Monday, January 21, 2008

Here's A Shocker

According to Fit Pregnancy magazine, Kansas City Missouri (my city) finds itself number 44 among cities ranked for the "Best place to have a baby." Find all the particulars on this website. Check it out to see if your American city is on the list. Now this is in no way scientific, its more for novelty. However it does draw attention to some important issues and it does use real numbers gathered from government agencies, private foundations, professional associations and public databases. Of course I'm not surprised that things are so dismal for my city. Fit Pregnancy cites very low breastfeeding rates (both initiation and duration), low access to midwifery care (just 2.6% statewide vs 7.3%nationwide- also low in my opinion), high smoking rates (12%), and low access to daycare. (It also sites our high crime rate and low access to healthy foods). Whew, where do I begin? While I have lots to say about crime and access to quality food (especially in the urban core) my focus is mainly on low breastfeeding rates, and low access to midwifery care. It strikes me that women choosing homebirth almost automatically use midwives and breastfeed. Among women who follow the typical course of perinatal care (OB care and complete or supplemental artificial breastmilk feeding) the skirting of midwifery care and good lactation education and support is almost complete. (Be honest, how many conversations did you have with your OB about breastfeeding?) Here in Missouri, lay midwives are illegal, but even CNMs aren't exactly welcomed with open arms. Doulas are still an anomaly in most places (downright unwelcome in some). Most hospitals around here don't get the importance of hiring LCs and most L&D nurses would just as soon stick a bottle in your kid's mouth than to blow 20 minutes teaching you how to latch. Kansas City's limited options means pregnant women and newborns have limited access to the very things that help ensure positive health outcomes.


Suz Ryan said...

KC is making progress in my mind. I arrived here in 2000 just after finishing my nurse midwifery program. I glumly told my instructor that I would never find a job in the midwest - and she told me if there isn't a job - make one! I've always had a midwifery job and now have the courage to have my own practice. I believe in time, with more access to having a midwife - either at home or hospital - ground roots of women's voices will be heard -even in the midwest.

Hannah said...

How sad, but great that there are women like you and suz ryan working hard for change there.

Laborpayne said...

I would argue that the women who would benefit from your care the MOST (low income women, medically indigent women, immigrant and refuge women, medically at-risk womenen) sadly are the LEAST likely to have access to your care. This is why I see KC more on a downward spiral. But yes, it is true that over the past 15 years KC has had a tremendous influx of CNM midwives. Heck, I remember when there were only underground DEMs (CPMs weren't around yet either), and when the average joe on the street couldn't tell me what a midwife was.

suz ryan said...

I loved your goal in 2005 for women in the inner city and sad to see it not work out. I also feel we lack appropriate care for pregnant women with addiction - I worked at the center of addition in pregnancy in Baltimore Maryland with 6 midwives and had great out comes making improvement in their lives, keeping their newborns and giving the work skills. That is also lacked here.
I wanted to go back to KC changes - and to Hannah's organization -- the KC Doulas. They have done wonders with women for natural childbirth and avocates in Breastfeeding. Keep up the good work --both of you! Suz

Mimi said...

I think 44th is better than many, sadly. I was impressed with the recent article from your neck of the woods.

Hugs, you and Suz are making the changes necessary! Thank you!