I'm pleased to see yet another ACOG (American College of OB-GYNs) Committee Opinion basically saying that maternity care in this country needs to mirror the care that midwives, particularly homebirth community-based midwives already delivers. In this latest statement, ACOG (largely due to the recent and overdue increased attention to the horrific maternal and infant health outcomes in this country, particularly for families of color), acknowledges that postpartum care in the US system needs to be "redesigned" and that a continuum of support throughout the entire fourth trimester is needed, vs a single postpartum encounter around 6 weeks postpartum. Once again, ACOG, basically summarizes the midwifery approach to care without any reference to midwives (they do say "other obstetric providers" though) or that this model of postpartum care using midwives successfully exists around the world and in our own country already. In fact, while recent great strides are being made with regard to Midwife/OB collaboration, the reality is that this professional organization has a history of working against the integration, licensure and utilization of community-based midwives like myself who are deeply steeped in the reality that the birth is just the beginning and the support of the still interdependent dyad of the person who gave birth and the baby is a HUGE part of our work! It is heartening and hopeful that this recognition of the need for holistic and sustained postpartum care is getting the attention it warrants--hopefully resources to make these services available to a wide range of the birthing population will follow and we as Certified Professional Midwives can be a part of the solution in shifting this paradigm for families regardless of where they give birth. I look forward to participating in the CPM Symposium next month to discuss and strategize around this and many other important issues and ideas for getting the Midwives Model of Care to more families to help save lives and improve health for new families.
And I hope that rather than trying to design something on their own, ACOG can be called in to learn from, amplify and magnify the collective wisdom that already exists within impacted communities about what is needed and what works to save the lives of mothers, birthing folks and babies, especially the work of midwives of color, like Jennie Josephs, Claudia Booker, Shafia Monroe and organizations like Southern Birth Justice Network, Uzazi Villlage, ROOTT, and Ancient Song Doula Services, and so many more amazing, powerful people and efforts that need to grow and be supported. Just in the past year several powerful reproductive-justice oriented reports were released from communities of color laying out the solutions to the challenges women, birthing people, babies and new families face (will share those reports in another post soon and link from the resources section on this site). This listening and gathering of experts on the ground who are already providing this model of care should be the starting point for this redesigning and reimagining of postpartum care, and indeed of the entire approach to the childbearing year (because midwives know that the seeds of a healthy postpartum time are planted throughout the pregnancy, not just once the baby has arrived!).
From the Committee Opinion-- sound familiar?
“New mothers need ongoing care during the ‘fourth trimester.’ We want to replace the one-off checkup at six weeks with a period of sustained, holistic support for growing families,” said Alison Stuebe, M.D., lead author of the Committee Opinion. “Our goal is for every new family to have a comprehensive care plan and a care team that supports the mother’s strengths and addresses her multiple, intersecting needs following birth.”
Check out my new website highlighting Fourth Trimester Services for all families!