Skip to main content

Q & A With Sherry Payne, MSN, RN, CNE, IBCLC

Posted by Midwives Alliance on September 3rd, 2014

Are you following Sherry Payne's Walk for Black Infant Mortality Awareness? She's walking across the state of Missouri to "bring attention to the invisible epidemic of African-American infant mortality - babies dying prior to their first birthday." We connected with Sherry before the walk began to learn more about her path to midwifery, her projects at Uzazi Village, and how we can all support the walk. You can also hear her speak at the upcoming MANA convention.

Q: You have had a complex journey on your path towards midwifery. Can you tell us about it? 

I spent many years trying to decide which pathway would be appropriate for me.  I hope to eventually have both a CNM and a CPM credential. I have started working with my CPM preceptor and have applied to CNM schools and am waiting to hear back. My path has been like many others. I started 20 years ago as a homebirth mother, then became a doula, then went to nursing school. I had a career as a labor and delivery nurse, then returned to school to get a masters in nursing education. I taught for a few years and then decided the time was right to pursue my midwifery education now that my youngest is now seven years old.

Q: This has not been a simple path for you. Why is becoming a midwife so important to you?

My passion is perinatal health, and my mission is decreasing perinatal health inequities, so midwifery care is an important component of that. I believe the midwifery model of care is appropriate for my community, even though the women of my community are the least likely to have access to a midwife. Becoming a midwife is important to me and my community to demonstrate what is possible when midwifery care is applied in a culturally congruent manner.

Q: Do you think there are challenges common to women of color who are working towards being a midwife?  

I think there are tremendous challenges to becoming a midwife for women of color. Chief among them are the tensions associated with working with dominant culture preceptors and their dominant culture clients. Will your preceptor understand your cultural context? Will the clients accept you as a care provider? I once had a client barely speak to me or answer my questions. When the midwife later entered the room, the client had nonstop questions. Afterward the midwife asked me why I hadn’t answered the client’s questions. I told her the client barely spoke to me even when I asked repeatedly if she had questions. I was in an awkward position: either look incompetent to my preceptor or present her client as not wanting to work with me. It was a very uncomfortable situation. Taking on a woman of color as a student will be fraught with such landmines. A lot of preceptors even unconsciously decide they don’t want to take this on. It can pit them against their own clients if their client is uncomfortable having a woman of color touch them. Some midwives don’t want to discover this about their clients or maybe even about themselves. All across the country I hear midwife students of color say what a difficult time they have finding preceptors.

Q: Tell us about your work at Uzazi Village.

Uzazi Village is a community-based nonprofit devoted to improving perinatal health in the urban core. We provide culturally congruent education for childbearing families, doula and breastfeeding support services. We also work with providers, offering continuing education on culturally congruent care and other perinatal topics. Finally we offer training and support for candidates of color pursuing perinatal careers.

Q: Can this model be replicated in other communities?

We have several replicable programs intended to be duplicated in other communities of color. The Chocolate Milk Cafe is a mother-to-mother support group model specifically for African-American women to support them in their breastfeeding journeys. Our Sister Doula Program™ pairs specially trained doulas with pregnant women on Medicaid. Finally, our Lactation Consultant Mentorship Program places IBLCE candidates in our free walk-in clinic, paired with qualified mentors to achieve mentorship hours required toward the credential. This program is designed to increase the number of IBCLCs of color.

Q: Tell us what you are speaking about at the MANA conference this year.

My two breakout session topics in October will be: “Saving Ourselves - Black Midwives and Doulas Impacting Inequities” and “What You Don’t Know Hurts Us: Racism, White Privilege, and Perinatal Health Inequities”. These two sessions will showcase what doulas and midwives of color are doing around the country to positively impact their communities and show how allies can assist in these efforts. It is always difficult to hear the structural racism and white privilege talk. Midwives, especially those who work with women of color and in communities of color, want to believe that they are doing good works. Having to confront structural racism in organizations and institutions they love and are committed to can be very challenging. I hope in my presentations at MANA to challenge midwives to really look at their own privilege, whom they do and don’t serve, the structural cultures of their organizations, and what work they need to do to move into a more aware space that would make room for students, apprentices, and clients of color. Not just having them there, but making them feel welcome and wanted.

