Do You Know Someone Who Died or Nearly Died in Childbirth? Help Us Investigate Maternal Health

By many measures, the United States has become the most dangerous industrialized country in which to give birth.

by Adriana Gallardo

By many measures, the United States has become the most dangerous industrialized country in which to give birth.

American women are more than twice as likely to die of pregnancy-related causes as British women, three times as likely as Canadians and six times as likely as Norwegians and Poles, according to 2015 data from the Institute for Health Metrics and Evaluation at the University of Washington. While other wealthy nations reduced maternal deaths in recent years, the U.S. maternal mortality rate jumped more than 25 percent from 2000 to 2014, researchers reported last August.

And for every expectant or new mother in the U.S. who dies, as many as 100 women come very close to dying, often with devastating long-term physical, emotional and economic effects. Maternal near deaths —from hemorrhages, strokes, aneurysms, clots, sepsis infections, cardiac arrest, organ failure and other life-threatening complications of pregnancy and childbirth— have been on the rise, and now exceed 65,000 a year, according to the Centers for Disease Control. The racial disparities are striking: African-American mothers are 3 to 4 times more likely to die or nearly die than whites.

ProPublica and NPR and Special Correspondent Renee Montagne are seeking your help in understanding why so many American women die and nearly die because of pregnancy and childbirth—and how the health care system can be improved to protect more mothers from harm.

Do you know someone who died or nearly died in pregnancy, childbirth, or within a year after delivery? Please tell us your story.

Are you a health care professional or policymaker with information to share? Please email us at maternal@propublica.org or maternalhealth@npr.org.

Follow our reporting here.

Via ProPublica

Black Mothers Face Higher Complication Rates When Delivering Babies in NYC

By Fred Mogul

Charity Hines didn’t have her ‘Go Bag.’

When she went into Kings County Hospital for a Week 40 checkup, she wasn’t in labor and did not expect to deliver a baby that day. During what she thought was a routine pelvic examination, the doctor kept going deeper. It was uncomfortable and confusing; when she hit what she figured was 10 on the 1-to-10 pain scale, she cried out, “What’s happening?”

As she recalled it, only then did the doctor explain she was probing the cervix to stimulate labor.

“‘Oh, I’m sorry, I should’ve told you that this was going to happen,’” Hines recalls the doctor saying. “‘Sometimes when we tell patients, they get apprehensive.’”

She eventually went into labor, which lasted 27 hours and ended with a C-section. Hines had a mild infection and a fever. Her baby son Kaleb went to the Neonatal Intensive Care Unit, or NICU. It was a day before she was able to hold him.

 

Sharon Griffith McKnight went to the Kings County Hospital prenatal clinic feeling dizzy in Week 41. Doctors decided to admit her, to be safe. After three days without dilating or contracting, they attempted to induce labor without success. 

Eventually, spiking blood pressure set off alarm bells, and staff wheeled her into an operating room for a C-section. When McKnight told the doctors she felt the scalpel cutting her skin, they put her under general anesthesia. She said she woke to find her baby in the NICU, and she had an infection. They were kept apart for three days.



On a recovery ward, McKnight said she waited for a nurse before going to the bathroom the first time, as she’d been instructed. When no one came, she crawled from her bed to the bathroom and back. She recalled finally finding a nurse and complaining to which the nurse said, “I guess you were able to make it there without our help.”

 

Across the street from Kings County, at SUNY Downstate Medical Center, doctors stopped Shadae Toliver’s epidural so she could push more effectively. It seemed to work. But then she started to tear and bleed profusely. They administered more painkiller to stitch her up, but it provided no relief, numbing only her leg, not the area that was torn.

Black women were twice as likely to deliver in below-average hospitals as white women. And white women were three times more likely than black women to deliver at above-average hospitals.


“I told them, and they just kept sewing,” she said.

To stem the bleeding, doctors placed gauze in her vagina — but didn’t follow standard protocol. They didn’t tell her about the gauze. They didn’t leave a piece of it hanging out of the vagina or put a bracelet on her to alert staff of the situation. And they didn’t attach a catheter to let urine pass. Unaware of the gauze, nurses downplayed her complaints. After about five hours of pain, someone realized what happened and attached a catheter.

“It hurt like hell,” said Toliver. “It was careless, but by that point it didn’t really surprise me.”

