The Cavalry Ain't Coming...

As I sit here in this lovely hotel lobby during the 2012 City Match conference in beautiful San Antonio, and listen to some of the greatest minds in US Maternal Child Health, and rub elbows with the biggest of the bigwigs from the CDC, the NIH, and the US Health and Human Services, it suddenly occurs to me, I need not attend any more sessions, the answers aren't here.  Not that I have not heard some amazing stuff and met some talented amazing people- all that is true.  However, the answers I seek can't come from federal bureaus,  health department policy wonks, or the latest data sets.  Let me explain.
In a moment of stunning clarity, it came to me.  I am the answer.  What I do within Uzazi Village offers up the greatest hope for my community.  I must find a way and I must do it without government or philanthropic grants (no one will give me money to save Black babies), without 'strategic partners', even without 'stakeholder buy-in'.  I must do it by grassroots organization, community will and bulldog tenacity. I am the only one that can do it.  These outsiders with their graphs and charts don't know ANYTHING about my community.  Neither do they care to learn.  I see no evidence that anyone is concerned with restructuring rascist institutions, the very thing that could facilitate the most change.  They only want to impose their own agendas and see their own outcomes.  I am throwing off this colonialist model and doing my own thing. 
The cavalry ain't coming... so I guess its up to me.

The Women of Bainbridge

     My long absences from writing reflects the busyness of my journey at this point.  I am traveling 2-3 days per week to be with my preceptor in another city.  My studies and baby catching continues and I am learning much as I progress through the process. 
      Yesterday, I had the privilege of presenting a program on reproductive health along with my cohort, Mariah, to the women of Bainbridge.  The Bainbridge is a monolithic apartment complex filled with single mothers and their children.  The building has a social worker that helps connect the families to resources.  It is an impossible task- one new graduate social worker for 165 families.  The women are like myself (or as I once was), young mothers with small children trying to scratch out a life in mean circumstances.  The reproductive health class was a great success.  Over a dozen women attended and the class was loud and raucous, there was much laughter and joking, and the women asked their questions, and had them answered by Mariah and myself in as plain spoken and as straightforward a way as possible.  What we had done was not so difficult.  Meeting women, in their own space, on their own terms, and answering their questions about their bodies and their health.  Yet as we did it, I knew that we were doing something radical, something key, something vital to the mission of Uzazi Village: connecting outcast women to the power that comes from knowing and understanding their own bodies.  The conversation was perfect in its inclusiveness.  We told the women, no question or topic was off limits.  And the questions came.  They poured out like a long awaited rain to a dry, parched land.  They asked about HIV prevention, the use of dental dams, men having sex with men, blue waffles (new one for me), how the morning after pill works, why inductions are a problem,  and the all important issue of DOUCHING.
     We are planning to return to The Bainbridge on a monthly basis with a different topic.  The social worker shyly inquired about our availability to other such buildings.  There are over a dozen such buildings employing other social workers.  The opportunity is vast, our capacity limited.  My desire is to build empowerment groups at each building where the women meet regularly to inspire one another toward their personal goals.  Uzazi Village would provide facilitators to keep the groups focused until we could train leaders from each group to take over the task, so that eventually they are all self run.  Uzazi Village would invest in those homegrown leaders providing ongoing support.  The Bainbridge is the largest of the buildings and the residents the most resistant to standard 'programing', and so seemed like the best place to start. (If we could prove ourselves there, they might just throw open the doors to the other locations.)  At any rate, the vision evolves.  Some suggested topics: menstruation: the start of all things reproductive, the dangers of labor induction, dancing for fitness, eating for a healthy pregnancy, saying no to unwanted sex, gentle parenting, everything you ever wanted to know about breastfeeding, planning for pregnancy and birth, cooking class: Soul Food for the Body, common STDs and how to avoid them, choosing the right birth control method for YOU.  I'm starting at the base of Maslow's hierarchy with topics related to safety and biological needs and hope to move the topics up the pyramid over time, to tackle subjects like education, employment, and relationship building. 
     I started our conversation rolling by gesturing to the table full of gift bags next to me.  "Be honest. Who came today just for the gift bag?" I asked.  One woman stated, "I did."  I told her, "Here, take it and go.  I want everyone here to be here of their own free will and not by compulsion.  The bag is yours to take and go with my blessing."  I asked the other women and they all answered the same, "I'm here to get the information."  The woman who took the gift bag, never left the room and was a great participant in the discussion, which went 30 minutes over its appointed  90 minute time slot.  I'm already loving the women of Bainbridge.