Q: Tell us about the Black Infant Mortality Awareness Walk.

I plan to walk across the state of Missouri from September 1-10, 2014.  My goal is to raise money for Uzazi Village Sister Doulas Program™, bring awareness to Black Infant Mortality, and engage my state in conversations about solutions to the problem of perinatal health inequities in my community. I have a support team that will accompany me. I plan to stop in towns and cities along the way and speak to churches, and universities, and hospitals. My first stop will be to legislators in the Missouri state capital to engage them on problems with Medicaid and to ask for Medicaid expansion. I have been planning this walk for months and training to get myself in condition. I’m hoping it will be a catalyst for others around the country to take on similar projects. Black infant mortality is a complex, multifaceted issue that needs to be addressed on many levels.  

Q: How can readers support your work?

  • Go to our fundraising website and make a donation.
  • Get pledges, track my walk, and collect donations based on the number of miles I walk
  • Go to our website and learn more about our organization and our programs www.uzazivillage.com
  • Make a donation to Uzazi Village on its donation page
  • If you are local to Kansas City, volunteer for one of our groundbreaking programs
  • Knit or crochet Boobie Hats for our mothers for gifts
  • Donate new and used babywearing gear for our Babywearing Fashion Shows
  • Schedule a talk or presentation with Sherry for your group or organization
  • Schedule a visit to Uzazi Village to learn more about what we do
  • Attend one or both of my sessions at MANA to learn more about health inequities
  • Track my daily progress on my walk
  • Join me on my walk for a day or two
  • Tell other’s about my work and mission
  • Tell me about others doing similar work
  • Friend me on Facebook, or like my Walk for Infant Mortality page or Uzazi Village page
  • Drop me a line, I can be reached at sherry@uzazivillage.com 913-638-0716

 

Sherry L. PayneSherry L. Payne has a bachelors of nursing and a masters in nursing education. She is pursing midwifery education and works part-time as a seminar presenter and nurse educator. She is a lactation consultant and a certified nurse educator. Upon completion of her midwifery studies, she plans to open an urban prenatal clinic and birth center. Ms. Payne founded Uzazi Village, a nonprofit dedicated to decreasing health disparites in the urban core. She owns Perinatal ReSource an education, training and consulting firm. She is an editor for Clinical Lactation Journal, and sits on the board of CIMS, Coalition to Improve Maternity Services. She also sits on her local FIMR Board (fetal infant mortality review). She presents nationally on perinatal and nursing education issues. Her career goals include increasing the number of midwives of color and improving lactation rates in the African American community through published investigative research and application of evidence based clinical practice and innovation in healthcare delivery models.

 

Jeanette McCulloch, IBCLCSherry was interviewed by Jeanette McCulloch, IBCLC, editor of the MANA blog and co-founder of BirthSwell. She has been using strategic communications and messaging to change policy, spread new ideas, and build thriving businesses for more than 20 years. Jeanette is honored to be working with local, national, and international birth and breastfeeding organizations and advocates ensuring that women have access to high-quality care and information.

Top Ten Reasons To Become A MANA Member

Posted by Midwives Alliance on August 26th, 2014

Topics  

1) Help families find you! All midwife members of MANA are eligible to be listed at Mothers Naturally "Find a Midwife."

2) Continuing education. Being a member also means discounted access to the MANA conference, which provides continuing education focused specifically on home birth and birth center practices.

3) Keep up-to-date on the latest research and practice guidelines. Our website, blog, and social media sites provide up-to-the-minute news and research.

4) Find your midwifery community. At the conference, on our social media sites, and our emails, MANA connects you to the midwives and birth professionals in your community.

