Rosemary, how did you first get involved with birth work?
My inspiration to become a birth worker came like lighting. In my early thirties my life took a 180 degree turn in my career path. Back in 2008, I had the opportunity to meet Rita Aparicio, a Puerto Rican traditional midwife and founder of Doula Caribe International. After completing Doula Caribe's doula certification facilitated by her and other local providers in the area, I knew birth work was my destiny. Soon after, in 2009, I founded Simple Touch of Life providing doula services, prenatal/postpartum massage, childbirth classes, and lactation support.
What was your experience of birth in Puerto Rico like?
Most of my birth work support from 2009 to 2013 was in hospitals in the San Juan metro area. More than 98% of births on the Island are performed in hospitals with a cesarean rate of 44%. Back in that time, the majority of the OBs attending births were trained with a very patriarchal and bigoted mindset. In 2009, the doula concept was still a foreign term for most hospitals in the area. This lack of knowledge made it hard and unpredictable for doulas to offer their services. There were times that I had to identify as a family member to prevent not been kicked out of the labor room and be able to advocate for my clients. Many times during labor, I witnessed my clients being harassed and bullied by their providers. Obstetric violence is not a myth - it's real! This caused so much trauma for the pregnant person and their families in a moment where love, safety, and respect should be the norm. There were very few OBs that understood the benefit of having a doula and how our presence and advocacy enhanced their client's birth experience. It was amazing on the rare occasion when everyone was on the same page and worked as a team towards the same goal - for our pregnant families to have a dignified and safe birth. With the hard work of local doulas, the government approved a law that protects Puerto Rican pregnant people to choose who they want to be with them during their labor, including doulas.
These experiences inspired me to become a midwife. This shift in my birth work journey provided me the opportunity to work with local Puerto Rican midwives and witness the power of the Midwifery Model of Care.
We are so excited to have a midwife of color on our team and we all know that birth outcomes for POC are much worse in general than for white people in the United States. How do you think midwifery care can serve POC and help turn this around?
It is all about taking the extra step and educating ourselves when caring for our POC communities. It can not be defined in one sentence. We all have complex and rich cultures with many layers of history.
Some basic suggestions:
1) Stop assuming. Assumptions can create a missed opportunity to have a better understanding of your client's health and build trust. For example, first generation native Spanish speaking clients (White, Black, Brown) can be from South or Central America, the Caribbean, or Europe. This means that we have a common language, but DIFFERENT diets, beliefs, cultures, history, health care, body structure, hair texture and so much more.
2) Learn more about the particularities for genetic conditions that are more common in particular ethnic groups. For example, a black person from Angola will be at a higher risk for having different genetic conditions than a black person from Cuba. This goes back to number one, do not assume!
3) Help access quality and equality of care in hospitals. BE AN ADVOCATE!!
What do you love most about being a midwife?
There are so many things that I love about being a midwife but at the top of the list is how the Midwifery Model of Care is about so much more than merely facilitating a birth. It is about reproductive and human rights! It is about providing the freedom and safety for pregnant people to have individualized care no matter their race, social status, sexual orientation, gender, or religion. Midwives rock my world!!
Is there anything else you'd like to share?
I want to send a shout out to all the midwives of color! Thank you for standing strong and making a difference. Sisters... I celebrate you!!