What is keeping midwives from building a giant statue to fight climate change? At first, there aren’t enough of them. The United Nations estimates that around 900,000 midwives around the world are missing. This deficit extends to the US, which has higher maternal mortality rates than other high-income countries where midwives play a major role in care.
In the US in particular, several insurance-related barriers stand between patients who want to work with a midwife or doula and actually do so. “The concern from an equity perspective is that black, Native American, and Latino communities often live in states where there are barriers to access to midwives,” says Saraswathi Vedam, senior researcher at the Birth Place Lab and a professor of midwifery at the University. in British Columbia. Vedam’s research shows that integrating midwives into America’s health care system improves equity and health outcomes.
There is a connection between the barriers to midwifery and the racist campaign to keep midwives from accessing medical care and the rise of white male and female doctors. In the early 1900s, these doctors attacked midwives, who were often black, by accusing them and denigrating their profession. A famous medical expert, Joseph DeLee, called midwives “cruel people.” This history shows why many Americans, at worst, think of midwives as insecure or unthinkable. “I have been a midwife for 37 years, and it still amazes me how little the average person knows about professional midwives and what they can offer,” says Vedam.
Connecting patients and providers who can provide climate-friendly care—to people who can ask their patients if they have air conditioning, if they have a flood plan, and if they know how to sign up for electricity bills—requires breaking down the conflicts that create and prevent barriers. of design.
Supporting the workforce itself is also important: Wheeler and colleagues at the National Birth Equity Collaborative are currently asking midwives, doulas, and other maternal care workers about what they’re already doing to address climate change and what they might want to do next. The idea is that these results can help develop collaborative learning between reproductive workers and other professionals, such as epidemiologists and climate scientists. He sees the project as a collaborative effort, noting that “the climate crisis is teaching us that we need to be more collaborative in our health care.” Such an agreement has been made before, albeit with little effort. For example, in 2018, researchers conducted a study on temperature and maternal health in a public room in El Paso, Texas, a birthing center. After the project, the doulas and midwives who attended said they regularly talked to their clients about the dangers of heatstroke.
But there is room for growth. Davies also thinks there is a need to make “continuing education a central part of midwifery education” – principles that go beyond midwifery’s deep connection to sustainability. Her philosophy, and her work in this field, has already influenced midwives in her country, New Zealand. Alison Eddy, head of the New Zealand College of Midwives, says Davies’ midwives’ research was instrumental in the project, encouraging them to think more deeply about how they can help tackle climate change.
There is a responsibility to “educate and guide midwives to become experts in climate change in their work, think and act critically about how they use resources in their practice, and reconsider their role in advocating for governments, hospitals, and politicians to respond.” ,” said Eddy. She has applied this belief: The College has encouraged the recognition of the special needs of pregnant women and infants in New Zealand’s Climate Change (Zero Carbon) Bill.
In the US, there is another way to manage midwives because of their connection to health outcomes: In June, the Biden administration released a “plan” to deal with the problem of pregnant women that includes a promise to work with countries to increase access to people. doulas and midwives. With women who are vulnerable to climate change, there should be similar efforts that show their connection to climate-related care.
Many issues related to climate change involve what we should stop doing. But expanded midwifery care is a rare example of what we can achieve.