Midwife Education in the South Decreasing while Black Infant Deaths Increasing

Miami Dade College, the largest institute of higher learning in the U.S., closes its midwifery program, citing economic distress. The students and community protest, citing Governor Crist’s Black Infant Health Initiative (BIHI).

MIAMI, FL. (August 23, 2008) -- The prevailing economic climate is forcing colleges like Miami Dade College in Miami, Florida, to eliminate programs. On August 1, the direct-entry midwifery program received the ax, leaving current and prospective students destitute.

Those students organized a rally, on August 8, to protest the closing of the program at a meeting the College scheduled as “informational.” The College officials vowed to return their money and directed the students to pursue vocational options within its Medical Center Campus.

Abandoned and enraged students contacted their officials, ranging from the College Board of Trustees and President Eduardo Padrón, to Florida legislators Sen. Frederica Wilson and Sen. Larcenia Bullard, and members of the Healthcare Council. The ultimate goal was to gather the voices of citizens concerned with the rising infant mortality among African-Americans, and to use that leverage to garner support for midwifery.

According to the Florida Department of Health, Black infants in Miami-Dade County are more than twice as likely to die as those born to White mothers. This ratio is evident across socioeconomic factors and is not limited to that county. The problem is so increasingly widespread that one year ago Governor Crist signed House Bill 1269, the Black Infant Health Initiative (BIHI), “to develop strategies to address the disparity.”

Medicaid pays for half of all births in Florida at a time when there are less obstetric providers due to rising malpractice insurance. Maternal care provided by midwives cost half of the care provided by hospital physicians. Midwives, particularly the students of Miami Dade College, are better able to reach the communities affected by the disparities because they represent those same populations--women of color.

But this may be the same old story. America has a history of disenfranchising black women in the teaching and health care professions, beginning in the 1920s and reaching an acme amidst the Civil Rights Era. Strangely enough, Miami Dade College was a progressive model serving as the first integrated college in Florida during that era.

Miami Dade College is not the only accredited institution in the South that has cut its midwifery program. The Medical University of South Carolina and the University of Miami just closed its nurse-midwifery programs. And the University of South Florida closed its program in 2003, leaving the University of Florida in Gainesville, and Emory University in Atlanta. One direct-entry program remains--The Florida School of Traditional Midwifery in Gainesville.

Although the prospective Miami Dade College midwifery students may be feeling demoralized, they move forward in the fight to keep their program and to save the lives of babies in Florida. The students continue to organize and prepare for what may be a repeat of the lunch counter sit-in at Woolworth--a movement revisited.
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Miami Dade College Suspends Midwifery Program

This should be a sad day for women as the only institution of higher education in the U.S. that offers direct-entry midwifery education, closes the program for supposed financial reasons.

As of the 2008 estimates in The World Factbook by the CIA, the United States ranks 42nd on the infant mortality list. With 6.3 deaths per 1000 live births, the U.S. trails behind Canada and most of Europe. Yet, we have the most "modern" and medicalized healthcare system in the world.

One in three births in the U.S. are by Cesarian section with an increasing maternal mortality rate as well. As OBGYNs are fleeing their obstetric practices due to rising malpractice costs and the threat of litigation, pregnant women have had decreased options for safe and effective maternal care.

Midwives step in and provide low cost care to healthy, low-risk pregnant women. There are minimal interventions and care can be coordinated with obstetricians in order to provide the most effective care for high-risk women.

A key to remember is that doctors are trained to identify and treat pathology. In most cases, pregnancy is not a state of ill-health or disease. Women have been giving birth since the dawn of time, assisted by other women, midwives.

Please, ladies, gentlemen, if you care about the increasing infant mortality rate, increasing c-sections, and a woman's right to choose a safe alternative for maternity care, stand up and say something about this.
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