What You Don't Know, Hurts Us

I talk to professional Caucasian people day in and day out about my proposed approach to health inequity.  I have resigned myself to being mostly misunderstood and maligned.  It is frustrating, and unfair, but I've learned to live with it.   It is so refreshing when someone actually HEARS what I am saying.  Here is the excerpt I received from an email yesterday, that I have permission to reprint for you.  I had been checking in on a group from another city that had come up to hear me speak last September.  I had given them a private session on improving breastfeeding rates in their agency after my conference session.  I was checking in to see if they had used any of my suggestions and how it was going. The writer (a Caucasian nurse) is just about to end her support group because it did not take off, but is thrilled by the response to the support group of the African-American breastfeeding peer counselor  (Monique) they had recruited.   I didn't expect this:


Both hospitals here are working on Baby Friendly, so we went from the WIC breastfeeding group + LLL to about 6 breastfeeding groups each month.  We decided to cancel mine since the attendance was lowest; appeared to me that we didn’t need the group with all the other options.

December was to be my last meeting and it fell right after Monique’s first Monday meeting.  Monique usually came to the group and, other than the two of us, the other attendee was a young, black breastfeeding mother who also happens to be a news reporter who’d heard about Monique’s group. 

Sherry, the whole tone of the room changed when the reporter mom walked in.  She and Monique engaged in a very animated, enthusiastic, boisterous conversation.  I played with the baby and observed those two….I learned SO much!!  Black women truly do talk differently with each other than they do with us white nurses!  Wow!  What an experience…it was like I was invisible and I could just listen and learn.  I know realize how much I DON’T know about helping black moms breastfeed.  I understand why I have struggled as a public health nurse working with black families.  I have so much MORE to learn!!!...  

I am grateful for the understanding that cultural congruency is a "thing".  The very thing that has been missing in breastfeeding support, the very thing that helps to feed inequities in support. It felt like a huge breakthrough to read those words.  I had just had a conversation with a local lactation consultant who turned down my request to have our lactation interns come to her hospital.  As we chit chatted some more, she mentioned that they had recently received a grant to fund the salary of a breastfeeding peer educator. I congratulated her and asked, if that peer counselor might be a woman of color.  She said, "No".  I said, "I'm sorry to hear, that." She said, "I'm sorry you're sorry" and went on to extoll the virtues of her hiring choice.  I tried to make my point that her hospital serves a clientele that is about 80% women of color, and that a peer counselor of color might have better fit the need.  She denied it, saying her peer counselor had a wonderful rapport with the clientele, and besides, no peer counselors of color applied for the job.  I told her, she should have spoken to us.  We've trained almost 15 peer counselors in the past year, most of which are women of color.  The conversation declined from there. I had put her on the defensive and there was no going back. Shortly after this phone conversation ended, I received the above email.  I responded to it, and asked permission to share her insights.  I later received this response:

 

I think those in my generation, those who grew up during the 60’s and observed the struggle for desegregation first hand, worry about this as on the surface, it appears to be a step backwards.  I realize now it is not a step in the wrong direction, but a move in a very RIGHT direction.  If we (white professionals) acknowledge our clients differing cultural styles, we need to look at how best to meet the client’s needs in a manner congruent with their culture, heritage, language, and social structure.  What I had overlooked was how different my culture is from the women of color in my community.  Funny thing, I was really, really good at working with the Amish culture in my years as a case manager and discharge planner.  Our pediatric pulmonologist couldn’t believe that families would agree to nebulizer treatments or home oxygen (with a concentrator).  They did because I learned their culture and built into my plan the strategies I knew they needed in order to get “English” medical technology into their homes.  It was a long process but well worth my effort.  So, if I could recognize the need to adapt my approach with this group, why did I not recognize the black and Latino families in my community might need similar adaptations?  Got to think on that one….  But at least I am more aware of available resources now!  I am looking forward to working with Mo and observing the changes in our community …..

This response is an interesting insight into the fear (and oftentimes ignorance) with which we are often approached.  How often have I counseled individuals and groups to be quiet, stand down, listen, hear, observe, but they are far too busy coming up with the next great idea...

