Op-Ed: Having A Midwife By My Side May Have Saved My Life

The womb and the miracle of childbirth are serious business. I dare say that the process is supernatural, and the nature of these things should be handled with great care at all times. Women hold the cradle of humanity in their bodies as incubators of life. Yet, and still, healthy women enter hospitals to give birth to their precious unborn babies, and some never leave. While emergencies during childbirth are a risk for women of all backgrounds, in America, a disproportionate amount of Black women die during childbirth. According to the National Institute of Health, there are several structural and systemic causes for this disparity. Implicit bias, a lack of cultural acuity and acumen among medical staff, and the history of America’s medical field have all played a part in this reality. However, this was not my story. I received the best prenatal and postpartum care at NYU Langone, and having a midwife who understood me culturally and socially may have saved my life.

With my first pregnancy, when I was much younger, I wasn’t fully aware of the breadth of birthing options available to me. When I became pregnant with my second baby later in life, I knew I wanted a nurturing certified nurse midwife by my side, and this decision made all the difference in the world. I’ve always believed that the privilege of carrying a life in the womb and ushering a soul “Earth side” is a miracle. I didn’t want just any healthcare professional or team alongside me based solely on their medical credentials or the hospital’s reputation. On the lookout for someone kindred, warm, and discerning, I instinctively knew who my midwife would be based on the colors she had on in her medical headshot: a vibrant shade of magenta with hints of red. I love color. Having already prayed for divine alignment before my first appointment, I felt immediate ease when Aisha L. Olivacce, CNM, walked into the room sporting magenta pants and a neon pink nail color. I asked if she was an AKA. She replied, “No,” but her favorite colors were pink and kelly green. Everything speaks, and I knew that upon meeting her for the first time, she would be a safe space for me on this journey.

It wasn’t that she had brown skin like mine and coily hair; it was the warmth of her smile, how she laughed from her gut when I talked about the unique epithets that I call my vagina, and how she actively listened when I talked about sex, marriage, and life. I didn’t have to overexplain or hide parts of myself. She just knew what it was whenever we communicated, and we clicked.

I’ve never liked hospitals. They often feel clinical and cold. However, the Midtown Manhattan 5th Avenue location for my prenatal and postnatal care was modern, beautiful, and filled with vibrant hues and unique decor. I knew I could trust my midwife in this medical space, or any other, because I felt seen. Pregnancy is a sacred, personal experience, and I was deliberate about inviting joy into my pregnancy journey from the start. My midwife was the ultimate professional. She ensured I had all the information I needed about each stage of this new pregnancy without being rigid. Every woman deserves to have conversations that feel like a hug when visiting their medical professionals, and being culturally and socially aware of the experiences of others, especially patients, regardless of one’s background, lends itself to better interpersonal connection altogether.

When speaking with Aisha after my pregnancy, about the importance of choosing a midwife or doctor that has cultural acuity, she shared, “In today’s culture, choosing a midwife or doctor that can understand exactly what you are saying without saying a word is everything. In the Black community, a head nod, a look, or a ‘hmm’ can say 1000 words. Patients really appreciate this, and it strengthens relationships.” I concur, and this was my experience, too.

According to the American Midwifery Certification Board, only 8.7% of Certified Nurse Midwives are Black. Historically, Black women “catching babies” has deep roots. When speaking with my midwife, she further shared that “Black midwives, historically known as granny midwives and healers, were vital to the community as their presence and expertise promoted longevity of Black women and their babies. They attended many deliveries of not only Black women but many white women as well.”

While I felt some comfort with having cultural affinity with Aisha, I chose to stay with my midwife based on her receptiveness to my personality, quirks, and preferences. She allowed me to pray during my prenatal visits. When my husband and I gave her our gospel playlist to play during the delivery, she just let us flow. As a result, there was such a sweet atmosphere in the room as my baby boy was being born.

Aisha advocated for me at every stage of my pregnancy. She was there at 6 a.m. when I arrived at the hospital, and the staff on duty during my delivery knew about me in advance. Midwives go the extra mile to ensure their patients feel safe, and they make the path easier for them. She even ensured that I had sufficient photos and videos to document aspects of my pregnancy and delivery.

