The Impact of Racism and Midwifery's Lack of Racial Diversity: A Literature Review

Abstract

The midwifery profession and its patients stand to substantially benefit from diversification of the field, which requires addressing racism within the profession. Structural competency is a new theory that offers an effective framework to guide these efforts.

Incorporating an Equity Agenda into Health Professions Education and Training to Build a More Representative Workforce

“…The climate transformation of health professions education programs and clinical environments is intended to enhance the educational experiences of all students, especially those of color, and increase diverse representation in the workforce . Because students form their professional identities and internalize professional ethics and behaviors during their training, an equity focus that enables future health care providers to develop critical consciousness and recognize bias and differentisms also has the potential to reverse current inequities in maternal and infant health .…”

“…Students are aware of who holds power in their educational institutions. A diverse composition of educators and administrators positively impacts perceptions of school and clinic climates, especially for underrepresented students . Conversely, a lack of representation in leadership makes it difficult for underrepresented students to see themselves as belonging…”

“…However, there are currently too few aspiring midwives of color entering midwifery education programs in the United States to significantly affect the diverse composition of the profession as a whole. For students who do start their training, retention rates are negatively affected by systemic racism and other related issues encountered in the classroom and clinical settings . Midwives of color who have completed their training report experiencing microaggressions, biases, prejudice, discrimination, hostility, overt racism, and/or social exclusion during their midwifery education and/or preceptorships .…”

“…Qualitative research findings indicate that midwifery learning environments require reform so that underrepresented students can feel safe, recognized, and valued. For example, participants in this body of research have recommended that changes be woven throughout the curriculum and institution, not addressed solely in a single course on racism or health disparities . Nursing scholars have also concluded that gaps in current curricula cannot be overcome by simply incorporating a stand‐alone module about social inclusion .…”

Prior Work and Educational Experience Are Not Associated With Successful Completion of a Master's‐Level, Distance Education Midwifery Program

“…Midwifery in the United States faces 2 major workforce challenges: increasing the number of midwives and diversifying the profession. More midwives are needed to care for women in the nearly 50% of US counties that lack a maternity care provider, and a more diverse group of midwives is needed to care for and address disparities in health outcomes for the increasing number of women of color . However, as of January 4, 2017, there were only 37 Accreditation Commission for Midwifery Education‐ (ACME‐) accredited and preaccredited midwifery education programs in the United States that were accepting new students.…”