5) Track your outcomes. Your MANA membership supports the MANAstats project. If you become a MANAstats contributor, you’ll get data you can use to track and compare your practice’s outcomes to nationwide benchmarks.

6) Support groundbreaking home birth research. MANAstats data is available to researchers worldwide, a critical tool in understanding what home birth practices lead to positive outcomes for families.

7) Get the tools you need to run your practice. At the MANA conference, in our email blasts, and on our blog and website, you’ll learn about the latest research, meet the people with groundbreaking models for care, and connect with others who are solving the same challenges you are.

8) Support your profession. MANA provides key education and advocacy for preserving the art and science of midwifery, advocating for maternity care policy reform, supporting and unifying midwives, endorsing a woman-centered maternity care model and preserving normal birth practices. Without your membership support, none of this work is possible.

9) Educate families about the value of midwifery. MANA creates tools you can use to educate families about midwifery care, including the I am a Midwife series, blog content tailored to educating families, and other visuals and content. We encourage all MANA members to use our content on your websites, Facebook pages, and other promotional materials.

10) Get your midwifery gear. The MANA marketplace offers books, t-shirts, and bumper stickers you can use to show your pride in midwifery.

But most importantly . . . because you care about your profession!

MANA is making it easy to take advantage of the many benefits of membership! Join now during the August membership special: $100 for one year.

Help us spread the word *and* win some MANA swag. Share this article *anywhere* where midwives are online. Leave a comment below with where you shared. We’ll pick one of you to win a MANA tshirt! Thank you!

Preview: Lancet Special Series On Midwifery

Posted by Midwives Alliance on June 20th, 2014

"Women should be at the heart of planning maternity services."
— Mary Renfrew, on the findings of the upcoming
Lancet Special Series on Midwifery

Midwives know from lived experience the value midwifery care has for birthing families, their communities, and the world. Next week, the evidence base for the impact of midwifery care will be significantly expanded.

At the recent International Confederation of Midwives meeting in Prague, upcoming publication of the Lancet Special Series on Midwifery was announced. What is this research about and why is this release so important?

The Lancet, considered to be one of the world's leading medical journals, is devoting an entire series to bringing together all of the available information about midwifery care in one place. It comes at a critical time when policy crafters are making decisions in the U.S. and worldwide about how to fill the growing gaps in the maternal health care system.

According to the series coordinator, Petra ten Hoope-Bender, the series will include six papers (read her full description of each paper here).

  • Midwifery and Quality of Care
  • Impact of Scaling Up Midwifery
  • Deploying Midwives in High Burden Maternal Mortality Countries
  • Improving Maternal and Newborn Health through Midwifery
  • Human Rights and Midwifery
  • the Research Agenda

According to the Healthy Newborn Network, the series will "Go a long way to helping make the case that investment in midwifery is a highly effective way of improving a nation's health, as well as just the right thing to do from a woman's perspective."

The series will also be multidisciplinary: ". . . It unites midwives with statisticians, epidemiologists, economists, and other disciplines," according to the Maternal Health Task Force.

The rollout will run Monday June 23rd through September and will be free and available online at the Lancet. Watch here and on Facebook and Twitter for updates, and be sure to join the conversation at #LancetMidwifery.

Nine Tips To Help Midwives and Doulas Work Together

Posted by Midwives Alliance on May 21st, 2014

Guest Post by Sharon Muza, BS, CD(DONA), BDT(DONA), LCCE, FACCE

Editor's Note: Tech issues as we updated the MANA site meant this post couldn't run during the month of May. However, this content remains relevant year round, not just during International Doula Month! 

International Doula Month, celebrated every year in May, is a great time to examine the issue of doulas and midwives working together to support birthing families. While the roles of both birth doulas and home birth midwives are clearly defined, it is not hard to imagine that along with the desire to offer the best professional service to a family, the professionals serving in these capacities might find themselves feeling a bit awkward with each other. There even may be some "jockeying" for position as the midwife and the doula strive to best serve the client and the client's family. Remember that not all home births have a doula presence, so the doula's presence may require some adaptations.

