Patients want to see people that look like them: Aspiring midwives of color as resistance to racism through concordant care in the United States

Midwifery care and racially or culturally concordant care are evidence-based ways to address the current perinatal health crisis and disparate health outcomes in communities of color in the United States. However, the midwifery profession lacks diversity, which hinders its ability to provide racial or culturally concordant care. Therefore, this study sought to understand the perspectives and journeys of aspiring midwives of color to gain insight into this lack of diversity. One-on-one interviews were conducted with 20 aspiring midwives from diverse racial, ethnic, and geographic backgrounds and analyzed using thematic analysis. Four themes were developed: 1) a long and complicated journey to midwifery; 2) structural and interpersonal racism as persistent roadblocks; 3) a justiceinformed, community-based model of care; and 4) how midwives of color can transform the midwifery profession. The meta-theme of midwives of color as resistance to racism through concordant care was present within and across the four themes. The findings from this study expose previously unrecognized barriers to entering midwifery and highlight how aspiring midwives are poised to create positive change for underserved and marginalized communities through active resistance against racism through concordant midwifery care. Facilitating the midwifery careers of these individuals will require intentional changes in policy, education, and the workforce in order to fully realize this potential.

Automated summary

Midwifery care and racially or culturally concordant care are effective methods to address the perinatal health crisis and unequal health outcomes in communities of color in the United States. However, the lack of diversity in the midwifery profession hinders the provision of racially or culturally concordant care. This study interviewed aspiring midwives of color and revealed the long and complicated journey they face, the persistent barriers of structural and interpersonal racism, and how they can resist racism through justice-informed, community-based care. The findings highlight previously unrecognized barriers to entering midwifery and the potential of aspiring midwives to create positive change for underserved communities through concordant care. Intentional changes in policy, education, and the workforce are necessary to facilitate the midwifery careers of these individuals.