Uzazi Village Open for Business

We all party hardy at the Uzazi Village Open House

Uzazi Village hosted its Open House last night.  It was well attended and went according to plan (well almost).  As we officially open our doors and invite community members to vie for board seats, I am amazed and humbled that we have made it this far.  The space is beautiful and meets our current needs.  Classes and support groups are up and going.  Volunteers are coming out of the woodwork.  The community vision for maternal wellness grows.   I look forward to our first free community childbirth class coming up next week.  This week also marks the start of our long awaited yoga classes.  I'm so excited that the space will be used in this way.

Line dancing led by our yoga instructor and one of the Sister Doulas

I spent a weekend with Sr. Morningstar visioning what a new model of culturally congruent prenatal care will look like, the model I plan to set in motion once I complete midwifery school.  It was absolutely mind-blowing.  I can't wait to shape and mold prenatal care around the existing community, rather than to bend women to a merciless model of care, that is harsh, and asks the impossible of them, and then punishes them when they cannot comply.  It will not look like what we think of prenatal care.  It will be woman-derived and woman-driven and wholly culturally appropriate.  No more waiting and no more waiting rooms.  No more paternalistic, dictitorial directives that tell rather than ask.  No more five minute conveyer-belt visits.  This is not the proper way to care for any woman, let alone my women.  This does not deliver acceptable birth outcomes.  It does not teach, guide or care about the women it allegedly serves.   A system that barely works for dominant culture women, really does not work at all for the women of my community.  Since we already have the worst birth outcomes of any other group, I have nothing to lose in trying some new innovations.  Time to roll up our sleeves and get to work.

Why I Choose the CPM Model for my Community

Suzy has no idea what a can of worms she is opening with her question,, "What's the difference between a CNM and a CPM?  A CNM- Certified Nurse Midwife has completed a bachelors in nursing and a masters in nurse-midwifery.  A CPM- Certified Professional Midwife has completed a course of study at a MEAC (Midwifery Education Accrediting Council) accredited school or a midwifery apprencticeship and passed a  NARM (National American Registry of Midwives) certifying exam.   CNMs are legal in all 50 states, CPMs are legal in 27  states ( they are legal in MO, but not in KS).  I choose to promote the CPM model for my community because it is a more practical and accessible model for rebuilding a lost community of midwives. Of course, I will support aspiring midwives in whatever pathway to midwifery they choose.  Frankly neither model has reached out to the African-American community, nor tried very hard to address health disparities in our community.  After I complete my own midwifery studies, I will make it a priority to raise up other Midwives of Color.  My goal is to reclaim the Community Midwife in order to create grassroot solutions to our concerns and not rely on outsiders to rescue us.  I am sad that the animosity between CNMs and CPMs is great, but I cannot be distracted by it.  I have too much work to do, and babies in my community are dying from a lack of concern or caring by majority normative culture.  I will welcome and embrace anyone who would join me in these accomplishing these goals.

On a Mission...

Things are really beginning to reve up.  I feel like snowball, rolling downhill.  I sign the lease on our new training space tomorrow and Uzazi Village will have an address!   Later this week, I leave for Orlando Florida, to attend the International Lactation Consultant Association conference, and to sit for the Lactation Consultant exam.  I also have finals this week and need to finish up my clinical assignments before I leave for Florida.  Next week, we move into our beautiful urban training space (exposed brick walls, high beam ceilings, and finished wood floors) and start training our Sister Doula candidates, and holding our Chocolate Milk Cafe (breastfeeding support group).  I am on an absolute high, seeing things come together, that I have long only dreamed of.  This weekend was the annual retreat for the Missouri Midwives Association, and I spent a blissful weekend with my sister midwives (mostly CPMs, the CNMs have their own group, sadly).  (Even though I'm training to be a CNM, I believe the CPM model is a better one for my community.)  I loved spending time with my sister midwives and was able to share my intention to fill their ranks with midwives of color.  Two other local midwives are starting a birth attendant class, and my peridoula course will serve as a nice pre-requisite.  With the local midwives taking on apprentices our little corner of the map is soon to become a hotbed of midwifery resurgence.  This is my personal mission- to restore midwifery to my community.