According to DONA International, birth doulas are trained to provide emotional, physical and informational support during labor, birth and the immediate postpartum period. The word "doula" comes from the Greek language and means "woman who serves," though there are both men and women serving in the doula role today. The typical birth doula will meet with his/her client once or twice prenatally to understand their preferences for labor and birth and how the doula can best support them and their family. They also explore any worries or concerns that the pregnant person may have. The doula will attend the birth and then close the professional relationship with a final postpartum meeting or two. The doula is a source of information for the family from the time of hire through the first weeks postpartum. (Postpartum doulas can be hired to provide services after the birth, including newborn care, meal preparation, light housekeeping, and family support.)

The midwife is a trained health care professional who provides clinical care along with information and emotional support during the pregnancy through six weeks postpartum. The term "midwife" means "with woman." Over the course of the pregnancy, a person will see their midwife 15-20 times for pre- and postnatal appointments, where the midwife will assess the client and baby and share information, along with benefits, risks and alternative of procedures, tests and assessments.

Here are nine tips for making the most of what doulas and midwives have to offer while working together:

1. Midwives support healthy, low risk birth and doulas help improve birth outcomes

Midwives are appropriate health care providers for healthy, low risk pregnancy. They are well suited to providing a safe and satisfying birth experience for their clients. Evidence shows that outcomes are good and families are very satisfied with the care they receive.

There is ample research on the benefits of doulas at births. (Hodnett, 2013) When the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) released their groundbreaking "Safe Prevention of the Primary Cesarean Delivery" Obstetric Care Consensus Statement in February 2014, one of their key recommendations to reduce the primary cesarean rate in the USA was the continuous presence of a doula at a birth. (Caughey, 2014)

By working with a midwife/doula team, families reap the benefits of both models of care.

2. Doulas work within their scope of practice

When doulas stay within the scope of their practice, they best serve their clients and are more likely to be a welcomed member of the birth team. Many doulas may be pursuing the path to midwifery. Some doulas may also be a trained midwife or birth assistant, working in that capacity with other clients. But in the doula role, emotional support, physical support and helping a client and the family to find their voice is key.

3. Respect pre-existing relationships

The midwife has an emotional relationship with the client, developed over time. The midwife has also been trained in providing physical support and promoting a normal labor. The midwife is the only one responsible for providing clinical assessments and providing medical advice. The client can make optimal use of both their doula and their midwife. Everyone at the birth has the same goal - healthy family and a healthy birth.

The midwife shares the responsibility of emotionally supporting the client with the birth doula, and recognizes the value of the doula-client relationship. Having a birth doula in attendance allows the midwife to take care of clinical tasks and documentation, and also rest to conserve her energy for the actual birth, when s/he needs to be on the top of their game and ready to respond to unexpected situations. The client views the two professionals differently, but relies on support from both of them. Midwives and doulas are both experts in providing emotional support and physical comfort measures at births.

4. Support in early labor

Often times, a doula will support a client prior to the arrival of the midwife. This early labor support helps the client to gain confidence in their coping abilities, feel supported and promote normal, physiological birth staying hydrated, nourished and changing into positions that promote progress. Sometimes, they arrive together and the midwife can feel confident that the client is supported emotionally while the midwife clinically assesses the situation and sets up birth equipment.

5. Two heads are better than one to promote progress

Having a doula present at a home birth often means that two heads are better than one when it comes to suggesting coping strategies and offering comfort techniques that allow the labor to progress. I always learn something from every midwife I work with; a new position, a different coping strategy. Frequently, the midwife may learn something from me. As a birth doula, I have the chance to work with a wide variety of midwives (and doctors and nurses) and I bring those diverse experiences to all my births.

6. Transfer support

One of the midwife's responsibilities is to provide medical information and assessments and make recommendations for care, prenatally, intrapartum and after birth. The midwife and client make the decision when it becomes necessary to transfer. The doula can help the client to receive all the information that is needed in order for the client to feel comfortable with their choices. The client may choose to transfer and the doula can help the client's voice to be heard.