All three women are African-American. All three live in central Brooklyn. Many mothers from different backgrounds similarly complain about callous treatment during childbirth. But disregard for patient choice and patient safety appears to be more rampant and more deadly in the poorest black neighborhoods in New York City, like where Hines, McKnight and Toliver live. And in those communities, women often have more health problems, and hospitals have a narrower margin for error.

According to one recent study, New York City hospitals that mainly serve African-American expectant mothers have severe complication rates two-and-a-half times higher than those that mainly serve white mothers, even after you factor in patient complexities.

And data obtained from the New York State Health Department show that four of the five large hospitals in the state with the highest rates of severe hemorrhage — an especially important childbirth complication — are in central Brooklyn: SUNY Downstate Medical Center, Kings County Hospital, Brooklyn Hospital Center and Wyckoff Heights Medical Center.  

These hospitals -- almost all of which declined to comment on their complication rates -- are set in communities with high rates of diabetes, hypertension, heart disease and asthma, chronic illnesses that increase the risk of potentially fatal childbirth complications.

In New York City, African-American women are 12 times more likely to diebefore, during and after childbirth than white women — a gap almost four times wider than the country as a whole. Overall, the numbers are relatively small — about 700 each year nationally and 30 locally — but per capita they’re higher than any other developed nation.

And for every woman who dies, about 100 come close. Annually, about 60,000 women nation-wide and and about 2,700 in the city face life-threatening childbirth complications such as hemorrhage, blood clots and organ failure.

Nationally, the rate of these increased from 74 to 163 per 10,000 deliveries between 1998 and 2011. In New York City, things are much worse. A recent Health Department report found the local complication rate climbing from 197 to 253 between 2008 and 2012.

And in the largely African-American communities of Brooklyn, the climb is higher still: to 400 per 10,000 in Canarsie, East New York and Bed-Stuy, and all the way to 500 in Brownsville and East Flatbush

Poverty and the health problems that go with it account for only part of these high complication rates. Even when black women have relatively high incomes and education levels, and even when they don’t have underlying conditions, they’re still much more likely to risk death when they deliver babies.

“Black women with a college education have a higher [complication] rate than white women without a high school degree,” said Assistant Commissioner Deborah Kaplan, who oversaw the Health Department study. “We believe a lot of this is a story of structural racism and the impact that the color of your skin has on how you are treated, what access you have and where you live, regardless of your socio-economic status.”

Kaplan and her staff are the first to look at severe childbirth complications at the city level, using a monitoring system developed by the federal Centers for Disease Control and Prevention. Their study examined racial, economic and other associations. To figure out what’s happening specifically in hospitals, Dr. Elizabeth Howell applied the same CDC tool to 40 of them in New York City, analyzing around 354,000 childbirth records over three years.

Howell, a researcher at the Icahn School of Medicine at Mount Sinai, found severe complications in 12 percent of deliveries at the least safe hospital and around 1 percent at the safest. After accounting for the sickness of the patient population each one serves, she still found a six-fold gap — .8 percent at the low end and 5.7 percent at the high end.

“We think of pregnant women — they go in, they have their delivery, and they bounce back,” said Howell. “And not everyone bounces back.”

In her study, Howell numbered and ranked the hospitals — legally, she couldn’t disclose their names or neighborhoods — and divided them into three complication-rate tiers: average, above average and below average (again, adjusting for the health of their core population). She then looked at the races of the women giving birth.  Black women were twice as likely to deliver in below-average hospitals as white women. And white women were three times more likely than black women to deliver at above-average hospitals.

Howell estimated this gap in safety jeopardizes the lives of nearly 1,000 black women in New York City each year.

“It’s quite striking,” she said. “A lot of this is preventable: communication failures, delays in diagnosis, mostly what we call ‘system factors’ that seem to be related with these severe events.”

Howell looked for patterns beyond race and couldn’t find any strong association with hospitals’ size, whether they were  public or private, or academic or non-academic. In her ongoing research, she’s trying to figure what high-performing hospitals are doing differently from low-performing ones. She hypothesized the answer could be found in ‘hospital culture.’

“Do hospitals use standardized protocols and procedures, checklists, things that we do, so that if a patient has a blood pressure of 160 over 110, what happens?” she said.

Howell said stories like those of Hines, McKnight and Toliver are widespread and help illustrate the disparity in treatment black women receive — even though it’s difficult to quantify the impact of such shoddy treatment. She can’t prove with data that it leads to the higher complication rates she found in certain hospitals, based on diagnostic codes of patient records.

Still, she strongly believes listening more closely to patients and treating them more humanely is crucial to improving childbirth safety overall.

