Midwife Jennie Joseph on Race, Power, and Changing Birth in America

Childbirth and Feminism aren’t words that are often paired together in the same sentence. The focus for most feminist movements is on the decision whether to have a child or not, and whether a woman has full agency in the decision when deciding not to carry a pregnancy to full-term. But what about the women who decide to have a child? Where do you find feminism active and engaged? In small feminist circles, you can find women advocating for empowering birth experiences, for doulas and birth plans and a bill of rights of sorts for laboring women. And in even smaller circles, you find women banding together to address the awful truth in this country that if you are a woman of color, simply by virtue of your ethnicity and NO other factor, you are 4 times more likely to die in childbirth than a white woman. Why is this circle so small? Why are we not agonizing EVERY day over this very real fact that our sisters are not all treated equally? Why are we not marching in front of the ACOG offices and in front of hospitals that aid diverse populations of women in childbirth? Why are we not pissed off ENRAGED about this uncomfortable truth?

In honor of International Midwives Day, we decided to shine the light on someone who IS making this her mission in life. Jennie Joseph is a British-trained, West Indian-descent midwife who cares for women in Orlando, Florida at her birth center and who lectures widely on a focused, successful strategy for reducing disparities in childbirth outcomes.

I first met Jennie Joseph when she came to a maternal mortality summit that I and a few other women put together in Washington D.C. a few years ago. I’d heard word on the street that she was a midwife who was doing something about it. I heard her name whispered with reverence, with awe, because damn, she was taking on this often silenced and uncomfortable truth about birth in America, and she was making a difference in the lives of the women who found their way to her birth center.

Jennie speaks with a soft British accent and, surprisingly given the weighty subject matter she tackles fearlessly, a great deal of humor. She’s been known to say, “In America, they don’t expect to hear a funny little English accent coming out of someone with such dark skin.” She may be right. And it may be part of why (and I’ve seen this) she’s able to make American obstetricians sit up and take notice (a sad commentary in and of itself). The outcomes at her clinic are so phenomenal, that I’m surprised that the chiefs of obstetrics from every American hospital are not lining up on the tree-lined street in Orlando where her clinic is located. They should.

It’s hard to pin Jennie down – she’s tireless in her mission to provide good care and tireless with her lecturing on the JJ Way® at conferences across the country. But StS is thrilled to have pinned her down long enough to get her take on the important work that she does:

Sheryl: You were born and raised in England and received your nursing and midwifery training in London. Tell us about your first experiences in the United States. Did you experience culture shock? What do you remember most about those first years?

Jennie: I was very surprised when I arrived in the United States. Unfortunately, I had not done any research. I knew about Walt Disney World and I knew Orlando to be a beautiful city—I was very excited about the possibilities, for my American husband to be and I. I came to America in May of 1989 and was married in August of 1989, and settled in, except that I did not realize that I wasn’t going to get any job in any hospital as a midwife in the state of Florida. I was trained as a hospital midwife and had practiced in both hospital and homebirth settings but did not know that there was such a controversy about midwifery and the midwifery model of care in the United States.

The culture shock that I experienced was that as a Black woman of West Indian descent; I assumed that I was culturally aware and able to manage assimilation into the American experience. I knew about the differences amongst races and I knew about racism, having experienced it myself. I figured that I would be able to understand how to navigate and negotiate the American way. In my personal life I experienced a lot of culture shock and certainly in my professional life on so many levels. It was beyond explanation. I felt alienated and marginalized as a professionally trained hospital-based midwife. I felt marginalized as a midwife who believed in empowerment for women and independence. I felt marginalized in that I wasn’t a registered nurse. I was a direct-entry midwife that had hospital experience and had built a career around access and privilege in the hospital system. I was marginalized from a place of being a Black woman with an English accent.

In many ways it was extremely difficult and I know that I could not have been prepared for it ahead of time. It had to be worked through in real time. I remember feeling isolated and was depressed for a good few years. I got to the point where I hardly ever wanted to say anything because I didn’t want the reaction of shock and surprise when I started to speak. So it was very difficult. I do remember I began to explore the history of midwifery. I began to understand the cultural perspective of midwifery, particularly in relation to the grand midwives of the South and their eradication during the latter part of the 20th century.

