A safe, peaceful birth is a priority for everyone involved in the birth of a baby. From the parents to the providers, all want the first moments of a baby’s life to be healthy.
We also know that starts with a healthy mother who has access to affordable and quality maternity and obstetric care — well before conception.
However, our current health system makes that ideal impossible for many mothers. Families face an astonishing number of barriers due to their income, race, geography, immigration status and more.
These hurdles just got a lot taller with the announced closure of two critical midwifery practices in the Denver area that largely serve low-income families.
We cannot understate what the loss of Rose Midwifery in Denver and Colorado Nurse Midwives in Aurora will mean to the health of mothers and babies in Colorado.
These practices were one of a few ways to provide equal access to midwifery care for both the privately and publicly insured. Without them, the inequities women face due to their race or background will continue to be passed on to their infants.
A recent, large-scale study of midwifery practices in the U.S. found that states with greater integration of midwives into their health care systems have some of the best outcomes for mothers and babies.
That means states including Washington, New Mexico and Oregon see lower numbers of interventions, less expensive health care costs and improved outcomes.
On the other hand, some states — including Alabama, Ohio and Mississippi — with the most restrictive midwife laws and practices tend to have significantly worse outcomes for mothers and babies on indicators of maternal and neonatal well-being.
While the study doesn’t assert that midwife laws are the primary causes of maternal and neonatal outcomes, it does find that midwifery care is linked to fewer interventions, cost-effectiveness and improved outcomes.
Colorado does not have far to fall to be among the worst states. Colorado’s maternal mortality rate nearly doubled between 2008 and 2013, from 24.3 deaths to 46.2 deaths per 100,000 live births, according to the Colorado Department of Public Health and Environment.
This rate captures the death of a woman during pregnancy or up to one year after pregnancy, due to any cause related to, or aggravated by, their pregnancy.
On the other hand, the infant mortality rate in Colorado has decreased dramatically over the past 25 years, falling by 43 percent from a rate of 8.4 infant deaths per 1,000 live births to 4.8 births per 1,000 live births in 2016.
But significant barriers remain for some racial and ethnic groups: the infant mortality rate of Colorado’s black babies remains particularly high, even when controlling for a mother’s income and level of education.
A body of research shows that stress associated with racism, discrimination and social isolation can have tangible impacts — and in some instances, tragic impacts — on the health of moms and babies.
The good news in the short term is that many of the families currently served by the soon-to-close practices have assistance in finding new providers.
Elephant Circle, a community organization, is coordinating support for families in the most critical situations in finding new care. The organizers are currently looking for prenatal providers who are available to take clients immediately.
Raise Colorado, co-convened by Clayton Early Learning and the Colorado Children’s Campaign, is also working on policy changes to help ensure all women, regardless of their source of insurance, have access to the maternity care that is best for them.
We have a long way to get to that idea, however, and in the meantime there are now hundreds of babies being born each month to mothers who aren’t able to determine for themselves how the first moments of their baby’s life will look.
Is this the kind of Colorado we want our babies to be born into?
Jacy Montoya Price and Christina Walker are co-conveners of Raise Colorado, a group of more than 50 organizations and individuals who advocate for expecting families, pregnant people, infants and toddlers in Colorado.
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