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Black Midwives: A Q&A with Dr. Nikia Grayson, CHOICES’ Director of Clinical Services

Dr. Nikia Grayson, CHOICES’ director of clinical services, said there are currently only four Black midwives in Memphis. Grayson discusses why increasing that number will mean more inclusive, culturally competent reproductive healthcare for Black women in Memphis. — Maya Smith

Memphis Flyer: What are the goals for the fellowship?

Nikia Grayson: We want to address the maternal and infant health crisis that we are seeing in the Black community. This fellowship will help to train Black midwives in a comprehensive, reproductive and social justice way that addresses the health inequities and systemic racism many are facing in the healthcare system. There aren’t that many midwives in the country and definitely not that many Black midwives. We would love to see more Black midwives in the South caring for their communities in a culturally congruent way.

Why does culturally congruent healthcare matter?

When patients see providers who look like them and understand their cultural beliefs and values, the way they communicate, and the things they may be experiencing, it leads to better patient outcomes. There’s a level of understanding and empathy. Studies have shown that patients with providers who are like them or come from their community have better health outcomes.

Why are there higher rates of pregnancy-related deaths among Black women than among white women?

One, there are providers who aren’t listening to their patients and who aren’t recognizing the importance of seeing patients as human and honoring their humanity. Because we have this disconnect between patients and providers, many people are seeking out care late. By the time they come in for prenatal care, many of their issues are exacerbated. Also, we know that patients who are underinsured or uninsured have very few providers they can go to. They also have to learn how to navigate the system. Just the stress of trying to navigate the healthcare system, as well as the stress of being a Black woman, really does take a toll on people’s bodies.

What does inclusive healthcare look like?

Inclusive healthcare looks like caring for the whole person. We have patients who might be experiencing housing, food, or job insecurity. So it’s being able to connect them to both the social and medical resources they need. There’s a fragmentation of care in our communities. We want to have an inclusive model where we build a care team so patients don’t experience that fragmentation.

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CHOICES Announces Training Fellowship for Black Midwives

CHOICES: Memphis Center for Reproductive Health is launching a fellowship to train Black midwives in an effort to create a stronger workforce of Black midwives here, the nonprofit announced Tuesday. 

The Center for Excellence Nurse Midwifery Fellowship will introduce recent midwife graduates to CHOICES’ full-spectrum reproductive and sexual health model. The year-long training program will also focus on reproductive and social justice principles. 

The goal is for fellows to be able to provide more inclusive, patient-centered healthcare, while taking action to dismantle systems of reproductive oppression and injustices. 

Dr. Nikia Grayson, CHOICES’ director of clinical services, said Black women are dying of pregnancy-related causes at much higher rates than white women.

“We must do our part to end racial disparities in maternal and infant health, and this fellowship is part of the solution,” Grayson said. “Black women deserve high quality, culturally competent providers, and we are truly honored at CHOICES to help train the next generation of midwives to care for their communities.” 

Black women were 1.5 times as likely as white women to die during or within the first year of pregnancy between 2017 and 2019, according to data from the Tennessee Department of Health. And Black women were 3.9 times as likely as white women to die from pregnancy-related causes. 

The fellows will have the opportunity to attend various types of births in different settings, working alongside CHOICES’ Black-led midwifery birthing team. 

Candidates must identify as Black or African American, have at least a master’s degree in nursing, have completed a certified nurse-midwife (CNM) program no more than a year ago, and have a current Tennessee CNM license or be eligible for one.  

CHOICES’ president Jennifer Pepper said the fellowship is the latest example of the nonprofit’s effort to be at the “forefront of innovation in the reproductive and sexual healthcare field.” 

“We are excited to share CHOICES’ values and to help create a workforce of Black midwives who are ready to care for people in a holistic and patient-centered way,” Pepper said. 

The fellowship is funded in part by the W.K. Kellogg Foundation, the UCSF Institute for Global Health Sciences Global Action in Nursing project, and Groundswell Fund’s Birth Justice Fund.