The Year in Review in Pictures

 

March 2014.  The CIMS Forum.  The time and work I put into this thing probably cost me my midwife program.  Was it worth it?  Only time will tell, but I think the ripples from this event continue to flow outward and affect lives.  I am at peace about my education.  I'm working diligently toward getting into another program, and I believe things will work out for the best, as they often do. Was the conference successful?  By the most important markers- yes.  It was quite a spiritual experience.  It helped to solidify my own life course in this movement.

Shortly after the CIMS conference, I headed to beautiful San Diego to attend a Doula Training with Penny Simkin in order to become a doula trainer.  Hopefully by this March, the process will be complete.  Its been a long journey to becoming a certified doula, and then trainer, but I've learned so much.

 

 



In May came my trip to Nashville to attend ACNM.  Here I am pictured with my longtime mentor, Ginger Breedlove.  I always feel ill at ease at ACNM because I don't quite fit in.  That feeling was amplified because I really wasn't an official student at this conference.  I did get to meet a lot of  CNMs of color.  The best part of the week was my visit with Ayesha Ibrahim.  We went to a wonderful soul food restaurant and talked for hours.  I went away with so many wonderful ideas- I'm still implementing them a year later.

 

In June I attended what was my favorite conference of the year (in a year of conferences) The Inequities in Breastfeeding Support conference in what is sure to become one of my favorite cities- Seattle. Here I am pictured with the Titans of Lactation: (from L to R) Michelle Sarju, Kathy Barber, Shafia Monroe, me and Kim Durdin.  I have so loved and enjoyed the ladies I met at this conference, and found a new bestie in Cynthia Good Mojab. It was here that my ideas caught the attention of ILCA.  I'll be presenting at their conference this year and acting as an advisory as they discuss the issue of diversifying the ranks of LCs (an issue near and dear to my heart).  Uzazi Village started its LC Mentorship Program in 2013 to help candidates get needed hours.  This conference was groundbreaking and has set the stage for continued dialog on white privilege and breastfeeding inequities and other perinatal inequities. 

 

 



Further proof that I visited some of the prettiest places in the country last year, this is from Utah at the Birth Activist's Retreat.  I made some very important connections at this retreat and look forward to continuing many of those relationships into the new year: Dawn Thompson, invaluable assistance on my upcoming walk across Missouri, Michal Klau Stevens, wonderful supporter and I admire her greatly, Kirsti Kreutzer, I just want to bask in her aura (and party with her), Kelly Kinney, thanks for bringing me to New Jersey this year, Josie Shapiro-Strano, love her ideas and her support of Uzazi Village, and my roommate Gina Crosley-Corcoran, bringing her and her workshop to Kansas City this year.  Boo-yah.

After the dust settled on my travels, I started my gatherings for birth workers of color and allies which has grown tremendously over the past six months. We now call ourselves TRIBE- Transformation Rooted In Birth Evolution.  We meet monthly over a communal meal and drumming. This group is transforming lives as we gather women and mentor them through their midwife and doula dreams. We are hosting a retreat this year for Black Midwives and Doulas. This group is among my favorite.

 So glad that I invested the time and energy into creating Perinatal Academy, a 16 week course for 'all things perinatal'.  Here I am with the 1st class celebrating our big finish in September after meeting all summer.  We celebrated at a local Indian restaurant.  National marketing of the course starts soon.

 

 

A photo of one of my favorite visits of the year.  I was flown to Washington DC to participate in a national discussion on breastfeeding, but the best part of the trip was meeting with these ladies who heard I was coming to town and invited me to address Black birth workers in DC.  Here pictured are Cassieta and Aza whom I continue to work with as I mentor them through their doula program, and they recently referred a client to me who is moving from DC to KC, Muneera, whom I came to love dearly, and Dr. Ameena Ali who will be coming to KC to speak at our Black Midwives and Doula Retreat.  Visiting with these ladies gave me a vision for what TRIBE can accomplish.

 

 The Kansas City Chapter of Baby Wearing International contacted us about donating babywearing gear.  We have also been the recipient of others generosity of donating gear.  Fast forward several months, we have dozens of slings, wraps and carriers, and are happily planning the first of quarterly Baby Wearing Fashion Shows and Give-Aways.  I have also been asked to be a keynote at their national conference in Phoenix this year.  I love babywearing!

 

 

The Fall brought another lovely trip to San Diego to teach a faculty workshop for a midwifery school.  Thanks to the lovely ladies of Nizhoni for hosting me.  I also had the thrill of having a day to  visit three birth centers in and around the city.  Can't wait for my next excuse to get back to San Diego.  This photo was from the school graduation ceremony.  Bittersweet- since my midwifery class graduated without me a few months back.

