...What is clear from the research about this issue is that women of color are less likely to receive midwifery care, and that disparity is larger than the population numbers would suggest. I think this dynamic is complicated by global sociopolitical historical factors. For example I experienced resistance from Latina immigrant women to midwifery care because of the stigma toward parteras (midwives) in their home countries. In many places in Latin America, midwives and home birth are seen as the option used by women who can’t afford to go to hospital for birth–basically an option only for those who have no other option.

That creates class and race stigma on home birth and midwifery care.

This stigma is no accident. Global socioeconomic policy in Latin America (and I assume elsewhere as well) has long promoted hospital-based childbirth as a marker of development, and encouraged this move with foreign aid dollars and other development initiatives. The medical students I observed in Ecuador were clear that their obstetrical training and guidance came from US practice. So does the push toward hospital-based birth and away from traditional midwifery care. ...

With African American folks who might not be recent immigrants, there is another factor at play. Claudia Booker was the first to make this connection for me. When hospital birth first began in the US, and for quite some time after, black women were excluded because of racism and classism. Those barriers to receiving care in the hospital created a similar race and class stigma to that I described from Latin America–meaning that women of color might also see midwifery or home birth as the thing you do when you have no other option. Hospitals are the place that people with wealth and privilege go to give birth. Why would one then choose to opt out?

Labels: class, culture, health care, midwifery, motherhood, pregnancy, race

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