If a transfer becomes necessary, the doula will stay with the client at the hospital until after the baby is born. Some midwives stay as well, after transferring care to the hospital health care provider. If the midwife leaves, the client will still have continuous support from the doula.

7. Twice as many postpartum visits

Both doulas and midwives have scheduled postpartum visits with the new family. Having separate visits from both professionals means more support for the family on breastfeeding and adapting to caring for and parenting a newborn.

8. Celebrate the different roles

Midwives and doulas serve different but valuable roles during the pregnancy, labor, birth and postpartum period. Working with a midwife should not preclude the benefits of working with a doula and having a doula attend the birth should not interfere with or minimize the trusting working relationship that the midwife has with his/her clients.

9. Collaboration is key

Working together, midwives and doulas are able to create a win-win situation that clearly supports healthy births, healthy parents and healthy babies. When doulas and midwives collaborate, the families reap the benefits. Unfortunately though, subtle (or not so subtle?) areas of conflict can arise, between midwives and doulas, as both strive to serve their clients in the best way possible. When all the professionals attending a birth work together and avoid conflict, the end result is exponentially more positive for all.

Summary

Doulas and midwives should recognize that each professional brings different skills to the birth, along with some overlapping, but not competing abilities. Working together, respectful of the boundaries of the other, will benefit the client and their experience, create a collaborative situation that builds on everyone's strengths and supports the best outcomes for parents and baby. There is no reason to feel territorial or defensive. Open communication between midwives and doulas, mutual respect and a clear definition of each other's scopes of practice create the optimum circumstances to welcome a new human being into the world.

Photo credit: ©2014 Patti Ramos Photography
www.pattiramos.com

References
  • Caughey, A. B., Cahill, A. G., Guise, J. M., & Rouse, D. J. (2014). Safe prevention of the primary cesarean delivery. American journal of obstetrics and gynecology, 210(3), 179-193.
  • Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub5.

About the author

Sharon Muza, BS, CD(DONA), BDT(DONA), LCCE, FACCE is a birth doula and teaches independent Lamaze childbirth classes in the Seattle area, including "VBAC YOUR Way", "Cesarean YOUR Way" and "Labor YOUR Way" classes along with a home birth series for Penny Simkin. Sharon is a birth doula trainer on the faculty at the Simkin Center at Bastyr University. She is the Community Manager for Lamaze International's Science & Sensibility blog for birth professionals and serves as a co-leader of the Seattle Chapter of the International Cesarean Awareness Network. Sharon has served on the board of several local birth organizations and frequently speaks at international conferences. Visit Sharon's website to contact her or learn more.

Rewriting Your Birth Story

Posted by Midwives Alliance on May 13th, 2014

There are many defining moments in a woman's life, but few carry more weight than the day she is born into motherhood. Seeing her child for the first time after the nine months the baby has grown inside her body is elating, and it changes her- whether she's experiencing it for the first time or the seventh time. No birth story is ever the same, and each is unique and compelling.

There are times, however, when the expectations of what labor and birth should have been like, do not come close to what actually happened. This can be at the very least disappointing, and worse, emotionally and physically traumatic. Perhaps it was a natural birth that ended up in unwanted or unnecessary interventions, a complicated c-section, or lack of concern toward the laboring mom's frame of mind. It could be one person, one word, one action that changes everything for that mother, and finding emotional healing is not always easy.

We invite you to listen to The Longest Shortest Time's podcast, "Rewriting Your Birth Story," as Hillary Frank, writer and radio producer, explores the trauma she felt in her own birth story. With her are the midwife who participated in the birth of her baby daughter, as well as maternal care researcher Saraswathi Vedam.

We welcome your thoughts on how we can help mothers who are feeling trapped by negative emotions surrounding their birth stories find their road towards emotional healing. Please share your insights with us.