Perinatal Doula Training

Preparing for an upcoming training:

Perinatal Doula Training

32 hours of training for certification as a Peri-Doula

Peri-Doulas care for women throughout the childbearing cycle- prenatal, labor and delivery, and postpartum. This training includes four certifictions:

• Certified Le Leche League Breastfeeding Peer Educator
• Certified Contraceptive Counselor
• Certified Birth Doula
• Certified Childbirth Educator

This course is $595 (installments offered) and will be held

August 4 (8am-4pm), August 11 (8am-4pm), August 18 (8am-4pm), August 25 (8am-4pm)

This course is offered by Perinatal Resource. For more information call Mariah Chrans at

913-486-8568 or Sherry Payne at 913-638-0716.

The Beat Goes On...

I remain in waiting mode, for word about the building.  I can't tell if God is trying to build my faith, or torment me.  I did not hear back about my tenant application last week as told, so I expect to hear back this week- hopefully in the next day or so.  The Uzazi Village website is complete (for now) and my next order of business is to open a bank account.  I need to depos. it the money from the fundraiser.  The board elected to go with a neighborhood bank, and they are in very short supply in the urban core.  (Now if we wanted to go with a title loan place or one of the 400% interest rate loan places... we'd have our pick.)  There are two banks to choose from so I'll see which has the best offers for business accounts.

I really need to devote some time to my books.  My publisher is waiting on overdue edits for my existing book, and I have a  New York literary agent wanting to see a proposal on my new book.  Writing is a very time consuming process and I need to just sit down and do it.  I have an outline for my book proposal, but no title, but I may just send it without a title. 

My work on the conference right now involves writing a preliminary budget and tracking down funding sources.  As soon as the hotel contract is signed, we can start marketing it.  This is going to be a fabulous conference.  The focus will be on decreasing health disparities with Mother-Friendly and Baby-Friendly care. 

On the education front, I have two upcoming conferences.  In two weeks, the Missouri Midwives Association is having its long awaited annual midwives retreat.   I will be teaching CPR and NPR and I have an agenda item on the business meeting: cultivating birth workers of color.  As usual I'll be the only woman of color there, and I need to start raising some awareness.  The other conference is the ILCA in Orlando (lactation consultants).  In just two more weeks, I'll be taking the LC exam.  This has been a HUGE undertaking that has taken me two years to prepare for.  My fee for the exam was $600.  If I pass (keeping my fingers crossed) I have already laid the groundwork for my doctoral thesis I call the "Pediatrician/Lactation Consultant Partnerhip"  I will work one morning a week in a local pediatrician's office (with an urban mostly African-American practice) assisting with breastfeeding issues in order to increase duration rates.  The pediatrician will start to track his number now- he has no idea what percentage of his clients breastfeed now, and when they encounter difficulties, he can only offer positive encouragement, but no skills to help.  (Part of the problem is that as a pediatrician, he can only assist on the baby side not the mother side - he can't bill for mother-based interventions, only baby interventions.  I'd also like to offer a breastfeeding support group in his office as well as promote the Chocolate Milk Cafe- which should be up and going in August.  Which reminds me, I have one more conference- Midwives Alliance of North American in Asilomar CA where I'll do a session on the Chocolate Milk Cafe.  That is coming up in September. 

     In the meantime I do what needs to be done for the current day- and today that is lots and lots of homework and study for a test tomorrow.  Bye for now.

Whirlwind of Activities- when it rains, it pours

The past two weeks have been filled with activity.  I decided not to go to Boston for clinicals and instead accepted an adjunct teaching position in the Fall.  I did so becuase things are moving faster than I thought they might, and I don't think I can leave my projects for an entire month.  The provisional board of Uzazi Village is making arrangements for a permanent board to be in place by October.  We are furiusly writing a business plan in hopes of a small nonprofit start up loan.  The biggest news is that we found a wonderful location for Uzazi Village and are waiting to hear if our lease application has been accepted.  If so, we will spend the month of July preparing our space and moving in, and will start operations the first of August.  I won't write about the space until I know we have it. 

There is so much going on all at once.  Antepartum (prenatal) clinicals this summer are a whirlwind and I am learning so much.  I am seeing between 4- 12 patients a day in the clinics I attend.  It has been a fantastic learning experience.  This Fall I look forward to catching my first baby (first of many, I hope.) 

