The vehicle is the Powerful Women and Families initiative aimed at helping women have healthy pregnancies and satifsying birth experiences, raise healthy babies, and become activists working to better their community. The program was born in 2010 out of the reminiscences of community elders recalling the days when midwives provided primary as well as prenatal care, delivered babies, and helped new mothers. Back in the day, midwives were central to the healthcare of the African American community, especially in the South, where there was no access to mainstream medicine. Since the mid-20th century, when midwifery declined, premature births, infant mortality, and the number of c-sections have increased. Moreover, fewer mothers have been breastfeeding, placing babies at increased risk of illness and obesity. To reverse these troubling trends, Powerful Women and Families aims in part to return the community to its cultural roots and give back ownership of an important part of black culture to childbearing women. The goal of this part of the program is to educate each participant sufficiently for her to make good decisions about her personal health, prenatal care, birthing and caring for her baby. The hope is that she will choose to be delivered by a midwife.
“One of the reasons we favor midwifery is a lot of time there is pressure to take on procedures that are unnecessary, that complicate pregnancy, complicate the birth,” said Shayla Walsh, who directs the Powerful Women and Families program.
While Shayla quickly noted that women who show any signs of complication or high risk are immediately referred to a physician and give birth in a hospital, she observed Miami’s unusually high rate of cesarean section[1] and the huge differential in cost between a c-section and a natural birth[2]. She feels that black women especially are pressured to undergo unnecessary c-sections.
“We want to protect our mothers to be able to advocate for themselves,” she said
To that end, the women – most of them single mothers and almost all pregnant -- come to Powerful Women and Families for information about health, nutrition and reproductive justice. During the first six-weeks of a two-part 12-week curriculum, a nurse-midwife instructs the class in what to eat, how to exercise, and how to distinguish the benign discomforts of pregnancy from signs of trouble. Those who need Medicaid are directed to Florida Legal Services, where one attorney works specifically on obtaining Medicaid for women and children. Those who do not have prenatal care are connected to a provider. In class, they discuss medical birth versus a natural birth, vaginal birth versus c-section, and the stages of labor. They practice breathing exercises to ease labor. They tour a hospital maternity unit and a birthing center, and they make a personal birth plan. They also look at issues they will encounter after delivery: breastfeeding, circumcision, diapering, contraception and more.
The second six weeks is devoted to reproductive
justice, where the moms learn organizing skills aimed at changing attitudes and
policies, at present toward breastfeeding. In what is called the “College of Leadership,“
the women learn the nuts and bolts of activism. Classes cover the core elements of
reproductive justice, democratic principles and practices, and the elements of
a campaign. They learn how to construct a
campaign, how to build a grassroots organization, and how to identify issues
and power. They discuss civic education
and participation, neighborhood and community participation, and strategy
development. They learn to tell their
story and practice public speaking.
But what happens outside the curriculum is at least as
important as what takes place in class.
Power U has created an informal but safe space where women can come and
be with other young moms. The staff
listens patiently and encourages the participants to do likewise. Whereas the
moms’ friends and neighbors in the community are not likely to be interested in
hearing about their problems with baby’s daddy, for example, they find a tolerant
ear and commiseration at Power U. The
staff makes no effort to mold the women into something they are not. Rather, they accept the moms for who they are
and try to help them grow. In the process, negative attitudes gradually shift toward
positive. Back stabbing gradually gives
way to more constructive conflict resolution.
By creating a supportive, non-judgmental environment, the staff helps
the women become comfortable relating candidly and talking with each other
about the parenting issues they have.Dontravia Mathis demonstrated the self confidence the program has spawned when, dressed in hose and heels, she returned from an afternoon of job hunting. Asked what the program has done for her, Dontravia quickly answered, “It’s broadened my horizons.”
After a presentation on the importance of whole grains and organic foods especially for lactating mothers, Dontravia tried some vegan selections she would never have considered tasting before. More important than trying new foods, Dontravia acknowledged, “I interact more now. I speak my opinions.” And she has gained the courage to move beyond looking for jobs on the internet to getting dressed and going out to search.
Transformed this way, those who complete the twelve-week course don’t want to leave, and so Power U is evolving an advanced curriculum to keep the women involved. In a continuation of the “College of Leadership,” the moms are putting the skills they learned in the earlier six-week course into practice. Consistent with Power U’s commitment to building the power of its members, the moms have planned and are running this facet of the program. At present, they aim to change attitudes toward and increase the practice of breastfeeding in the African American community.