“For patient safety, communication is one of the basic tools we have — whether that be communication for staff members when they’re caring for an acute event or communication with patients,” Howell said. 

Dr. Ralph Ruggiero agrees. He is the chairman of Obstetrics and Gynecology at Wyckoff Heights Hospital on the border of Bushwick and Ridgewood in Brooklyn.

“When a patient has a concern, I want my faculty member to really listen to what they’re saying,” he said. “There could be something to it.”

Since taking the helm of his department three years ago, Ruggiero has taken a multi-pronged approach to improving patient safety and reducing complications. 

He helped expand the hospital’s satellite clinics to improve prenatal care and women’s health overall; set up a system where a single doctor or midwife took primary responsibility for each patient; demanded doctors and nurses ask patients more questions, listen to their answers and, as much as possible, accommodate their requests; instituted more drills and training; and standardized and enforced protocols and guidelines.

“When we write a policy, we get down to the nitty-gritty,” he said, whether it’s the details on who goes where when a hemorrhaging patient needs a blood transfusion, or what it takes to medically justify an episiotomy.

Ruggiero said he arrived at Wyckoff on a Monday and ran his first emergency hemorrhage drill that Thursday. It didn’t go well.

“We looked like the Keystone Cops,” he said.

Gradually things have improved, and the drills have gotten more advanced. Along the way he’s ruffled some feathers.

When I first got here, we had a lot of good doctors, but they all practiced differently, and they practiced based on their experience” not based on the latest research, Ruggiero said. “There was some pushback, but now much of the staff has changed.”

When he arrived, the obstetric staff had one woman and a dozen men, and no one was bi-lingual. Now there are 10 women and three men, and almost all are bilingual. And he’s added four midwives.

Ruggiero said the reforms have shown progress: pre-natal visits are up, unnecessary interventions are down — especially episiotomies and C-sections for first-time mothers — and complications have declined significantly. 

In the past three years, the annual count of severe lacerations has gone from 27 to 11; severe hemorrhages, from 16 to 6; unplanned ICU admissions, from 15 to 6; blood clots, from 16 to 2; and unaddressed severe hypertension, from 8 to 0.

“It’s all these different approaches working together,” Ruggiero said. “We’re working all the time to make labor and delivery safer, but I think the real work is outside the four hospital walls. We need to get out into the community, get to all the people who are getting erratic care -- or no care --  and get them to come into our clinics to see us sooner.”

Via WYNC

Watch: The granny midwives who birthed untold numbers of babies in the rural South

A tradition of black, lay midwifery dating back to slavery

1-XSNdGmOP9yN6XR2Fyu2pPw.jpeg

Mary Coley was among the last generation of granny midwives providing care to pregnant women across the rural South. These women were indispensable at a time when hospitals were often out of reach, and they have a history of service to their community. Thanks to a 1952 informational documentary filmed for the Georgia Department of Public Health, we can observe Coley at work and delight at the new lives she so carefully brings into the world. How did this tradition become completely eradicated?

 

Postpartum Diaries: Get Over It!

Get over it!
Right away!
Or else you'll miss it right it front of you
Put the phone down
Turn the tv off

The baby is crying and the only way to soothe him is with you touch

Man that sucks that my hands weren't the first one to touch my baby's skin.

Get over it!
You're holding your baby now.
Your baby is home now.
That was yesterday.

So I make sure my hand is the first one you touch every opportunity I get.
Pass the baby, You're spoiling the baby
You hold the baby too much
You're still feeding the baby.
You're still giving the baby the boob.

GET OVER IT!
It's what I feel is best.
It's what eases my stress.
That anxiety of not being with my baby.
That uncertainty of what's in the formula can
It's a remedy to help me get over it.

Sensitivity
Informed consent
Believing im doing my best

Almost a year ago and I guess I can get over most of it cause now I have new old shit to worry me.

I have to get over it because there's a new hill ahead of me.

The clock will keep ticking and before you know it I have to protect my anxiety.

I have to ease the worry of having my black baby in this world that wants me to get over the hurts that are fresh cause there will always be the hurt from way before.

Get over it.
Get above it
Over stand
And make sure you stick to you plan.
I was just trying to stick to my birth plan.

My birth plan stopped at A cause we didn't believe in plan B
We wanted this glorious
We wanted this family
We need to be a family

I was just tryna stick to the plan, my birth plan that put precaution to the hurt from other women before
And still I got hurt

Get over it
Get above it
Over stand they never wanted to acknowledge it because you walked into their turf.