 

Ah home to my longtime Sisterhood, in the Ozarks.  I enjoyed a much need weekend in a cabin in the woods at the Morningstar Retreat Center.  I spent a day teaching NRP to midwife students and then enjoyed a Feminine Mass led by Sr. Morningstar. 

 

Enjoyed a wildly successful reception for local healthcare providers to learn about our upcoming continuing education classes.  This same day, our first Chocolate Milk Café replication was set in motion as Racquel traveled from our state capital three hours away to spend the day with us training as a facilitator.  We are thrilled to see our support group model replicated, especially by a WIC agency!

 

Yes, 2013 has been amazing.  Can't wait to see what 2014 holds. 



Brown Baby, Black Milk

I feel as though nearly all of 2013 has been primarily focused on breastfeeding issues.  It may feel that way to me because in the past twelve months I have attended the CIMS Forum, the United States Lactation Consultant Association Conference, the American College of Nurse Midwives, the Missouri La Leche League conference, The Inequities in Breastfeeding Support Summit, and the United States Breastfeeding Committee special meeting.  I have presented the Chocolate Milk Café talk about 10 times in the last 12 months..

Foremost in my mind is the "Inequities" summit which to date has been the most thoughtful if also the most difficult public tackling of a subject some would rather leave unbroached.  During the planning phase, La Leche League pulled out as a sponsor of the discussion, they apparently didn't want to be associated with a discussion about white privilege and systemic racism inherent in breastfeeding support.  I have concerns that this type of blatant denial will lead LLL down a path of irrelevancy.  Will they become a relic of a time now long past as they cling to their circa 1950s model of mother to mother support?  They are unwilling to have a discussion about white privilege while their organizational structure excludes almost everyone except stay-at-home white middle-class mothers.

I'm also exasperated by an occurrence that is all to common in communities across the US.  I left my doula client happily nursing her baby a couple of months ago, after her delivery.  When I visit her on her first day home (only two days later!) she was bottle-feeding! The nurses initiated this when the mom hit a snag on day two.  Oh, the frustration!  We've been working our way back to breastfeeding ever since.  My work undone, the client's confidence undermined, a baby denied its mama's milk.  This is not okay, people!  Babies being able to access their mama's milk is a big deal.  No more excuses for or from the nurses.  We have to start teaching  nurses what they need to know to support mothers.  Breastfeeding support for every nursing mother is not optional.  Where is the support for moms once they go home?  We need to be creative and innovative at finding solutions to mothers (especially in our communities) having no where to go with their questions and concerns.  We need to work more collaboratively with hospitals,and WIC clinics to bridge that gap in community-based support. And finally, we need to really address systemic racism embedded in healthcare organizations that unfairly targets women of color and penalizes them.  This is where my own work will focus- I look forward to opportunities the new year will hold.

Retreat, Retrench, and Regroup

After a long hiatus from this blog, I am back.  I'm happy to report that I have made what I hope will be a game-changing decision. Starting in January I will no longer be attending anyone else's meetings on a regular basis.  I will maintain my memberships in all the professional organizations I am associated with by paying my dues but I will no longer be in regular attendance at meetings.  It eats up too much of my valuable time and there is very little return on investment.  Same with conferences, I will invest time in planning my own, but I won't assist with others (though I will continue to present at conferences and attend conferences).  My energy is best used on my own work so I'm stepping out of other projects.  I'm happy to announce that the conference I wanted to hold in 2014 is happening.  It will be the "Midwest Black Doulas and Midwives Retreat- featuring Dr. Ameena Ali" on June 6-8, 2014.   I'm hoping it will draw birth workers of color from around our region who wish to discuss issues pertinent to our community and pertinent to our role in improving perinatal health outcomes.  I did not get into a CNM program this past Fall or this coming Spring.  I will reapply next Fall.  I will also be busy training for my Black Infant Mortality Awareness Walk next September.  I am putting together a team to help me with the walk.  If you are interested in walking with me or being a member of the team, go to www.uzazivillage.com and click on the Black Infant Mortality Awareness Walk page.  I'm excited to be rethinking where I will put my energy, time and resources.  Most will go to my family, followed by Uzazi Village, and my book writing.  When I restart school, that of course, will take up the bulk of my time.  It feels good to close ranks and be more focused.  I'm also hoping it will make me more effective.

