Racism is a motivator and a barrier for people of color aspiring to become midwives in the United States

Objective To understand motivators and barriers of aspiring midwives of color. Data Sources and Study Setting Primary data were collected via a national online survey among people of color in the United States interested in pursuing midwifery education and careers between February 22 and May 2, 2021. Study Design Cross-sectional survey consisted of 76 questions (75 closed-ended and 1 open-ended questions) including personal, familial, community, and societal motivators and barriers to pursuing midwifery. Data Collection/Extraction Methods We recruited respondents 18 years and older who identified as persons of color by posting the survey link on midwifery, childbirth, and reproductive justice listservs, social media platforms, and through emails to relevant midwifery and doula networks. We conducted descriptive and bivariate analyses by demographic characteristics and used exemplar quotes from the open-ended question to illustrate findings from the descriptive data. Principal Findings The strongest motivating factors for the 799 respondents were providing racially concordant care for community members (87.7 percent), reducing racial disparities in health (67.2 percent), and personal experiences related to midwifery care (55.4 percent) and health care more broadly (54.6 percent). Main barriers to entering midwifery were direct (58.2 percent) and related (27.5 to 52.8 percent) costs of midwifery education, and lack of racial concordance in midwifery education and the midwifery profession (31.5 percent) that may contribute to racially motivated exclusion of people of color. Financial and educational barriers were strongest among those with lower levels of income or education. Conclusions Structural and interpersonal racisms are both motivators and barriers for aspiring midwives of color. Expanding and diversifying the perinatal workforce by addressing the financial and educational barriers of aspiring midwives of color, such as providing funding and culturally-competent midwifery education, creating a robust pipeline, and opening more midwifery schools, is a matter of urgency to address the maternal health crisis.

Automated summary

This study examined the motivators and barriers for aspiring midwives of color. Findings revealed that providing racially concordant care, reducing racial disparities in health, and personal experiences in midwifery care were the strongest motivating factors. However, the main barriers included the costs of midwifery education, lack of racial concordance in the profession, and financial and educational barriers, particularly among those with lower income or education levels. Addressing these barriers is crucial to address the maternal health crisis.