Get over it
Get above it
Over stand the next, well maybe there won't be a next time

Get over it
Get above it
Over stand you will be strong enough and the next time will be a better time on your turf.

Shaina Holmes is a proud breastfeeding mom who lives in Brooklyn, NY

Shaina Holmes is a proud breastfeeding mom who lives in Brooklyn, NY

All we need is One Tit, One hour: My experience of being robbed of the breast crawl Part II (obstetric violence)

Violence as a public health issue is a real thing. Young men being gunned down is a public health issue just as much as failure to inform a mother on the best way to prepare for birth, both result in the mortality of, particularly, black children, young men and mothers. Violence stems from fear so what is society exactly afraid of when it come to the womb of black and latinx mothers?

The cause of so many horror stories from United States labor and delivery room outcomes stem from a series of obstetric offences that fall under the larger obstetric violence umbrella. Obstetric violence can be described as any unpleasant and non consent, or coerced act against a mother during prenatal visits, in labor and delivery, and postpartum. The mulitfaceted spectrum of violence shows up in many instances such as:

 -A mother's request not being honored or ignored during and after labor

 -Redirecting a mother's request, so that it meets the need of anyone other than her.

 -When a mother is constantly being offered an epidural during birth without receiving information about the high probability of long term effects on a mothers back.

 - Unneccessary utilization of any surgical equipment outside of an emergency (i.e. mothers being sold the idea that scheduling a cesarean for the best aesthetic but do not tell you that the epidural is required to have a cesarean).

 -The improper education on how to utilize a breast pump after birth.

 -Being discouraged or flat out opposed on the idea of having a vaginal birth after cesarean (VBAC) (2nd birth and on).

 -No education on any birth related terminology.

 And the list goes on...

 Obstetric violence occurs too often leaving mother's feeling traumatized and disempowered during a time they should be feeling the greatest joy of their labor of love. In my experience of violence, carried out in the form of being rushed when one hour skin to skin was requested, proved to play a huge role in my son being unable to latch on within his first hours of life. I almost gave up in the hospital due to pressures by staff and my mother saying that my son looked dehyrdrated and undernourished and that I had to stick a formula bottle in his mouth before he died, essentially. This added pressure, following my pushing him out, along with him not latching on, only exacerbated my self doubt as a care giver to the point of tears. Yet, right in that moment, my son rejected the bottle! He would not open his mouth as I cried in surrender and shame, for I had been pushed to the edge. Pushed by hopsital staff, physicians, and family. But HE REJECTED THE BOTTLE. Shortly after he began nursing like a champion. I was glad (an now impressed) that he hadn't rejected me and clearly felt the instinct to latch on. He simply needed time. But not every mother gets loucky to understand, witness, or experience this. Many mothers feel powerless because they, along with society, are taught to view providers as authoritative figures and mothers in labor and delivery are often victimized and even coerced into this unhealthy dynamic during childbirth. Providers are not doing a good job creating safe space for mothers because they are focusing on numbers and getting to the next mother. Without the necessity to utilize surgical tools hospital do not get as much funding.

 

The shame associated with our black bodies stems from historical systemic violence. The physical and sexual abuse we've encountered throughout colonialism and patriarchal dictatorships of, for example, having been ripped away in many cases from our young only to play the role of wet nurse to our master's children or being experimental subjects to our "authoritative figures" strongly plays into the dynamic of our labor and delivery room scenes. Subconsciously, our current mistreatment in the delivery rooms is endured because we feed into this false narrative of deficiency and not being enough as women in this patriarchial system. Imagine the level of self doubt felt women of color. During segregation we were not even allowed in the delivery and this worked to our advantage because many people of color resorted to midwivery. Once integration occurred racism followed into the delivery room and hospitals that serviced a majority of people of color were not well resourced. Simply pointing out the disadvantages.

 

But coupled with poor resources and being subjected to violence during the founding of this nation women of color are easily targeted and this needs to be eradicated. In my humble opinion the fact that 1 out 4 black mothers dies in child birth or gives birth to a pre-term or low weight child goes beyond genetic disposition (epigenetics). Violence shows up in oppression that breeds toxic stress no matter the socioeconomic status. Keeping individuals miseducated drastically decreases the chance to make informed decsions and restricting society from exploring and knowing our bodies perpetuates this oppression.