More importantly, my midwife assembled a warm and attentive team around me and created a safe atmosphere in the hospital before, during, and after the delivery. While things don’t always work out like this, my doctor for the delivery, Sarah A. Shawki, MD, was so gentle and emotionally in tune with me. My anesthesiologist and his team were tender with me during the epidural, too. Everything was in alignment. A good midwife, no matter their ethnic or cultural background, will be there to empower you, show up wholeheartedly without implicit bias, and have a mindset to be of service to the birthing process. My certified nurse midwife attended to the details while I prepared to push out life. Every mother deserves to experience this type of care during childbirth, and with access to the right information and team, it’s possible. So, be encouraged! But do your research, too.

A Few Things to Consider When Choosing a Midwife

In any partnership, it’s important to surround yourself with people who make you feel seen. This holds true when choosing a midwife as well. Yaa Haber, PhD, Executive Director of the Institute for Excellence in Health Equity at NYU Langone, also a mom of 5, shared in a recent chat the necessity for choosing a midwife with cultural acumen and how it can be a game-changer in saving one’s life. “When your care team understands who you are, can speak to you in the language you prefer, makes recommendations to you based on understanding what resources you have access to, it makes a world of difference. For example, if my doctor knows that I live in a neighborhood that is not walkable because it is unsafe, they will think twice about recommending that I go for a walk around the block as a part of my care treatment. It makes it easier for me to bring my entire self to the medical visit because I know they will make recommendations that take my entire lived experience into account.”

It’s also important to do your due diligence and research the background of the medical team that you align yourself with. She further shared, “Implicit bias are the assumptions a person makes based on preconceived notions and stereotypes of a group of people. For example, there is a general assumption that Black women have a high tolerance for pain and discomfort. If a provider buys into this generality and is treating a Black woman in childbirth, they may find themselves, refusing to provide pain medication to that woman and or ignoring signs of discomfort because they assumed that their pain was not critical.”

The Benefits of Partnering With a Midwife

There are many advantages to having a midwife. Midwives advocate for you in the hospital setting if needed; they are trained to discern your unspoken needs, and a culturally sensitive midwife can help to shield you from unnecessary hardships during your pregnancy. It’s so important to trust your instincts while pregnant. No one knows your body better than you. It’s equally important to have a professional who has been trained to be intuitive around the female body as well. Women who have a midwife are less likely to have a C-section. Haber shared, “The average rate of C-sections under midwifery care is 6%, which is way lower than the national average of 36% with typical care. This shows that the quality and safety of the prenatal birthing experience is much safer when a midwife provides that care. Midwifery is not just a profession, it’s an art form.” They make you aware of the risks and benefits of options while gently guiding you to the decision that best suits your unique needs.

Questions to Ask Your New Midwife

Asking your new midwife the right questions can help to set healthy expectations between you and your healthcare professional. Every pregnancy journey is different, so it’s important not to make assumptions and to be transparent about your concerns and needs from the very beginning of the partnership.

Will I be able to have continuity of care?

Will I feel comfortable and safe with you as my midwife during my pregnancy, labor, and postpartum period?

Can you recommend doulas you’ve partnered with in the past?

What is your philosophy on pain management?

What are your thoughts on the benefits and risks of sticking to a birthing plan?

At what point should I seek medical attention, and when is it better for me to stay home and rest?

What is your availability, and when and how can I contact you?

What happens if I disagree with or refuse your treatment recommendation?

What should I do if I feel uncomfortable with a treatment recommendation you make?

Resources to Take Actionable Steps on Your Pregnancy Journey

Midwifery In Color

The National Black Midwives Alliance

Sista Midwife Directory

Black Midwifery Collective

Christian Hypnobirthing (Not Black-owned, but exercises cultural acuity)

Recommended Reading on the Legacy of Midwifery

The Women Who Caught The Babies: A Story of African-American Midwives by Eloise Greenfield

Delivered By Midwives: African-American Midwifery in the Twentieth-Century South by Jenny M. Luke

Birthing a Slave: Motherhood and Medicine in the Antebellum South by Marie Jenkins Schwartz

A History of Midwifery in the United States: The Midwife Said Fear Not by Joyce E. Thompson, Helen Varney Burst