Sheryl: What originally drew you to midwifery as a career?

Jennie: I was absolutely called to be a midwife. I knew at the age of 16 that I wanted to pursue that path. I barely knew what it meant and I had no experience at that age.

I graduated from high school and was determined to go into midwifery. So much so that at my age I was told I was too young and had to wait until I was 20, but I managed to get started at 19 because I was so enthusiastic and I wouldn’t let up until I was finally admitted into a program a year earlier than I should have been.

I knew in my spirit that I was going to do this work. I have never done anything else. I’m approaching age 55 and I have been working in midwifery since I was 19.

Sheryl: When did you first become aware of disparities in care for women of color?

Jennie: I began to figure it out two years after I arrived. I was also a victim of those disparities in that within a year of arriving to the United States, the OBGYN that I worked for managed to dictate to me that because of my endometriosis—which I had suffered from for many years—the only answer for me was to have my uterus removed.

As a knowledgeable and informed patient with a background in women’s health, I was still drawn into that place where I felt unable to speak for myself and felt concerned not realizing the industry where women’s bodies have been historically taken advantage for gain and for power. I didn’t understand the racial connotation of hysterectomy in the United States.

At the age of 30, like a sheep to the slaughter I had my uterus removed and he took both my ovaries at the same time.

Sheryl: Tell us about your method of maternity care, the JJ Way®. How did it come about?

Jennie: I developed the JJ Way® model as I grew my midwifery practice from a homebirth practice into a birthing center practice. I realized that there were very few women of color coming into my homebirth practice. I felt that I could reach women of all races and socioeconomic statuses if I could open the idea of taking care of women in the prenatal period regardless of where they wanted to deliver their baby.

Image from Beautiful! by Jennie Joseph

My experience was that the women of low income or women of color who were not educated or supported in natural birth felt more comfortable in the hospital environment. For them there was some benefit in having their babies that way. So rather than try to convince them and to cajole or try to force on them my way of thinking, I decided to open a practice where I could provide good quality midwifery care for women of all races that was holistic, patient-centered, empowered, safe, and culturally competent and yet those women that chose to have their babies in the hospital still got to deliver their babies with a physician in the hospital.

That helped me to realize that the benefit of that work was that, regardless of where they were giving birth, they were having healthy full term infants, they were empowered, actively planning their births, and breastfeeding after delivery. So I realized that was something that I could offer and I have developed it into a fully replicable model that could be used by any midwife, physician, physician assistant or nurse practitioner in any clinic or birth center setting.

Sheryl: Can you share a few memorable stories about women you’ve served who have benefited from the JJ Way®?

Jennie: Over the years, I’ve seen much change in many of the women and their families. Ultimately, even though it’s intangible—it’s difficult to say if it’s because of a specific aspect of the JJ Way® or the combination of all of the points—something has shifted in the way these women are in themselves, with their baby, with their children and with their families. One woman comes to mind that came to me at 19 years old with her first baby, the father of the baby in tow. They were certainly at least acting excited about the birth and the upcoming pregnancy. They were video taping the first prenatal visit, having a good time. It all fell apart very quickly. It was not a good relationship, they broke up and she was unsupported through her remaining pregnancy and birth. She was very attached to our practice and came to literally depend on us, which is not the goal of the work, but she would call us every day very much wanting information and education—she was soaking it in. She had a very lovely and empowered birth, at term and went on to come back to support the work by volunteering. She eventually started nursing school and she’s currently a bachelor’s nurse. We know that the influence of how we supported her through her pregnancy made the difference for her to be able to empower herself and raise her child in a different way than perhaps she would have with the absence of that work.

Sheryl: What do you think modern feminists most need to know about childbirth in the United States? Internationally?

Jennie: I think all women need to know about having their power in the birth room and the importance of being prepared and educated throughout their pregnancy so that by the time they reach childbirth they know what they particularly want, what helps them feel safe, and what helps feel in charge of the experience—and it doesn’t look the same for everybody.

In the absence of that knowledge, women go into their labor and delivery experience at the whim of whoever is attending. And that is dangerous. In many cases, that can kill you. The lack of knowledge and preparation can put your life in jeopardy because you are so unaware and unable to stand for yourself.

