Midwifery and Antenatal Care for Black Women: A Narrative Review

Abstract

It is well established that Black women are at greater risk for preterm birth (PTB) and infant mortality than other race/ethnicities in the United States, particularly in the south. Evidence exists supporting the effects of adequate prenatal care to significantly reduce the risk of PTB among this vulnerable population (Debiec, Paul, Mitchell, & Hitti, 2010; Picklesimer, Billings, Hale, Blackhurst, & Covington-Kolb, 2012). However, Black mothers are 2.3 times more likely than White mothers to receive prenatal care late, or not at all (Office of Minority Health [OMH], 2015). Rationale for this trend remains unclear. The purpose of this article is to examine how current literature addresses Black women's experience of antenatal care, including the role that midwives may have in that care. A brief history of Black midwives and their role as the major health care providers for Black women, as well as the current trends in midwifery, will provide background and offer a point of reference. While much of the literature focuses on birth outcomes, provider qualities, and situational life factors in conjunction with the prenatal care received by Black women, very few investigate the effects that historical underpinnings may have played in Black women's current reception of prenatal care. The history of Black women's health care and the prominent role that midwifery played is all but forgotten. Throughout this review, the term Black is used rather than African American as birth certificate data and much of the early demographic data use the term Black as a racial indicator.

The COVID-19 pandemic: A focusing event to promote community midwifery policies in the United States

“…The benefits of midwives have long been clear: improved maternal and newborn health outcomes, reduction in unnecessary interventions, and cost savings to families and the health system ( 5 , 6 ). In fact, the midwifery model offers support and care to both the physical and psychosocial needs of their patients ( 7 ), especially helpful to Black women who weather historical, structural, and/or personal racialized trauma ( 8 ).…”

Black midwifery in the United States: Past, present, and future

“…While these midwives have come to be known as “granny midwives,” Goode and Rothman (2017) suggest the term “grand midwives” as granny does not reflect the vast knowledge of these midwives. Grand midwives served in the Deep South from the 1600s to the mid‐1900s despite the professionalization of physicians (Yoder & Hardy, 2018).…”

“…There is more research about Black mothers' experiences in hospitals than out of hospital birth (Guerra‐Reyes & Hamilton, 2016; Yoder & Hardy, 2018). We know that Black women suffer from higher abuse and racial discrimination in obstetrical care than White women (Rosenthal & Lobel, 2011; West & Bartkowski, 2019).…”

“…The mothers in the Bronx also liked the camaraderie with other mothers while socializing at the birthing center before and after appointments. Yoder and Hardy (2018) reviewed research about a program, Centering Pregnancy, a prenatal care model started in 1993, that gave women group care for those with close due dates. Similar to the mothers mentioned above, most Black women reported satisfaction with these program in terms of camaraderie, more information, less waiting time than at clinics, better relationships with providers, and improved healthy practices (Yoder & Hardy, 2018).…”

“…Yoder and Hardy (2018) reviewed research about a program, Centering Pregnancy, a prenatal care model started in 1993, that gave women group care for those with close due dates. Similar to the mothers mentioned above, most Black women reported satisfaction with these program in terms of camaraderie, more information, less waiting time than at clinics, better relationships with providers, and improved healthy practices (Yoder & Hardy, 2018). However, Sharon Rising, the CNM who started the program, acknowledges that some Black women are guarded in group settings (Davis, 2019).…”