In what ways were you misinormed about the birthing process? Outside of labor and dellivery when have you felt powerless when going for a doctors visit?

I am a conduit advocating for women and children empowering them to know their true selves, and identify their purpose by way of education, love, and understanding.

—Ayo
Farahly Ayodele Saint-Louis is a Doula and coordinates programming related to reproductive justice. She received a Bachelor of Arts from the City College of New York and also acquired a Master’s of Science at Hunter College. A native of New York, Ayodele holds strong ties to her Haitian origins. Inspired by a trip to Haiti in September 2009, she is determined to shed light on the taboo subjects of sexual violence and reproductive wellness among women and children through art therapy in Haiti and other developing nations. As a member of Big Apple Playback Theater Ayodele continues to utilize the arts as an outlet for healing and enjoyment supporting others in doing the same. She has a strong passion for, and seeks to contribute to, psycho-social improvement and healing, through the arts, birth work, and programming in developing societies with respect to women and children’s rights. Ayodele believes in the possibility of approaching the political process through a social justice lens and honoring humanity with the hopes of influencing the current state of the system. 

Farahly Ayodele Saint-Louis is a Doula and coordinates programming related to reproductive justice. She received a Bachelor of Arts from the City College of New York and also acquired a Master’s of Science at Hunter College. A native of New York, Ayodele holds strong ties to her Haitian origins. Inspired by a trip to Haiti in September 2009, she is determined to shed light on the taboo subjects of sexual violence and reproductive wellness among women and children through art therapy in Haiti and other developing nations. As a member of Big Apple Playback Theater Ayodele continues to utilize the arts as an outlet for healing and enjoyment supporting others in doing the same. She has a strong passion for, and seeks to contribute to, psycho-social improvement and healing, through the arts, birth work, and programming in developing societies with respect to women and children’s rights. Ayodele believes in the possibility of approaching the political process through a social justice lens and honoring humanity with the hopes of influencing the current state of the system. 

We're Talking ICI, IUI and IVF, OH MY!

Learn about the difference between ICI, IUI and IVF! In this section, we'll discuss three different ways that queer families might conceive.

Morgane Veronique Richardson, MA., is a DONA Certified Doula, Childbirth Educator and Certified Breastfeeding Counselor. She is also the Director-Elect of the NYC Doula Collective. Morgane holds a B.A. in Sociology/Anthropology and Art History from Middlebury College and an M.A. in Gender and Peace building from the United Nations University For Peace.   Morgane happily makes her home in Brooklyn with her wife, Alexandra, and their dog, Joplin

Morgane Veronique Richardson, MA., is a DONA Certified Doula, Childbirth Educator and Certified Breastfeeding Counselor. She is also the Director-Elect of the NYC Doula Collective. Morgane holds a B.A. in Sociology/Anthropology and Art History from Middlebury College and an M.A. in Gender and Peace building from the United Nations University For Peace. Morgane happily makes her home in Brooklyn with her wife, Alexandra, and their dog, Joplin

Giving birth during hurricane Irma under emergency situation

A Guide for Pregnant Women, Parents, Supporters, First Responders and Good Samaritans by Florida based midwife Jennie Joseph. Follow the simple steps outlined below when 911, emergency services or medical assistance is not immediately available.