The Black Route

           OK, I'm ready to talk about it.  Why I am no longer in my CNM program.  I was interviewed today by a midwife of color preparing a report for a CPM midwifery organization.  She wanted to know about my midwifery education journey.  I asked, 'Will my story help you, I'm taking the CNM route, not the CPM route."  She quickly corrected me.  "No", she said," you are taking the Black Route."  She explained that my story had much in common with midwifery students of color no matter which route to midwifery that they took.   I actually told my story twice today.  After the morning telephone interview, I later in the day visited with an old midwife friend visiting from out of state.  She made the mistake of asking me how school was going.   When I told her she was furious and smothered me in hugs and apologies.
            The short and sweet version is that I flunked out of school- with only one semester left to go.  That failure came with some assistance on the part of the system.  After watching my classmates received at clinical sites that I was denied and being asked to repeat a course because I didn't get enough births (something my classmate who also worried aloud about not getting enough births was not asked to do) I cowered to the suggestion that I do 'independent studies' until the course rolled around again.  I was told my work was inferior.  (I had made only As and Bs to that point).  We were encouraged to apply for a midwifery scholarship, but when I asked for the required reference letter, I was denied, twice.  In the end my untimely demise came about because I didn't trust anyone, not the individuals,  not the system and certainly not the institution.  I truly felt all alone- and I was all alone.   I consider this all a valuable lesson learn: NOTE TO UNIVERSE- I got it.  I settled for a hospital midwife program that did not fit me.  I was a freak from the start, both because of my homebirth devotion and my Black skin (neither of which this Midwestern state university had seen before).  I applied to another program for this Fall but my application was denied.  I will apply to other programs in the Spring. 
             I am more committed to becoming a midwife than ever.  Students of color who come after me will have a soft place to land because I'll be there for them.  I have had to shoulder my burden geographically alone, (except for a few wonderful 'allies' who were not afraid to take me under their wing- bless them).  There are no other midwives of color in my state, only one other LC of color.  But the next generation of midwives won't be alone.  My resolve is stronger than ever.  I am a midwife that will nurture that next generation and restore true midwifery to my community.  I have just a few things to keep me busy this Fall while I research other programs to apply to (one that will value what I bring to it):

• two book contracts (more about those on a later post) both books are due this Winter and will be published in the Spring.
• I just applied to a board position at IBLCE.  If I get it, it is a 3 year commitment with 2 meetings a year.
• I just took on the Mother-Friendly Nurse Recognition program oversite at CIMS.  I plan to overhaul the program and market it nationally.
• My nonprofit Uzazi Village just signed its second year lease with many programs in the works, but we continue to look for a permanent building to house the expansion into a clinic after I graduate.
• Today I was invited to a meeting in DC (all expenses paid) by the United States Breastfeeding Committee with a select group of other breastfeeding advocates from around the country after notice was taken of the work being done at Uzazi Village.  I'm really looking forward to the dialog that will come out of that meeting.
• I have presented at several local and national conferences so far this year, and have three more presentations on my calendar for the Fall.
• A new Breastfeeding Clinic is in the works for Uzazi Village.  A retired nurse/lactation consultant will run the free community clinic and will simultaneously mentor lactation consultant candidates getting their required hours to sit for the IBLCE exam.  I am so loving the symbiosis of this idea.  We start in August. Community women will see an LC for free but the mentees will pay a small stipend for the mentoring.
• We may have secured some funding for our 100 Breastfeeding Ambassadors program (won't know for sure till Fall) in which Uzazi Village will train 100 Breastfeeding Peer Educators for free.  In exchange for their free training, they must submit a plan for how they will impact their communities with breastfeeding promotion.  I'm very excited about this.  Hoping it will become a national model. 
• Partnering with a local midwife for my company Perinatal ReSource to add a midwifery assistant class to our growing list of training offerings.  We are already getting inquiries for this training even thought its still in its planning phase.
• Have a wonderful class of five students to pilot my 16 week course, Perinatal Academy. So far, so fantastic. (A local nursing program has given me access to their simulation lab, so two of my courses include a trip to the Sim Lab!)  Nice to have collaborative partners.  Enrollment for our other classes are filling up.
• A local domestic violence shelter is hiring me to bring perinatal education to their pregnant residents.
• In talks with the local school district to bring perinatal education to pregnant and parenting teens in the district to help with the goal of keeping them in school.
• Currently seeking sponsors for my first annual Symposium on Perinatal Health Inequities that I plan to hold here in KC next Fall (and the next Fall, and the next Fall...) 
• Simply adore my new 'Midwives in the Making' support group I started for midwife students of color and 'allies'.  This group will be an invaluable tool for gathering future midwives together and nurture them through the  process of becoming a midwife. We gather in our homes, drink wine, eat good food, tell our stories, and support and encourage one another through the process.  This is just downright soul healing. 

