Monisha Washington Richard was pregnant in 2020 in the middle of the pandemic. During that pregnancy, she wished she wouldn’t have to give birth at Regions hospital – where she gave birth to her first child almost 20 years ago.
That birth was traumatic for her. She was a teenage mom and said that while the doctors did various tests, they didn’t tell her what the problem was, she said. Her baby was breached and was born with hip dysplasia. She described having pain throughout the pregnancy, which she learned much later was because her baby’s leg was lodged in her rib.
“It was a horrible experience,” she said. “I (was) dismissed in some ways, and a lot of questions were unanswered. I really didn’t think I would go back to Regions,” she said. “After I had the C-section, I was left in a room for multiple hours without any pain medication or anything. I was crying, and I was asking for my mother or somebody to come help me.”
For her 2020 birth her provider at the Minnesota Community Care Clinic recommended she join the D.I.V.A. Moms program. Once she got to know the midwives and the rest of the team, she quickly felt that she could trust them to help her through her pregnancy.
Part of the mission for D.I.V.A. Moms (Dynamic Involved Valued African American Moms) is to ensure mothers are valued and heard throughout the pregnancy. Formed in 2018 by a group of midwives wanting to improve birth and maternal outcomes for U.S.-born Black women, the program has worked with 285 mothers to date, according to program manager Kindra McGee.
Support
McGee herself was a teenage mom. She says something like D.I.V.A. Moms would’ve been very helpful when pregnant.
“As a teenager and in that pregnancy, I didn’t have much support,” McGee said. “I had my mom and my daughter’s dad, but as far as medical (support), I think I might have done a total of six visits total in my pregnancy at that time.”
For Washington Richard, having people in the program who listened and understood her concerns without bias was extremely comforting.
Since she was above 35 years old, her pregnancy was considered higher risk. That, combined with the statistics of Black women being more at risk of dying due to giving birth meant she needed extra support.
“My mother had passed, and she was pretty much my doula (a woman who provides support to pregnant women during labor) with my other two births,” she said. “It was important for me to find another supportive solution when it came to giving birth.”
On top of that, Washington Richard lost her job during the pandemic.
“The moms that are the most stressed out are because they don’t have enough things to make ends meet. They don’t have financial support, or they’re that single mom that’s trying to do everything, or it’s a brand new mom that just simply doesn’t know what to do,” McGee said.
The moms who come to the program are often referrals from Minnesota Community Care or other health systems. Right now, the program has 15 midwives that support the moms.
Minnesota Community Care partners with various clinics to focus on improving birth and maternal outcomes. Its largest clinics are La Clinica and East Side Family Clinic in St. Paul.
People come with a variety of questions, ranging from wanting to learn about breastfeeding compared to using formula to asking about medical terminology used by their doctors, McGee said.
Community building
Participating mothers and leadership meet monthly at events focused on various topics. During Washington Richard’s pregnancy, she joined Zoom meetings, where she formed a support system.
“It was really a sisterhood that I felt with the other moms,” Washington Richard said.
That feeling of comfort was not only with the other moms but also with the providers in the program. Washington Richard had a Black midwife, something that improved her experience, she said.
“It’s a different level of understanding when someone understands you culturally. You don’t have to explain things from a cultural aspect. You can talk in your own language, and they understand you. Even though we’re both speaking English, you can say stuff, and they understand because they come from the same culture. They understand your language, the way you speak, and the way you explain things, and you’re not questioned in certain ways,” Washington Richard said.
Unlike with her previous pregnancies, this time around, Washington Richard felt comfortable with the providers.
“She was phenomenal. Anytime I had a question, I felt heard. I didn’t feel dismissed. I didn’t feel like my question was a dumb question,” said Washington Richard. “I just felt like my cultural needs and also just being heard when I asked the questions, when I had any concerns about giving birth, it was answered, and it was answered in a way that I could understand.”
To ensure the program is addressing all the factors that can affect maternal and birth outcomes, McGee collects basic information when moms come in to get a sense of what they’re needing. She often finds people in need of transportation, help with insurance, housing and various baby supplies.
“If I have a mom that comes through and she says, ‘My niece has a baby, and she could use some diapers.’ That’s what community is. I’m like that auntie, the sister type friend that if you need something and D.I.V.A. Moms has it, by all means, let me know, contact me, call me,” McGee said. “I’m not just helping them in pregnancy; it’s a life; I’m helping them in their life. That’s what D.I.V.A. Moms does.”
Impact
Improving outcomes is not necessarily an easy thing to measure, said Sonja Batalden, director of Perinatal Care at Minnesota Community Care.
“The reality is the outcomes aren’t different because of any one magical thing that we can do. The answer is not, ‘Well if we could just help people get to a prenatal visit by giving them transportation, then if they came, it would all be better.’ Or if we did more ultrasounds or even if we gave people food. When we talk about removing barriers to healthcare or barriers to wellbeing, those things are relatively simple to fix, even though they can sometimes be tricky. What’s a lot harder to think about is how do you actually begin to undo the centuries of discrimination and racism and what that has done and how that has shaped our healthcare system?” Batalden said.
Despite having given birth two years ago, Washington Richard is still tight-knit with McGee and the rest of the D.I.V.A. Moms community.
“I had a very quick birth, so she (McGee) didn’t make it to my actual birth, but she came right after. It was a Sunday, so she left church, she left what she was doing, and ran to my assistance, Washington Richard said. “Not only did she do that, but she continued to follow up while I was in the hospital.”
The impact of a full-term birth is unlike no other, Batalden said.
“Even though the numbers might seem small, the impact can be really big when you’re talking about a healthier, full-term baby,” Batalden said. “For example, moms who haven’t been able to parent their children in the past due to different struggles that were able to actually parent their next child with that support from the community. That’s amazing. That is a life-changing event, not only for that child but for that mother and for everyone in that family. When you see those types of outcomes … I still get shivers down my spine thinking about the joy on that mom’s face and the that she brought to that child.”
What a great program! It’s sad that it didn’t exist before…and it’s sad that it has to exist to give Black mothers-to-be a safe and affirming birth environment. One of the reasons that health outcomes are so poor for Black people is that they’re ignored and generally treated poorly by the medical system relative to white patients. While women, in general, are more likely to be treated like they don’t need to have a stake in their own health, this is especially true of Black women. Now, imagine all that heaped up on a pregnant, Black woman…and add teenage to that…and you have a recipe for lifelong harm to both the mother and the child. Just being born white is a privilege that Black babies don’t get. And no, whatabouters, it’s not about poverty. This disparity exists even when you control for income, insurance, age, and severity of health issues. https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/
Beyond curing the systemic racism and sexism in medical care, imagine what we could do if patients were treated like people rather than profits; if doctors had the time and training to really care for patients (and were expected to as professionals); and where nurses were valued and compensated more in accordance with their essential role in health care.