I think that using support such as doula support, having childbirth education and lactation education, involving family and friends in your birth team, and having a very solid plan is the difference between life and death. Internationally, I think women need to understand their specific birthing practices and environments and, again, choose for themselves what they want.

Sheryl: What do feminists get wrong about birth?

Jennie: I don’t think I can address that. I don’t think anybody gets anything wrong about birth. We know what we know and we act accordingly. At this juncture, so many of us know so little that we don’t have a place to stand or any ability to make that difference for ourselves or for our sisters in birth. With that we are somewhat left helpless and at the whim of those who do have power and information.

Sheryl: Tell us about your vision for the future of maternity care.

Jennie: I believe that we can transform maternity care in the United States by changing the way we approach birth in the first place. Until we can embrace the idea that birth is not an illness but actually a transformative time in that woman and her family’s life. Until we remove the fear, because this is a fear-based industry, and provide women with the tools to navigate this fear-based industry we will not be able to see a change.

I strongly believe from the grassroots up we can influence and bring about the necessary changes to re-empower birthing women and families in America. We need education at a level that is accessible, that is warm, non-judgmental, non-punitive, and non-lecturing where women can share stories and experiences, as well as learn from an angle of understanding that is pertinent to their lives.

The educators need to change. They need to be the same women from the communities from which they hale so that there are peer level educators as well as more formally trained educators, but everyone working from the same place.

Finally, if we cannot break down the system that stands—and it would be a very difficult and arduous task—then we need to create a system outside of that for those women that are healthy, low risk and are not expecting complications in their birth. That system could be midwifery, but it could also be public health. It could be private hospital-based services, birth center-based services, or community-based services, or of course, homebirth.

I have a very broad and hopeful vision for the maternity care system in America but I believe it has to be purposeful and collegial. We have to work together to bring about a change, but before that we have to agree that there is a need for change and at this point I don’t think we have that.

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Jennie Joseph was born and raised in England and received her midwifery education from Barnet School of Nursing & Midwifery in affiliation with Edgware General Hospital in London. Always a pioneer for women’s special healthcare needs, Jennie brings 26 years of combined expertise to help pregnant women achieve the birth of their dreams. Visit her on Facebook and check out her website.

 

Pine Box Reading in Seattle Tonight!

For those of you in Seattle for the AWP conference, don’t forget the So to Speak reading today, Saturday, March 1, from 3 PM to 5 PM! Our reading features poetry by Laura-Gray Street, fiction by Jessica Barksdale, and nonfiction by Tim Denevi and takes place at the Pine Box, a restaurant and bar located only a half-mile from the Washington State Convention Center at 1600 Melrose Avenue, Seattle, Washington 98122.  We’d love to celebrate great feminist writing and have a drink with you! Most importantly, you’re not going to want to miss the line-up!

 

AWP Dreaming!

Headed to Seattle? Looking for a guide to all things literary and feminist at the AWP conference?

We’re pleased to share the line up put together by poet Sheila McMullin, past So to Speak editor and current VIDA web assistant. Check out her fantastic list of exactly which AWP panels next week in Seattle fall under the feminism umbrella!

“For your feminist appetite I have complied a savory dish of 2014 AWP Seattle feminist panels. How, you ask, do I know these are feminist panels, when few of them self-identify as feminist? Well, identify, rather, identity is going to be the key term here.”

http://moonspitpoetry.com/2014/02/19/awp-2014-seattle-feminist-panel-guide/

Looking forward to seeing some of you at the events. Don’t forget to stop by the So to Speak table for custom buttons and to say hi!

 

AWP Offsite Reading at The Pine Box!

The staff of So to Speak would like to invite you to our offsite reading at the 2014 AWP conference in Seattle, Washington!