So as you can see Dear Reader, what hasn't killed me has only made me stronger as I continue my education via The Black Route.

Saving the World... one class at a time

I am headed to Seattle Washington later this week to present at the Inequities in Breastfeeding Support Symposium.  http://www.brownpapertickets.com/event/361570  I will be offering a culturally specific view of barriers African-American women face in their lactation journeys and strategies normative culture providers can use to preserve, protect, and promote successful lactation.  I am very excited to present this information to a wider audience though I have given this talk about 10 times in the past two years at various local and national conferences.  I look forward to seeing Seattle (my first trip out there- though I have a feeling it won't be my last) home of Bastyr University and Penny Simkin (whom I will miss completely while I'm there- she'll be traveling).  I'm grateful to the planners of this conference to attempt a 'white privilege' take on this topic.  I hope it draws a broad audience.  I have two more invitations this Fall to present my topic and plan to attend the AABC conference in Minneapolis in September (a very busy month for conferences).
While I am gainfully unemployed and unschooled, I am taking advantage of the 'free' time to build an empire. (Insert wry smile.) I am quite excited about my business, 'Perinatal ReSource'  (www.perinatalresource.com) and the products I am producing.  I am producing books and curriculum like a mad fiend, and I am excited for where this company/school is headed.  I am teaching my first class through Perinatal ReSource on Monday nights.  Perinatal Academy has four very diverse students for the initial class.  It is 16 weeks of all things maternal- infant.  I wrote it, I teach it, and I will evaluate its value.  I want to do other niche education, and to that end, am on the lookout for coalitions, and alliances.
I'm still waiting to hear back from Frontier, whether or not I'm accepted into the Fall class, and what of my credits they will accept.   There are so many irons in the fire right now.  Things are going well, my life is quite productive, and many, many things seem possible. I want to use my time wisely this summer and set into motion projects that will have lasting impact.  I plan to keep my readers posted and how my book writing is going (I currently have two book contracts with two different publishers), the status of my nonprofit, Uzazi Village (I'm working on our annual report today- we're coming up on the end of our first fiscal year), and gearing up for hosting my first (of many) annual symposiums on perinatal health disparities.  So its off to work I go (at my dining room table- my makeshift home office).  There's much to be done in the battle against perinatal health disparities.

Midwives in the Making

I've decided to resume my writing on this blog.  I was trying to wait until I had definitive news to report, but I may not know for a while still.  The big news?  I am no longer in the midwifery program at KU.  I have instead applied to the Frontier at-a-distance program and am waiting to hear back about my application.  I don't wish to elaborate, but the experience has made me more determined than ever to complete my degree and start my career.  I have a much better understanding of why there are no midwives of color in the states of Kansas and Missouri,   The midwifery model of care is a beautiful model of care.  I absolutely do believe that it can be a part of the answer to health disparities, HOWEVER, midwives (and their professional associations) have not made this a priority.  With due deference to those who have tried to bridge the disparities gap, neither have they made the healthcare impact they should have made by now, leaving the women who might best benefit from midwifery care with the least access to it.   I have re-committed myself to the goal of Uzazi Village to restore the community midwife.  I understand much better now, why I must start my practice, and within that practice give midwifery students of color a place to be supported and nurtured.  To that end, Uzazi Village has started a new group, "Midwives in the Making."  This group is open to any aspiring midwife pursuing any path to midwifery, but it is ESPECIALLY a safe haven for women of color to nurture their dreams of becoming midwives.  We will meet the last Sunday of the month from 6-8pm and will rotate between member homes to share a meal and share our stories.  This is how I currently feel led to fight for my community.  To carry on in my own personal fortitude, courage, and moral veracity to make a space that does not currently exist for aspiring midwives of color.