Every October, we pause to celebrate National Midwifery Week and the important work of midwives around the globe. This year was particularly special given the World Health Organization’s (WHO) designation of 2020 as the Year of the Nurse and the Midwife.
We also use this time to bring greater awareness to the rising maternal mortality rate in the U.S. Approximately 700 women die per year during pregnancy and childbirth, the most of any developed country, leaving hundreds of newborns to navigate life without the love and care of their biological mother.
Black families face this harsh reality three times more often than white families. The Black population’s infant mortality rate is also more than double the mortality rate for white newborns. Midwives have been fighting these battles for many years as they care for women in underserved areas to improve access to quality maternity care.
Several factors contribute to these troubling statistics. As COVID-19 has continued to spread across our country, the racial and ethnic disparities in health care have become even more glaringly apparent. The CDC reported over the summer that Black and Native Americans are five times more likely to be hospitalized than non-Hispanic white persons during a COVID-19 episode.
There is no evidence that people of color have any biological factors that make them more susceptible to disease. According to the CDC, “Longstanding systemic health and social inequities have put some members of racial and ethnic minority groups at increased risk of getting COVID-19 or experiencing severe illness, regardless of age.”
We see the same health disparities caused by systemic racism in many health indicators in the U.S. Racism is a double-edged sword that not only affects a person’s health, but also their ability to receive quality health care. Daily racial discrimination has been linked to underlying conditions and can increase the risk of severe illness. Crowded living conditions, lack of health insurance and financial challenges are obstacles to health in some Black communities.
My colleague Dr. Heather Clarke and I discussed this topic during Frontier Nursing University’s recent National Midwifery Week virtual event. As Dr. Clarke shared, racism is a constant, persistent toxic stress that weathers the human body. With decreased public services, poor schools, food deserts and low paying jobs, some Black families may have fewer protective factors to shield them from the effects of stress. Dr. Clarke also noted that stress could be transmitted three to four generations forward through a pregnant mother.
At Frontier Nursing University, we teach that good family health begins with caring for the mother. We educate Certified Nurse-Midwives (CNMs), who are primary health care providers to women of all ages throughout their lives. CNMs focus on gynecologic and family planning services, as well as preconception, pregnancy, childbirth, postpartum and newborn care. They also provide primary care, such as conducting annual exams, writing prescriptions and offering basic nutrition counseling.
According to the WHO, the world needs nine million more nurses and midwives to achieve universal health coverage by 2030. Recognizing this need, we began offering a distance education program in 1989 to educate nurse-midwives and nurse practitioners in their home communities. Most of our graduates continue to serve in their home communities after completing the program.
Students are on campus for a three-day orientation before completing online courses and then again for a brief five-day session to prepare for their clinical experience. In 2021, we will open a new, larger campus in Versailles, Ky., allowing more nurses to advance their careers with masters and doctoral degrees. We reach students across the country who work in rural and underserved areas through our distance education model. While they complete their coursework at home, they have access to a much more extensive network through FNU.
We also strongly support the need to increase diversity within the nursing and nurse-midwifery professions because patients are more receptive to care from a health provider who understands their culture and socioeconomic background. Our graduates serve people of all races and cultures, and our student of color population has increased from 9 to 24 percent over the past 10 years. It is imperative that our students, faculty and staff have cultural awareness and competency to help overcome racial disparities in health care.
Many of us can grasp, empathize and even identify with the constant and persistent stress families face when a loved one is sick. Our hope is a renewed focus on social injustices will allow people to open their hearts in the same way when it comes to racism.
Many mothers face unseen challenges as they bravely welcome new lives into the world with joy and hope. Nurse-midwives do their best to affect change by listening, respecting and assessing relationships, support systems, parenting styles and more. From social workers to churches to health departments, we know it takes a village to address stresses and create strong support systems.
COVID-19 has emphasized the importance of community for all of us. While tragic, let’s allow the universal nature of a global pandemic to help us see things in a new light and bring us together to address racial disparities in health and maternity care. This is the year of the nurse and the midwife, in more ways than one. There is no better time than now.
Dr. Susan Stone, President, Frontier Nursing University
Carrie Belin is an experienced board-certified Family Nurse Practitioner and a graduate of the Johns Hopkins DNP program, Johns Hopkins Bloomberg School of Public Health, Georgetown University School of Nursing, and Johns Hopkins School of Nursing. She has also completed fellowships at Georgetown and the University of California Irvine.
Angie has been a full-scope midwife since 2009. She has experience in various birth settings including home, hospital, and birth centers. She is committed to integrating the midwifery model of care in the US. She completed her master’s degree in nurse-midwifery at Frontier Nursing University (FNU) and her Doctorate at Johns Hopkins University. She currently serves as the midwifery clinical faculty at FNU. Angie is motivated by the desire to improve the quality of healthcare and has led quality improvement projects on skin-to-skin implementation, labor induction, and improving transfer of care practices between hospital and community midwives. In 2017, she created a short film on skin-to-skin called 
Justin C. Daily, BSN, RN, has ten years of experience in nursing. At the start of his nursing career, Justin worked as a floor nurse on the oncology floor at St. Francis. He then spent two years as the Director of Nursing in a small rural Kansas hospital before returning to St. Francis and the oncology unit. He has been in his current position as the Chemo Nurse Educator for the past four years. He earned an Associate in Nurse from Hutchinson Community College and a Bachelor of Science in Nursing from Bethel College.