Typically, Black women say “breasts are for my boyfriend, not for my baby” or “I figured formula was just as good.” Some say breastfeeding hurts. Others just never thought about it. Regardless of their reason, few African American women breastfeed. Yet the advantages of breastfeeding are profound. Breast milk is easier to digest than formula and helps protect babies from all kinds of illnesses, including asthma and respiratory infections, obesity and diabetes. It’s also good for mothers, offering protection against diabetes, breast and ovarian cancer, and postpartum depression. It’s economical, involves less work than bottle feeding, and promotes a nurturing physical bond between mother and baby.
At the same time, it can be challenging. Sometimes babies have trouble latching on and sucking effectively, which can be frustrating. While there are good support services in the community – La Leche and Healthy Start, for example -- hospitals can sabotage the effort by not giving mother and baby immediate skin to skin contact, by not encouraging nursing on demand, by offering moms formula for baby’s first feeding and providing samples for mom to take home. So the reproductive justice project set out to catalyze change.
The campaign is taking the moms first to hospitals to persuade the administrators to implement policies that promote breast feeding and help new moms adapt to it successfully. They are also making presentations to other organizations, and they developed a questionnaire so they could survey five African American communities in an attempt to identify common barriers to breastfeeding and strategies to overcome them. They hope the analysis of their results will be a useful tool for service providers. In addition, with the help of a fine arts student volunteer from Florida International University, they have created and posted a huge mural promoting breast feeding outside a church at the corner of Third Avenue and 14th Street in Overtown.
Finally, they are ready to collaborate with Healthy Start to initiate a training program for lactation peer counselors. Thirty-five moms are interested in this 26 hour training. Once trained, they will be able to go to a girlfriend if she needs help and make an immediate impact on the friend’s success at breastfeeding. One by one, the women hope to create a new trend in their community.
Everyone knows that breastfeeding is best,” says Shayla. But when supportive policies are not in place, “the women are not set up for success, to feel empowered in their choices. When you go into a grocery store and someone gives you a weird look because you’re nursing your child, that’s not empowering the mother. So what we’re trying to do is dehypersexualize the act of breastfeeding in our community so that moms don’t feel like they have to do it in the closet or would rather use formula because they’re going to get less pressure because of it.”
The Powerful Women and Families project began in 2010 with two or three cycles a year. Ten to 15 women participate in each class. Some come by word of mouth. Two interns, hired from previous classes, also go door to door to recruit. In light of Miami’s inadequate public transportation system, Power U has obtained a seven-seater van to pick up the moms and their babies, bring them to the two-hour class and deliver them back home. A healthy supper is served and child care, staffed by former students, is provided.
Although the program is new and numbers small, outcomes are encouraging. Four of the 15 moms in the last class, which ended in January, are breastfeeding.
“That’s huge for us,” said Shayla. “Even if we had just one mother breastfeeding it would be amazing.”
In addition, eight core leaders emerged and continue to come to every meeting and work actively on the policy agenda. Two have held down jobs for as long as they’ve been in the program. Considering that the women involved are single mothers who, with rare exception, have (at best) a high school diploma, this number is significant.
Powerful Women and Families is just one of Power U’s initiatives. A broader leadership development program focuses on varied civic, political, social and economic issues of the community. Participating members discuss the issues and work to bring about needed change. The restorative justice initiative aims to disrupt the troubling “schoolhouse to jailhouse track” that characterizes many inner city schools. Environmental economic justice and renters rights complete the list.
Powerful Women and Families has a staff of three: one program director plus the two interns hired from within. The Health and Nutrition component is taught by midwife Sharon Hamilton. The initiative has a $115,000 annual budget, 100% from grants.
Power U
164 NW 20 Street, Unit 104
Miami, FL 33127-4802
305-576-7449
www.poweru.org
[1]
According to a 2011
report by HealthGrades Obstetrics and Gynecology in American Hospitals,
Florida’s C-section rate was 38.6 percent in 2010, compared to a national
average of 31.8%. With five Miami hospitals performing more c-sections than
vaginal births, Miami leads the nation in rate of cesarean section.
[2] Data from the Florida Agency for Health Care
Administration (October 2010 – September 2011) show cesareans in
South Florida hospitals range from $11,000 to $44,000, while vaginal births
range from a low of $7,000 to a high of $30,000..