Photo credit Kendall Jones

Our multi-genre reading will be held on Saturday, March 1 (the last day of the conference) from 3 PM to 5 PM and will feature poetry by Laura-Gray Street, fiction by Jessica Barksdale, and nonfiction by Tim Denevi.  The reading will take place at the Pine Box, a restaurant and bar located only a half-mile from the Washington State Convention Center at 1600 Melrose Avenue, Seattle, Washington 98122.  We’d love to celebrate great feminist writing and have a drink with you! Most importantly, you’re not going to want to miss this line-up:

Laura-Gray Street’s work has appeared in Many Mountains Moving, The Human Genre Project, Isotope, Gargoyle, From the Fishouse, ISLE, Shenandoah, Meridian, Blackbird, Poetry Daily, The Notre Dame Review, The Greensboro Review, and elsewhere; selected by George Garrett for Best New Poets 2005; commissioned by the New York Festival of Song; and included in Pivot Points, an exhibition of poets and painters that traveled internationally.  Street has received a Poetry Fellowship from the Virginia Commission for the Arts, the Editors’ Prize in Poetry fromIsotope, the Emerging Writer in Poetry Award for the Southern Women Writers Conference, the Dana Award in Poetry, and The Greensboro Review’s Annual Literary Award in Poetry, and fellowships at the VCCA and the Artist House at St. Mary’s College in Maryland.

Jessica Barksdale is the author of twelve traditionally published novels, including Her Daughter’s Eyes and When You Believe. Her novel Becca’s Best is forthcoming from Ghostwoods Books. Her short stories, poems, and essays have appeared in or are forthcoming in Salt Hill Journal, The Coachella Review, Carve Magazine,  Mason’s Road, and So to Speak. She is a professor of English at Diablo Valley College in Pleasant Hill, California and teaches online novel writing for UCLA Extension.

Tim Denevi’s first book, Hyper, a memoir and history of ADHD, will be published by Simon & Schuster in 2014.  He received his MFA in nonfiction from the University of Iowa, his MA in English from the University of Hawaii, and his BA from Northwestern University. Recently he was awarded fellowships by the MacDowell Colony and the Virginia Center for the Creative Arts.

Can’t wait to see you there!

Representations of the Feminine Body and Psyche: An Interview with Lili Almog

Photo by Lili Almog

I first discovered Lili Almog’s work at the Brooklyn Museum’s Elizabeth A. Sackler Center for Feminist Art, where her stunning images illuminated an intimate stillness in women’s faces and poses, each emotionally naked before the camera. When confronted by the images, I knew I had been invited into a conversation, a conversation about gender, about societal roles, about faith and culture. An energy pulsed from the stark, stripped view she captured through her lens.

Born in Israel, Lili Almog worked as a photojournalist before attending the School of Visual Arts, graduating in 1992. Her vision as an artist has taken her into people’s bedrooms; villages in Western China; Carmelite monasteries in Israel, Palestine, and the USA; and beyond. Increasingly, she stretches the boundaries of her photographic training to include drawing, sculpture, and video in her art. She has exhibited her work in galleries around the globe; published two monographs, Perfect Intimacy and The Other Half of the Sky; contributed to four books; and won awards. One curator says of Almog, “In times when the tides of aggression seem high on the horizon, an intimate seeking for the feminine without gender characterizes Lili Almog’s work.”

We invite you to share in this intimate conversation with Israeli artist, Lili Almog:

Sheryl: How would you define your role in the artist-subject-viewer relationship?

Lili: My intention as an artist is to enter an extremely private space without disrupting the delicate essence of communication between subject, their experience and the viewer. I wish to move beyond documentation, to preserve the private moment by transcending limits imposed by preconceived ideas, cultural stereotype and prejudice so that people may speak their stories to me.

Sheryl: You grew up in Israel and studied art at the School of Visual Arts in Manhattan. How did your childhood affect your art vision, which developed in art school?

Lili: My upbringing Israel was a creation of the powerful dynamic between women. I grew up surrounded by my mother, grandmother and sister; men left no permanent trace on our lives. Was this a kind of feminism?  Perhaps in Israel it was, since the greater society surrounding us was very traditional male-centric values. Living in a home created by, and for, women, and we were always aware of the tensions between our family’s modern feminine values and the traditional Israeli society around us. My art reflects the female bonds that were so vividly present in my childhood, and the compelling and dynamic clash of traditionalism and modernism in the culture around me.

Sheryl: Who are some of your feminist influences?