Download PDF here

Jennie Joseph  is a British-trained midwife, a women’s health advocate, the founder and executive director of Commonsense Childbirth Inc. and the creator of  The JJ Way® . She moved to the United States in 1989 and began a journey that has culminated in the formation of an innovative maternal child healthcare system,  markedly improving  birth outcomes for women in Central Florida.  Jennie has worked extensively in European hospitals, American birth centers, clinics and homebirth environments. She has been instrumental in the regulation of Florida midwives since the 1990’s and has been involved in midwifery education since 1995. She is the former chair of Florida’s State Council of Licensed Midwives. Currently she owns a Florida licensed midwifery school attached to The Birth Place, her nationally renowned birth center and maternity medical home in Winter Garden, Florida.  Due to the high prematurity rates experienced by low income and uninsured women she established an outreach clinic for pregnant women who are at risk of not receiving prenatal care. Her  ‘ Easy Access’   Prenatal Care Clinics offer quality maternity care for  all,  regardless of their choice of delivery-site or ability to pay, and have successfully reduced both maternal and infant morbidity and mortality in Central Florida.  The Birth Place  offers a unique opportunity for pregnant women to  choose  the site, setting and type of provider for their prenatal care and the delivery of their baby. Working in partnership with women by raising their status from patient to client, Jennie has empowered them to be proactive about their treatment and care. Fathers, family members, and friends are brought in as part of the mother’s team and engaged in the goal of helping her achieve a healthy, full-term pregnancy.  Jennie has pressed for linkages and collaboration with other public and private agencies in an effort to maintain continuity of care for the safety of her clients but also in order to bridge the gap between America’s maternity care practitioners. She has developed and administers perinatal professional training and certification programs to address the health care provider shortage, diversify the maternal child health (MCH) workforce and address persistent racial and class disparities in birth outcomes. There are both quantitative and qualitative studies underway regarding Jennie’s work as well as continuous reviews of the impact of her clinical and educational programs. Jennie’s model of health care,  The JJ Way® , provides an evidence-based system to deliver MCH services which improve health, reduce costs and produce better outcomes all round.  Jennie Joseph has built up a reputation across the United States and has given numerous presentations, including a Congressional briefing on Capitol Hill, in order to discuss the statistical data as well as describe practical solutions to improving birth outcomes. Jennie is a regular presenter at maternal child health conferences and organizations; she has a leadership position amongst US and international midwives movements and is a subject matter expert on racial and perinatal disparities in the USA.  Jennie firmly believes in patient-centered, woman-centered care and works tirelessly to support the systems, providers and agencies charged with delivering that type of care. “Until women and their loved ones feel that they have enough knowledge and agency to be part of the decisions around their care and until they have access to the education and support that they are lacking, they will continue to be at risk.”-Jennie Joseph   To have Jennie speak at your event or for training and consulting needs please email  speaker@jenniejoseph.com

Jennie Joseph is a British-trained midwife, a women’s health advocate, the founder and executive director of Commonsense Childbirth Inc. and the creator of The JJ Way®. She moved to the United States in 1989 and began a journey that has culminated in the formation of an innovative maternal child healthcare system, markedly improving birth outcomes for women in Central Florida.

Jennie has worked extensively in European hospitals, American birth centers, clinics and homebirth environments. She has been instrumental in the regulation of Florida midwives since the 1990’s and has been involved in midwifery education since 1995. She is the former chair of Florida’s State Council of Licensed Midwives. Currently she owns a Florida licensed midwifery school attached to The Birth Place, her nationally renowned birth center and maternity medical home in Winter Garden, Florida.

Due to the high prematurity rates experienced by low income and uninsured women she established an outreach clinic for pregnant women who are at risk of not receiving prenatal care. Her Easy Access’ Prenatal Care Clinics offer quality maternity care for all, regardless of their choice of delivery-site or ability to pay, and have successfully reduced both maternal and infant morbidity and mortality in Central Florida. The Birth Place offers a unique opportunity for pregnant women to choose the site, setting and type of provider for their prenatal care and the delivery of their baby. Working in partnership with women by raising their status from patient to client, Jennie has empowered them to be proactive about their treatment and care. Fathers, family members, and friends are brought in as part of the mother’s team and engaged in the goal of helping her achieve a healthy, full-term pregnancy.

Jennie has pressed for linkages and collaboration with other public and private agencies in an effort to maintain continuity of care for the safety of her clients but also in order to bridge the gap between America’s maternity care practitioners. She has developed and administers perinatal professional training and certification programs to address the health care provider shortage, diversify the maternal child health (MCH) workforce and address persistent racial and class disparities in birth outcomes. There are both quantitative and qualitative studies underway regarding Jennie’s work as well as continuous reviews of the impact of her clinical and educational programs. Jennie’s model of health care, The JJ Way®, provides an evidence-based system to deliver MCH services which improve health, reduce costs and produce better outcomes all round.

Jennie Joseph has built up a reputation across the United States and has given numerous presentations, including a Congressional briefing on Capitol Hill, in order to discuss the statistical data as well as describe practical solutions to improving birth outcomes. Jennie is a regular presenter at maternal child health conferences and organizations; she has a leadership position amongst US and international midwives movements and is a subject matter expert on racial and perinatal disparities in the USA.

Jennie firmly believes in patient-centered, woman-centered care and works tirelessly to support the systems, providers and agencies charged with delivering that type of care. “Until women and their loved ones feel that they have enough knowledge and agency to be part of the decisions around their care and until they have access to the education and support that they are lacking, they will continue to be at risk.”-Jennie Joseph

To have Jennie speak at your event or for training and consulting needs please email speaker@jenniejoseph.com