Five Issues. Five Solutions.
As the husband of doula and childbirth educator, Aimee Brill, and the father of two sons who were safely birthed in our home, I'm sure I've thought about birth and birth-choice more than most people. I know that educating women and families about and ensuring access to the full range of birth options does not compromise the health and well-being of mothers and infants. In fact, education and access are the keys to healthy birth outcomes.
There is much work to do in Onondaga County. Of the 62 counties in New York, Onondaga ranks 3rd or 4th for rates of: fetal death, infant mortality, infants with low-birth rate, and maternal death. It also has the second highest rate of babies delivered by cesarean section, and the second highest percentage of low-income women with gestational diabetes.
Perhaps most troubling of all, the infant mortality rate for black babies in Onondaga County is 15 deaths per 1,000 births, compared to 4.8 deaths per 1,000 for white babies -- three times higher than the state average. We have a moral obligation to do more to support all of of the pregnant women in Syracuse and Onondaga County.
With regard to birth, my team's overarching goal is to improve birth outcomes in Syracuse and Onondaga County and to work toward eliminating the racial and class disparities within today’s maternity system.
One: Childbirth Education for All
Every mother deserves to feel informed, supported, and empowered as she prepares for birth and the transition into motherhood. Childbirth education for all women at all stages of motherhood is essential for improving birth outcomes regardless of income, race, or ethnicity. Access to childbirth education classes focusing on a reduction in the disparities in perinatal health is essential.
Two: Volunteer Doula Programs at All Hospital Births
A "doula" is a woman experienced and trained to support childbirth. She provides one-on-one physical, emotional, mental, and spiritual support throughout pregnancy, labor, birth, and the postpartum period. Doulas do not perform medical exams or provide medical diagnosis and are not hired to replace primary care providers. They offer support during cesarean births and vaginal births. Doulas respect the desire of the woman without imposing their own agenda on a birth experience. They are present for support, companionship, guidance, and to offer resources for the family. Doulas are committed to patient confidentiality and they abide by a professional code of ethics and practice.
Volunteer doula programs in all local hospitals would ensure that every woman who wants a doula has a doula. Our vision is dedicated to making a positive impact in all women's lives by offering unconditional support through the antenatal, birth, and postpartum period. Many studies have shown the benefits of having a doula present at a woman’s birth. Having a doula as a member of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, and requests for an epidural by 60%.
Three: Fair Insurance Policy for Midwifery
Create equitable, progressive tax policy that do not unduly burden midwives with steep professional insurance or set personal insurance rates do high that women are denied their full range of birth options.
Despite studies that show the cost savings of birth under the care of professional midwives compared to a medical model of care, many insurance plans do not have midwives in their provider networks, or do not cover midwife care at all. The extreme cost for midwives to insure their practice is forcing many out of business, denying women a range of birth safe, healthy options.
We advocate for fairness in insurance policy, taking into account the many studies that demonstrate the safety and cost savings of midwifery care.
Four: Community Birth Advocate Program/Refugee Program
Syracuse is one of the nation's largest refugee relocation destinations. In our new model, we imagine training programs that prepare women to become Community Birth Advocates (CBAs) -- trained professionals empowered to enter their communities and provide comprehensive perinatal education, as well as labor and postpartum support for pregnant women and their families.
Our vision is one of women integrating their own cultural birth practices as they train to become CBAs. We feel this will result in a greater capacity to better understand and navigate American hospitals, as well as a more concrete ability to support (and be supported by) their own community and the wider community of birth professionals in Syracuse and Central New York.
Five: Syracuse as a Leader in Humane Birth Practices
Throughout the world, models are being used that prioritize and centralize a woman's experience of birth and her desired birth choices. My campaign's vision honors the positive outcomes of the midwifery model of care and supports a wide range of childbirth options, ones that promote awareness and accessibility to evidence-based, mother- and baby-friendly, models of maternity care.
Birth in America, unfortunately, is not based on the most current evidence-based research. The current medical model of birth is not based on the fact that birth is a healthy, normal, physiological occurrence. Instead , birth is often seen through the lens of what can go wrong. It is seen as a problem that needs to be fixed.
When it comes to birth, we need to recognize that we are in a crisis. Options are limited, and women are living in a culture where they are taught to fear birth. With a current cesarean rate of 32.7%, birth has become a human right's issue. This rate has climbed over 60% in the last decade. Five of the ten most commonly performed procedures in our institutions are childbirth related. Despite this, the US ranks a sobering 49th in maternal mortality, with African-American woman nearly four times more likely to die of pregnancy related complications than Caucasian women. We want to create a new vision where every woman experiences a humane and respectful birth.
Our ideas to improve birth locally include:
- Waterbirth in the hospital as a safe and affordable option for women
- An increase of VBAC (Vaginal Birth After Cesarean) options in the hospital
- Accessability and education on the safety of homebirth as a birth option
- Access to Childbirth Education classes for all women and families
- Volunteer Doula Programs in all hospitals
- Community Birth Advocate Programs
- Building strength in our community by connecting birth advocacy groups to one another