Home » More nurse-midwives needed to address racial disparities in maternity care

More nurse-midwives needed to address racial disparities in maternity care

By Dr. Susan Stone, President
Frontier Nursing University

Every October, we pause to celebrate National Midwifery Week and the important work of midwives around the globe. This year was particularly special given the World Health Organization’s (WHO) designation of 2020 as the Year of the Nurse and the Midwife.

We also use this time to bring greater awareness to the rising maternal mortality rate in the U.S. Approximately 700 women die per year during pregnancy and childbirth, the most of any developed country, leaving hundreds of newborns to navigate life without the love and care of their biological mother.

Black families face this harsh reality three times more often than white families. The Black population’s infant mortality rate is also more than double the mortality rate for white newborns. Midwives have been fighting these battles for many years as they care for women in underserved areas to improve access to quality maternity care.

Several factors contribute to these troubling statistics. As COVID-19 has continued to spread across our country, the racial and ethnic disparities in health care have become even more glaringly apparent. The CDC reported over the summer that Black and Native Americans are five times more likely to be hospitalized than non-Hispanic white persons during a COVID-19 episode.

There is no evidence that people of color have any biological factors that make them more susceptible to disease. According to the CDC, “Longstanding systemic health and social inequities have put some members of racial and ethnic minority groups at increased risk of getting COVID-19 or experiencing severe illness, regardless of age.”

We see the same health disparities caused by systemic racism in many health indicators in the U.S. Racism is a double-edged sword that not only affects a person’s health but also their ability to receive quality health care. Daily racial discrimination has been linked to underlying conditions and can increase the risk of severe illness. Crowded living conditions, lack of health insurance, and financial challenges are obstacles to health in some Black communities.

My colleague Dr. Heather Clarke and I discussed this topic during Frontier Nursing University’s recent National Midwifery Week virtual event. As Dr. Clarke shared, racism is a constant, persistent toxic stress that weathers the human body. With decreased public services, poor schools, food deserts, and low paying jobs, some Black families may have fewer protective factors to shield them from the effects of stress. Dr. Clarke also noted that stress could be transmitted three to four generations forward through a pregnant mother.

At Frontier Nursing University, we teach that good family health begins with caring for the mother. We educate Certified Nurse-Midwives (CNMs), who are primary health care providers to women of all ages throughout their lives. CNMs focus on gynecologic and family planning services, as well as preconception, pregnancy, childbirth, postpartum and newborn care. They also provide primary care, such as conducting annual exams, writing prescriptions, and offering basic nutrition counseling.

According to the WHO, the world needs nine million more nurses and midwives to achieve universal health coverage by 2030. Recognizing this need, we began offering a distance education program in 1989 to educate nurse-midwives and nurse practitioners in their home communities. Most of our graduates continue to serve in their home communities after completing the program.

Students are on campus for a four-day orientation before completing online courses and then again for a brief five-day session to prepare for their clinical experience. In 2021, we will open a new, larger campus in Versailles, Ky., allowing more nurses to advance their careers with masters and doctoral degrees. We reach students across the country who work in rural and underserved areas through our distance education model. While they complete their coursework at home, they have access to a much more extensive network through FNU.

We also strongly support the need to increase diversity within the nursing and nurse-midwifery professions because patients are more receptive to care from a health provider who understands their culture and socioeconomic background. Our graduates serve people of all races and cultures, and our student of color population has increased from 9 to 24 percent over the past 10 years. It is imperative that our students, faculty, and staff have cultural awareness and competency to help overcome racial disparities in health care.

Many of us can grasp, empathize, and even identify with the constant and persistent stress families face when a loved one is sick. Our hope is a renewed focus on social injustices will allow people to open their hearts in the same way when it comes to racism.

Many mothers face unseen challenges as they bravely welcome new lives into the world with joy and hope. Nurse-midwives do their best to affect change by listening, respecting, and assessing relationships, support systems, parenting styles, and more. From social workers to churches to health departments, we know it takes a village to address stresses and create strong support systems.

COVID-19 has emphasized the importance of community for all of us. While tragic, let’s allow the universal nature of a global pandemic to help us see things in a new light and bring us together to address racial disparities in health and maternity care. This is the year of the nurse and the midwife, in more ways than one. There is no better time than now.

Dr. Susan Stone, President, Frontier Nursing University


Frontier Nursing University, based in Versailles, Ky., is one of the largest not for profit universities in the United States for advanced nursing and midwifery education. Visit Frontier.edu to learn more.