In the midst of the abortion debate, the clinic asks: Who takes care of the mothers? | Health, Medicine and Fitness

By LEAH WILLINGHAM – Associated Press

JACKSON, Miss. (AP) — Miracle Allen used her last tank of gas to drive an hour and 15 minutes to the nearest clinic that would care for her and her unborn baby.

Allen, 29, was four months pregnant when Hurricane Ida devastated her community of Houma, Louisiana. She spent three nights in the remains of a house with a torn roof and no electricity. His car was all he had left. So Allen — along with her 6-year-old daughter, her mother and a niece — fled to the rural town of Kosciusko, Mississippi, where her family lives.

Her first priority was to find a doctor to monitor her little boy. But the only local obstetrician splits her work between two rural counties and isn’t taking on new patients. Allen couldn’t find another doctor even within an hour’s drive—certainly not one who would take a patient without insurance or ID, which was destroyed at her home by Ida.

Finally, a Jackson-area hospital that turned her down suggested the Sisters in Birth clinic. On this last tank of gas, she arrived panicked. Would they see her? Had the stress of the storm affected her pregnancy? Where would she go if this place pushed her away?

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Almost all of the mothers served at the clinic in Mississippi’s capital are uninsured black women, like Allen. Many haven’t seen a doctor for years until they become pregnant and qualify for Medicaid. Most are at risk for diseases such as hypertension and heart disease. Almost all of them have nowhere to go.

The clinic’s CEO and founder, Getty Israel, says Mississippi leaders fail these women every day. As Republican officials in the state spend time and resources trying to ban abortion and await a ruling that could overturn Roe v. Wade, advocates say nothing is being done to support women who choose to give birth.

“We are doing everything wrong,” Israel said. “Mississippi is pro-birth, but not pro-life. If we are truly a pro-life state, we need to do more than end abortion and ensure women are healthy.

Mississippi has the highest infant mortality rate in the nation, and black babies die at about twice the rate of white children, according to federal statistics. Mississippi also ranks among the states with the highest number of maternal deaths, with black women again being disproportionately affected. And rural hospitals are closing at an alarming rate, leaving gaps in health care, while about 20% of Mississippi women are uninsured, according to census figures.

All of these problems plagued Mississippi before the pandemic, but Israel and others said COVID-19 made matters worse, with overwhelmed hospitals and a struggling economy.

Israel opened her clinic amid pandemic need, in June 2021. She wanted to teach patients, especially black women she has seen taken advantage of in the medical system, how to take control of their bodies and defend themselves.

Sisters in Birth is a midwifery clinic that provides education and care for pregnant patients – ultrasounds, prenatal vitamins, checkups with the nurse midwife and staff doctor. But Israel is also trying to focus on more than medical care; she said she takes a holistic approach to women’s physical, social and emotional health.

The clinic’s community health workers help create diet and exercise plans, meet with patients at home, and join them in the hospital for labor. Employees assist with enrollment in Medicai d and community college. In particular, Israel wants Sisters in Birth to address any health disparities before patients – many of whom are at risk of complications given demographics and lack of access to care – give birth and offer them a social support.

When Allen arrived, she was greeted by the art of female activists on the heartwarming sea green walls: Toni Morrison, Dolores Huerta and Madonna Thunder Hawk. Magazines with black women on the covers sit in front of colorful sofas.

Staff members agreed to see Allen – a single mother and waitress who lost her 12-year job during the pandemic – without insurance. They helped her apply for Medicaid, put exercise and nutrition plans in place, and offered her gas money to get home.

“I felt like I could finally breathe,” Allen said.

Once she reached the seventh month, Allen said that thanks to Sisters in Birth, she had already received more medical care than in her entire last pregnancy. Israel calls her on days when the clinic is closed to check in.

The stability helped her transition to life in Mississippi — finding housing, replacing paperwork, signing up for food stamps — while pregnant.

“They know me by name when I walk in,” she said. “You don’t have to remind them who you are and what you’re going through.”

Now Israel wants to expand – but it needs the money to do so. With the help of Mississippi’s only black congressman and Democrat, Representative Bennie Thompson, she seeks $3 million in federal funds from the Community Project Funding Program to open Mississippi’s first birthing center. She imagines a place where black women can give birth naturally and take back their agency.

Currently, there is a nurse midwife on staff – one of the few midwives in Mississippi. Despite the dwindling numbers, there is a rich history of midwifery in the southern states. For generations, most black babies were delivered by midwives because of racist policies that barred black women from hospitals. In the late 1950s and 1960s, midwives were pushed out of the industry as hospitals became desegregated and white doctors sought to control the birth market.

Israel wants to hire more midwives, for a total of four, and provide training. She also provides a cabin for women to be there and supported before work.

Although Sisters in Birth does not offer abortions – the clinic does not usually counsel women on this either, as the focus is on providing services to women who want to give birth – Israel expects if abortion is banned, she will see an increase in patients.

“Poor women who are now pregnant, because they can’t have an abortion, will seek out clinics like mine that have no limit on the number of Medicaid patients they accept,” she said. declared. “Support makes a difference whether a woman wants an abortion or not.”

She wants to be able to support more women and for them to have the possibility of giving birth in the center rather than in the hospital. There, Israel said she often sees doctors imposing inductions and C-sections that are not medically necessary. Federal data shows that Mississippi has the highest rate of C-sections in the United States. Black women have experienced the highest cesarean delivery rates in the nation since the 1990s.

In 2018, a five-year, federally-led study comparing birthing centers with other forms of maternal childbirth care for women on Medicaid found a dramatic reduction in preterm, low birth weight, and C-sections. for birthing center patients. The results showed a reduction in racial inequalities — there were no differences by race for cesarean and breastfeeding rates, for example — and Israel wants to replicate that for women in Mississippi.

Jackson’s Yasmin Gabriel said she sought out the clinic from Israel because she wanted to have a woman of color in the room when she gave birth.

“So often we are just ignored,” she said. “I wanted our babies to come into the world without stress, without me having anxiety, because I’ve seen other people not listen to our pain threshold or listen to what we want.

“I just wanted to make sure I had someone who looked like me and understood what I was going through.”

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