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Systemic Injustices Being Highlighted By COVID-19

We are living in unprecedented times as we face the global COVID-19 pandemic.

Whether you are stuck in your home due to a shelter-in-place policy, out of a job due to lay-offs, caring for a sick loved one, battling COVID-19, or dutifully showing up to work at your essential place of employment, likely your life has changed in the past several weeks. Everything has changed. One thing, however, has not changed: babies continue to be born.

During this global crisis, pregnant people continue to give birth despite fear and anxiety. Babies continue to be born into the world.

You have likely seen news coverage of some of the issues affecting pregnant people and childbirth during the pandemic. We have seen outrage, pushback, and even human rights violations over injustices being suffered by pregnant and birthing families. And we have been encouraged by the people who are speaking up against these injustices. But guess what: these issues aren´t new for some people. These are the same exact issues that have affected vulnerable birthing people – the majority of whom are Black – for years, and many of these issues are the same factors that contribute to our country´s astonishing rates of maternal mortality and morbidity, especially among Black populations. The crisis is just highlighting these issues.

 


Here are 4 birthing injustices that birthing people across the country are experiencing now because of COVID-19 and that are just now coming to light, but that have been prevalent in Black birthing populations for years due to systemic injustices and institutional racism.

 

  1. Support people being banned in the labor and delivery room – a hospital system in New York City took the initiative of banning not only additional support people but partners of birthing people from the labor and delivery rooms. Luckily, New York State was quick to issue an executive order reversing this inhumane policy.How birth centers and midwives have historically addressed this injustice:Birth centers have always encouraged the presence of partners and additional support professionals – most commonly doulas. Numerous studies have found that having continuous support during labor leads to better outcomes for both the birthing person and the baby. Black birthing families have less access to resources like doulas, and we are committed to ensuring community access to doulas for all birthing people in our new birth center.
  2. Separation of baby from birthing parent and its implications for bonding and breastfeeding –– against the recommendations of the World Health Organization, many United States-based groups, including the Centers for Disease Control and Prevention, have recommended separation of newborns from mothers who are infected with COVID-19, causing alarm and concern within families and public health bodies due to the documented impact this has on breastfeeding and infant health.How birth centers and midwives have historically addressed this injustice:
    Unfortunately, even before the pandemic and despite evidence on the importance of skin to skin care for mother-baby health and breastfeeding, many hospital systems in the U.S. have continued to practice routine separation of newborns from birthing people. As hospitals have been slow to change policies to support skin to skin care, birth centers have consistently had the highest rates of skin to skin care and policies supporting this practice.
  3. Overuse of non-medically necessary interventions – there have been reports of pregnant people being advised to schedule non-medically necessary inductions or even cesarean sections as a response to the coronavirus threat, and the reasoning behind this logic is unclear, especially since each labor intervention carries risks of complications and additional, more invasive interventions (known as the Cascade of Interventions). This is concerning in a country where the cesarean section rate is already dangerously high (31.9% compared to the recommended 10-15% by the WHO).How birth centers and midwives have historically addressed this injustice:
    Midwifery care, and the birth center model, encourages physiologic birth, which refers to labor that begins spontaneously and is powered by the normal, biological process of labor without medical or technological interventions. Physiologic birth
    results in better outcomes for both the birthing person and baby in normal, healthy pregnancies. Families who plan for birth in a birth center experience a 6% cesarean section rate versus the national rate of 31.9%.
  4. Lack of choice in childbirth and access to midwifery care and out-of-hospital birth – as a result of the pandemic, many families have sought to transfer their prenatal care and birthing plans to birth centers to avoid being in hospitals where the sick people are. In some cases, it is considered too late in their pregnancy to be able to change practices, and in other cases midwifery practices are full beyond capacity and unable to accept additional patients. Meanwhile, birth center care is not even an option for many low-income families and families of color due to factors such as cost, proximity to birth centers, insurance coverage, and more. Birth centers are largely an option for populations with privilege and resources.How birth centers and midwives have historically addressed this injustice:
    Our birth center will primarily serve families of color who historically have had little access to choice in childbirth in Philadelphia. Our center will accept Medicaid as well as the uninsured. No one will be turned down due to the inability to pay. 


It is heartbreaking to see so many families and pregnant couples affected negatively during pregnancy and childbirth due to the pandemic. However, it is not surprising and highlights the many injustices that have been present within our maternity care system for decades, mostly affecting Black families.
This is why we are committed to opening a birth center. 


How can I support this important project?

If you would like to continue to support our initiative, please be sure to keep an eye out for our monthly newsletter updates and share exciting news about our FPCN Birth Center with your loved ones!

For more information or to donate to the Birth Center, click here. And of course, please follow us on Facebook and Instagram for real-time updates. If you are not on our newsletter list already, email mary.porth@gmail.com to be added to our list and receive updates.

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