Lili: I will have to start with my mom; my mother was a model of the modern feminist woman, with all the difficult choices she had to make in order to give me a foundation to be an independent and free thinker. But I admire so many women in so many areas of life: I respect and am influenced by Simone de Beauvoir’s theories of the “other gender.” Sarah Schenirer, an early orthodox Jewish pioneer of education for young women is someone I admire greatly because of the changes she made in religious Jewish society.

Sheryl: What personal factors do you feel inform your art?

Photo by Lili Almog

Lili: My art focuses on creating representations of the feminine body and psyche.  I try to capture the cultural and spiritual identity of women set in their private spaces. My images combine elements of history, social class, and personal experience in surroundings that have timely significance.

My subjects are often from remote cultures not experienced with mass media exposure. I utilize a variety of photographic means — portraiture, landscape, and video camera —as testimonial recorders, to emphasize the individuality of my subjects, their enduring dignity, their sense of self worth and their traditional values.

Sheryl: Many of your photos are poetic, stories onto themselves, and they invite interpretation.  If there were one piece of which you’d like to tell the story, which one would it be? What is that story?

Lili: Here is a story about a nun who I photographed during my “Perfect Intimacy” project.

Photo by Lili Almog

On the way to the monastery in Bethlehem we stopped for lunch. I observed a nun fixing her habit, with a fairly large cross made of brass sticking out of a little pocket in the center of her chest, under her scapula. I asked her if her cross had a special meaning and she told me that each sister has her own personal crucifix that she receives on the day of her Profession of Vows.  Each nun receives her Profession Crucifix from the Prioress and always carries it next to her heart. This nun held her cross very gently and lovingly as she showed it to me. I was deeply moved by this and Somehow for me it became a symbol of their relationship with God From that point on, when I would photograph a sister I would ask her to show me her personal Cross.

Sheryl: You’ve travelled around the world and captured women in many different environments. Is there one culture that has affected you most?

Lili: In my project, “The Other Half of the Sky”, I created portraits of minority women in the countryside, small cities and villages in China with an emphasis on Muslim women in China. The Mosuo women are one minority that I encountered in my visits to China. They are one of the last matriarchal societies existing in our world. Geographical isolation enabled the Mosuo society to preserve their matriarchal way of life until the 1970s, when a road built into the mountainous area opened up the Mosuo culture to the outside world.  In recent years, the traditions of the Mosuo society have been severely challenged by modernization, which has brought an invasion of tourists — and tourist dollars to the Mosuo region.  Traditional practices are being abandoned for more financially lucrative opportunities, for example, farmers are leaving their fields for tour-guide jobs and women are charging money for dressing up tourists in traditional clothing. Some male tourists come to the region for sex. In the Lake Lugu red-light district, prostitutes from other parts of China dress up as Mosuo women and offer their services. The younger generation is starting to abandon tradition for all things modern; older Mosuo wonder how much longer their unique culture will survive. My work documented the Mosuo struggle to hold on to their unique matriarchal practices despite the erosion of their culture by modern society.

Sheryl: What are you working on currently?

Lili: My focus has shifted from the private space to more global space. Currently I am exploring the broad spectrum of changes in culture via landscape.  I have been working on a project, “Beyond Presence and Absence”, which documents topographical change in a kibbutz in Israel due to a natural catastrophe. Although I live in New York, I personally identify with the intimate kibbutz community and the way it deals with change so differently than we do here. I am also documenting massive change in the American post-industrial landscape from a local topographical perspective. The visual questions I am exploring are boundless . . . and intrigue me.

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Lili Almog is an Israeli-born artist based in New York whose work in photography and video investigates female identity. Her exhibition and book, The Other Half of the Sky, portray women in rural China. Beginning in 2006, Almog traveled to remote Chinese provinces to document women of diverse backgrounds and societal functions such as members of the Muslim minority, tile factory workers and farmers. She produced portraits in six distinct geographic sections: mountain, lake, factory, street, backyard and land. Recent solo exhibitions of her work include The Art Museum of Lexington, KY; the Emmanuel Valderdorff  Galerie in Köln, Germany; and Andrea Meislin Gallery in New York.

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