Brandy Jackson serves as the Director of Undergraduate Nursing Programs and Assistant Educator at Wichita State University and Co-Director of Access in Nursing. Brandy is a seasoned educator with over 15 years of experience. Before entering academia, Brandy served in Hospital-based leadership and Critical Care Staff nurse roles. Brandy is passionate about equity in nursing education with a focus on individuals with disabilities. Her current research interests include accommodations of nursing students with disabilities in clinical learning environments and breaking down barriers for historically unrepresented individuals to enter the nursing profession. Brandy is also actively engaged in Interprofessional Education development, creating IPE opportunities for faculty and students at Wichita State. Brandy is an active member of Wichita Women for Good and Soroptimist, with the goal to empower women and girls. Brandy is a TeamSTEPPS master trainer. She received the DASIY Award for Extraordinary Nursing Faculty in 2019 at Wichita State University. 
Dr. Sabrina Ali Jamal-Eddine is an Arab-disabled queer woman of color with a PhD in Nursing and an interdisciplinary certificate in Disability Ethics from the University of Illinois Chicago (UIC). Dr. Jamal-Eddine’s doctoral research explored spoken word poetry as a form of critical narrative pedagogy to educate nursing students about disability, ableism, and disability justice. Dr. Jamal-Eddine now serves as a Postdoctoral Research Associate in UIC’s Department of Disability and Human Development and serves on the Board of Directors of the National Organization of Nurses with Disabilities (NOND). During her doctoral program, Sabrina served as a Summer Fellow at a residential National Endowment of the Humanities (NEH) Summer Institute at Arizona State University (2023), a summer fellow at Andrew W. Mellon’s National Humanities Without Walls program at University of Michigan (2022), a Summer Research Fellow at UC Berkeley’s Othering & Belonging Institute (2021), and an Illinois Leadership Education in Neurodevelopmental and related Disabilities (LEND) trainee (2019-2020).
Vanessa Cameron works for Vanderbilt University Medical Center in Nursing Education & Professional Development. She is also attending George Washington University and progressing towards a PhD in Nursing with an emphasis on ableism in nursing. After becoming disabled in April 2021, Vanessa’s worldview and perspective changed, and a recognition of the ableism present within healthcare and within the culture of nursing was apparent. She has been working since that time to provide educational foundations for nurses about disability and ableism, provide support for fellow disabled nursing colleagues, and advocate for the disabled community within healthcare settings to reduce disparities.
Dr. Lucinda Canty is a certified nurse-midwife, Associate Professor of Nursing, and Director of the Seedworks Health Equity in Nursing Program at the University of Massachusetts Amherst. She earned a bachelor’s degree in nursing from Columbia University, a master’s degree from Yale University, specializing in nurse-midwifery, and a PhD from the University of Connecticut. Dr. Canty has provided reproductive health care for over 29 years. Her research interests include the prevention of maternal mortality and severe maternal morbidity, reducing racial and ethnic health disparities in reproductive health, promoting diversity in nursing, and eliminating racism in nursing and midwifery.
Dr. Lisa Meeks is a distinguished scholar and leader whose unwavering commitment to inclusivity and excellence has significantly influenced the landscape of health professions education and accessibility. She is the founder and executive director of the DocsWithDisabilities Initiative and holds appointments as an Associate Professor in the Departments of Learning Health Sciences and Family Medicine at the University of Michigan.
Dr. Nikia Grayson, DNP, MSN, MPH, MA, CNM, FNP-C, FACNM (she/her) is a trailblazing force in reproductive justice, blending her expertise as a public health activist, anthropologist, and family nurse-midwife to champion the rights and health of underserved communities. Graduating with distinction from Howard University, Nikia holds a bachelor’s degree in communications and a master’s degree in public health. Her academic journey also led her to the University of Memphis, where she earned a master’s in medical anthropology, and the University of Tennessee, where she achieved both a master’s in nursing and a doctorate in nursing practice. Complementing her extensive education, she completed a post-master’s certificate in midwifery at Frontier Nursing University.
Dr. Tia Brown McNair is the Vice President in the Office of Diversity, Equity, and Student Success and Executive Director for the Truth, Racial Healing, and Transformation (TRHT) Campus Centers at the American Association of Colleges and Universities (AAC&U) in Washington, DC. She oversees both funded projects and AAC&U’s continuing programs on equity, inclusive excellence, high-impact practices, and student success. McNair directs AAC&U’s Summer Institutes on High-Impact Practices and Student Success, and TRHT Campus Centers and serves as the project director for several AAC&U initiatives, including the development of a TRHT-focused campus climate toolkit. She is the lead author of From Equity Talk to Equity Walk: Expanding Practitioner Knowledge for Racial Justice in Higher Education (January 2020) and Becoming a Student-Ready College: A New Culture of Leadership for Student Success (July 2016 and August 2022 Second edition).