Community-Based Midwives and Hospital Systems: A Case for Partnership (The Notes)

These notes are extracted from This Article

  • A set of good vitals and an uncomplicated medical history are not remedies for social inequities or lifelong lack of access to healthcare education and navigation, or accessible, timely, effective, and therapeutic interventions.
  • When a patient presents with a medical complication, a midwife can identify it and ensure access to appropriate care if she has access to those who would provide it.
  • The midwifery model of care recognizes that technical improvements in healthcare delivery are irrelevant without addressing the places where unjust and deeply impactful social determinants of health drive the patient’s life experiences.
  • This work [of midwifery care] results in trusting connections between patient and midwife. Indeed, at the time that hospital staff or a physician meets the patient, she may be experiencing a very real grief over the potential change in relationship with her provider and hopes for a unique and well-planned birth experience.
  • No one anticipates that the nurse or physician standing before them will do harm, but how likely is it that they will see you as an ally in their care when you take a stance of juxtaposition and even mockery of the one provider who has ever truly listened to, heard, and understood them?
  • Ignoring or belittling the midwife or any community-based provider for accessing those resources will make them hesitant to enter into the system in the future.  It is this behavior that pushes midwives to move patients further away from safe and timely interventions.
  • However, the ideals of community-based hospitals, so richly developed in many places, is to open the doors and welcome what the community brings, and to share the fullness of knowledge and technology from a place that recognizes the humanity of each patient and the irreducible needs of each person with whom it interacts.
  • …at all points of intersection [of the preventative and therapeutic pathways of care] patient health improves when they can easily step from one to the other as is appropriate for their needs.
  • We know that the impact of technical interventions is effective and wonderful but it is reliant on hospital policies that make these interventions accessible to the community.
  • If we can look together beyond the responsibility of the hospital to the community and financial interest in receiving midwifery patients, here are some ideas that lead to beneficence [see article suggestions]
  • Joining efforts to achieve the common goals of good health and easy, timely access to healthcare resources can only lead to improved outcomes and the development of a model that can truly serve the consumers and the providers in our community.

Author: Midwifery

Jodilyn is a licensed midwife (WA, TN) and certified professional midwife. Recently relocated to Memphis, TN, and passionate about the intersection of social justice and perinatal healthcare. She owned Essential Birth & Family Center in South Seattle's Seward Park neighborhood. She is co-founder of South Seattle Women's Health Foundation, an organization dedicated to providing midwifery-led maternity care in a collaborative community-based setting and to increasing capacity within the community to support healthy birth and breastfeeding practices.