Midwifery Care, Community Birth and Health Equity: Preliminary Findings from the MANA Stats Women of Color Study
Melissa Cheyney LDM PhD
The purpose of this study is to describe outcomes of care for women of color who plan home and birth center births with community midwives in the United States. Birth weight, mode of delivery, transfer rates, hospitalizations, breastfeeding rates and NICU admissions were examined within and between groups using client-identified race/ethnicity categories. In addition, we explored the relative impacts of social determinants, such as age, education, race and marital status, on birth outcomes, including cesarean birth. Findings suggest that community midwifery care, and especially culturally concordant midwifery care, is associated with improved outcomes among women of color, as well as a significant flattening of the maternity care outcome disparities gradient between White and Black clients and babies. However, findings also indicate areas where implicit bias within community midwifery may be shaping the provider affect, especially towards elevated cesarean birth among pregnant people of color. This presentation will conclude with evidence-informed recommendations for improving care and amplifying birth justice.
Melissa Cheyney PhD CPM LDM is Associate Professor of Clinical Medical Anthropology at Oregon State University (OSU) with additional appointments in Global Health and Women Gender and Sexuality Studies. She is also a Licensed Midwife in active practice, and the Chair of the Division of Research for the Midwives Alliance of North America where she directs the MANA Statistics Project. Dr. Cheyney currently directs the International Reproductive Health Laboratory at Oregon State University where she serves as the primary investigator more than 20 maternal and infant health-related research projects in nine countries. She is the author of an ethnography entitled Born at Home (2010, Wadsworth Press) along with dozens of peer-reviewed articles that examine the cultural beliefs and clinical outcomes associated with midwife-led birth at home in the United States. Dr. Cheyney is an award-winning teacher, and in 2014 was given Oregon State University’s prestigious Scholarship Impact Award for her work in the International Reproductive Health Laboratory and with the MANA Statistics Project. She is the mother of a daughter born at home on International Day of the Midwife in 2009.