting the disproportionately high rates of maternal mortality experienced by black American women. Disparities in health care are often compounded by “unconscious biases that are embedded in the medical system,” a ProPublica report found.
“Research shows that…when a provider looks like the patient, there’s better outcomes for a variety of different reasons,” Chaney said. “We looked around at our classroom and realized there were two midwives of color in our class out of the 22 of us.”
A fear rooted in history
Kateryn Nunez, another recent midwifery grad who is a woman of color, experienced the disparity firsthand.
Growing up, Nunez was acutely aware of her mother’s fear when interacting with white doctors. Her mother often advised her to omit information when talking to her physician, she said, with the recommendation: “Say everything is good, and don’t say anything else.”
“There’s this irrational fear of your children being taken away from you for things your physician would know,” Nunez said. “It’s that fear of people in positions of power.”
Nunez saw the phenomenon again while in school. She recounted a situation where she was practicing under a white midwife, and they were helping a Latina patient decide on a form of birth control. The midwife recommended an IUD, and the patient hesitated, worried a doctor would refuse to remove it later if she decided she wanted to have children.
“The white midwife was confused by that,” Nunez said, “but I knew exactly what she was talking about. It’s not just the history of forced sterilization, but also just the fear that exists in communities of color surrounding health care professionals.”
When people of color are matched with providers of color, the experience can become easier, Nunez said. She understands the concerns of Latina women, and can “sense their fears.”
“I think the scholarship is a little drop in the pond,” Nunez said. She hopes the it will start a “domino effect,” setting an example for the rest of Penn’s midwifery program. She’d like to see the school create a whole class on disparities in health care and bring in more faculty members of color, providing students of color with accessible mentors.
“We need women of color to care for women of color,” Nunez said. “Midwifery is especially poised to do that, because midwives especially care for these women.
We owe it to the women who are dying every day to step our game up.”