Melanated Group Midwifery Care: Centering the Voices of the Black Birthing Community

Abstract

Access to safe and dignified pregnancy, childbirth, and postpartum experiences is a fundamental right for all pregnant and postpartum people. In the United States, systemic racism fuels distrust and disengagement in a health care system that continues to dehumanize the Black community. The respectful maternity care literature explains how these systemic, structural, and institutional failings produce maternal health disparities and expose a pattern whereby Black women receive less adequate maternity care. The implementation of trustworthy policies and practices is urgently needed because no single intervention has or will substantially reduce maternal disparities. The purpose of this article is to describe a multicomponent maternity care innovation, Melanated Group Midwifery Care (MGMC). MGMC was codesigned with community partners and is responsive to the needs and desires of Black women, making MGMC a culturally adapted and patient‐centered model. Racial concordance among care providers and patients, group prenatal care, perinatal nurse navigation, and 12 months of in‐home postpartum doula support are 4 evidence‐based interventions that are bundled in MGMC. We posit that a model that restructures maternity care to increase health system accountability and aligns with the needs and desires of Black pregnant and postpartum people will increase trust in the health care system and result in better clinical, physical, emotional, and social outcomes.

Racial/Ethnic Disparities Impact the Real-World Effectiveness of a Multicomponent Maternal Smoking Cessation Program: Findings from the CTTP Cohort

“…When considering the higher proportion achieving abstinence among Hispanic cohort members (42.9% of the cohort), another possible explanation is the concordance in ethnicity these cohort members shared with the three health educators who were Hispanic and Spanish speaking. To address the overall racial disparity evidenced by a 3–4 fold increase in maternal morbidity and mortality in US Black women, Liese et al developed a multicomponent intervention model that involved racial concordance between all care providers (including patient navigation and health workers support) and patients, group prenatal care, perinatal nurse navigation, and 12 months of in-home postpartum doula support (Liese et al, 2022 ). In the Aboriginal/Torres Strait population of Australia, indigenous community health workers were shown to be effective in promoting maternal smoking cessation (Mersha et al, 2022 ) and adult smoking cessation (Kennedy et al, 2022 ).…”

Senior Editors’ Response to Letters on Melanated Group Midwifery Care: Centering the Voices of the Black Birthing Community

“…The JMWH approach to publication review aims to mitigate bias, be anti-racist, and be responsive to the profession. 2 As the editors of JMWH, we appreciate the discourse generated by this article 3 and affirm our decision to publish innovative approaches to practice and to give voice to authors in sharing their perspectives within our peer review and editorial processes. In our collective efforts to improve perinatal care in the United States, dismantle systemic racism, and achieve health equity for all persons, uncomfortable conversations will likely arise, and discomfort is often a catalyst for change.…”

Comment on: “Melanated Group Midwifery Care: Centering the Voices of the Black Birthing Community”

“…The article by Liese et al states that “the predominance of white midwives in the US health care system also contributes to the distrust, disengagement, and systemic failings that underlie alarming Black maternal mortality and morbidity rates.” 1 (p696) This statement is unreferenced.…”