Voices of Diversity in Midwifery

As I'm narrowing down my thesis topic (which I thought I had, but then ran into all kinds of roadblocks with my advisor, whom I trust) I read an article from the Journal of Midwifery and Women's Health:

"Voices of Diversity in Midwifery: A Qualitative Research Study"
by Kennedy, Erickson-Owens, and Davis.

Abstract: The practice of midwifery reflects the spectrum of diversity among
midwives and the women they serve, yet the composition of midwives in ACNM does
not reflect the diversity of the women for whom they provide care. Providing
culturally appropriate care for women requires our best understanding of their
beliefs, needs, and desires; it also requires a wide range of diverse
clinicians. This study proposed to learn more about the practice of midwifery
from a diverse sample of midwives. A qualitative research design, which included
small group interviews, videotape collection of data, and content analysis, was
used. Four major themes were identified: 1) the worldview of midwifery through
the lens of diversity, 2) the experience of diversity, 3) midwifery strategies
rooted in diversity, and 4) the legacy for the profession of midwifery. There
must be purposeful action by every individual in the profession, as well as the
collective voice of midwifery, to identify barriers to inclusiveness and to
foster a culture of diversity through respect, recruitment, and mentoring.

I'd provide links to the articles but I know they wouldn't work because they're connected to university server access and all kinds of codes are required...the whole knowledge is only for the privileged, *sigh.*

Anyway, from the article:

"No studies have examined perspectives of midwifery practices from midwives who represent racial, ethnic, or gender diversity."

"...by listening to the voices of diverse midwives, we help to ensure that the characteristics of the midwifery model of care are not limited to the exclusive views of the predominantly white women of the profession."

...they should have added that the model is also very influenced by the fact that not all kinds of midwives are allowed to join the ACNM and so it is also narrow in that way...

One of the things that informed my choice of a research topic was this:

"Several described their own difficult student years where they had to struggle with the challenges of nonwhite status and language barriers."

Then, from one of the participants in the study, further explanation:

"So we're alone, because most of the time, we're just one or two. If we're
lucky, we have another colleague in the class. If not, we're by
ourselves. So it's very hard to find someone, another student to
collaborate with that would help you through school..."

According to the authors: "The sense of invisibility went very deep, enough that one participant believed it could affect her viscerally, even when, intellectually, she knew the fault did not lie with here.

The participant said:

'Yes, it's their problem, but it becomes your problem in a subtle way, that
there's a reaction in you when you are rendered invisible, like...a biochemical
reaction...that something happens to us when we're treated that way."

This grabbed a hold of me because the participants in this study had graduated from a range of 7 to 40 years ago...and still they're thinking about, talking about, what happened to them in midwifery school. Since I'm dead in the middle of it, I know what the hell is going on, and how...hard...this is, but it's hard to get other people to understand it. I think this point, that they're still thinking about it, is one way to say, look, this is not a game...I am not just a moody pisces...this is not oversensitive me...me who just doesn't want to go to the potluck...this is me who is consciously trying to limit my exposure to this stuff...stuff that you are so oblivious to...stuff that isn't good for me...

And so I decided that this was what I wanted to do my thesis on:

What are the lived experiences of black american students in nurse-midwifery programs?

I presented it in research class and it was fine, but then I met with my thesis advisor over break and she had a lot to say. Mainly, that this is actually a dissertation topic because of the lack of research already existing about it. Her position is that a master's level thesis expands on a topic that has already been researched, while a dissertation presents something totally new...which is what my topic is...maybe. So we talked about doing a literature review, but couldn't find any articles so far that could be reviewed. *sigh* We talked about how we would need IRB approval to do the project because I'd be interviewing people, and how that IRB approval would have to be applied for at all the schools whose student I would interview. And about how they only gave us 12 months to write the thesis, and how I'm school for most of that time. All of this to say, this topic is probably not going to happen...and all I could think about was "and this is how they do it...this is why the research is so few and far between...these are the gatekeepers to what gets written...why what the hell is happening in midwifery, nurse midwifery, is happening in secret, in quiet behind closed doors, when it comes to race and diversity. This is why I feel like I'm losing my mind alone despite the fact that most students of color felt this way when they were going through grad school...because not enough people are asking the questions and writing down the answers.

One day I got an email from my friend/mentor/life guide (that's a new on for ya, H ;o) about those posts I had been consumed with about losing my mind and spiraling into descent. She emailed back this quote from Where We Stand: Class Matters by bell hooks:

"Living in a world above the absolutes of law and man-made convention was
what any black person in their right mind needed to do if they wanted to keep a
hold on life. Letting white folks or anybody else control your mind and your
body, too, was a surefire way to fail in this life. That's what [her
grandmother] used to say--may as well kill yourself and be done with it."

H also said: Your struggle is classic and enduring. You are not the first; you are not the last. You are not alone.

Someone has to ask us students the questions so that we can write down the answers so that those coming after us don't feel like...well, they'll probably still feel like it, but so they know that they aren't losing their minds...

The article was good, I had questions afterwards, which is to be expected, but overall, it was good to read the words of some non white midwives...