Uzazi Village is now calling for applicants interested in free training to become Sister Doulas.  These peridoulas will be trained and certified in doula services, childbirth education, breastfeeding peer counseling, and contraceptive counseling.   We decided to move ahead with the Peridoula Demonstration Project without any grant funding.  This is a complete act of faith.  The training will take place the month of August, and the selection process begins now.  We are hoping to train 5-10 Sister Doulas to have in place ready to go, should our proposal be accepted by a local Medicaid HMO.  The Sister Doulas will be paired with Medicaid moms for the purpose of decreasing health disparities through prevention of preterm birth and the promotion of breastfeeding and baby spacing.

My other big project is the CIMS conference for 2013.  It is a go and it will be held here in Kansas City.  That means I am also simultaneously trying to raise funds for conference expenses an to pay for the big name speakers we are trying to get here in KC.  I know this will be a fantastic event and I look forward to seeing many of my readers there.

A Week of Meetings

Its been a somewhat eventful week.  I met with a local retired physician who gave me some good advice and feedback on the new website.  I met with a contact person in a Medicaid HMO and pitched my idea for peridoulas.   I looked at a building that might be suitable for a birthcenter that will become available next Spring.  I spoke to a local LLL leader's group about the Uzazi Village vision.  I made more contacts, and touched base with my liutenents.  Through student clinicals I got a glimpse of midwifery at both ends of the spectrum- midwives caring for a middle-class clientele, and those caring for a low resource population.  Viewing midwifery practices up close and personal and been valuable and enlightening.  I am excited for the shape that the work is taking.  I have more appointments set up over the next few weeks- a local birth center, a health advocacy group for African-Americans, a local pediatrician.  I'm also trying to get on the agendas for several organizational meetings.  I'm currently on the lookout for commercial space that I can use as a small office/clinic and meeting space.  I need something with a large meeting room, a small office, an exam room, a bathroom, and a small kitchenett.  It needs to be in the city, near midtown or downtown.  Once I secure a space, I will begin hosting the Chocolate Milk Cafe- a breastfeeding support group for African-American moms.  I hope its up and going by August if not sooner.  In the meantime, I'm hitting the road to Connecticut and Rhode Island to present my educator workshops.  I'll return next week and jump back into the thick of things.

Oh, and one other 'meeting' worth mentioning.  I visited a relative living in the urban core, and overheard a cousin berating an uncle for not 'investing' in his business.  His business happens to be selling dope.  Yeah, that's what I'm up against.

What it is, What it isn't

This blog is not about my experiences as a student midwife.  While I might feel compelled to journal about some of those experiences, this is not a student midwife blog.  This is a visionary's blog.  This blog is about manifesting an impossible dream: community-centered care for an outcast population.  These women and babies have been thrown away by our society- left to scavenge the crumbs of the healthcare system.  No one really cares about what happens to them- except to the extent that they can be exploited for profit.  This blog is about creating a model of care that truly cares.  I don't consider myself gifted for this task, but I do feel I am called to it.  I extend an open hand to those who would join me in the work.  It is no small undertaking.  It will take all of us.  Consider this your engraved invitation to the revolution.

Count Down

The countdown has begun.  Exactly one year from now I will have completed my midwifery program (Lord willing and the creek don't rise!) and will be taking my boards and hopefully, my clinic will be ready for operation.  From this vantage point, this seems nearly impossible, but then so is improving our dismal perinatal measures in the urban core.  The entire idea is highly implausible, so I may well just talk about what I intend to do, possible, plausible, or otherwise. 

I am very involved right now in making connections in the community.  I have an entire page of people listed that I intend to visit and share the dream with them.  Some have been easy to get in to see, others put up a lot of barriers.  No matter, I intend to see them all.  Some will become partners, others just interested onlookers.  I intend to sort through the entire community until I have the support and resources I need to carry out the work.  I have a separate list for the philanthropic community, and hope to begin raising funds to start the Sister Doula program.

Today will be spent finishing the curriculum and making a marketing plan for getting the word out.  I'm hoping to get at least five good candidates who want to become doulas who make it through the training.  I meet with a Medicaid HMO next week, whom I'm hoping will partner with us and allow us to pair our Sister Doulas with their clients.  Once that is in place, I will secure funding for stipends with some of the local health foundations.

In the meantime, I am still scouting out locations for the Chocolate Milk Club to meet.  Hopefully something will open up soon.   It is the simplest of my intitiatives and I'd like to get it up and going.

Welcome

Welcome to my new blog, which will follow me on my adventure of midwifery school and setting up a new practice and clinic over the next year.  I am a student in a CNM program in the midwestern United States.  I will be sharing the process of becoming a new midwife, and ministering in the urban core.