Elaine Welteroth: ‘We Shouldn’t Be Dying in Birth Anymore’

Belathée Photography

According to data from the World Health Organization, the US has the highest maternal mortality rate of all industrialized nations, and the CDC reports that Black women are three times more likely to die during and after childbirth than white women. These sobering statistics inspired journalist and broadcaster Elaine Welteroth to explore—and ultimately choose—a midwife-led home birth for the delivery of her son in February 2023.

After what she describes as a “life-changing” experience, Welteroth set out to raise awareness about the urgent need to create more access to midwifery care—which the CDC says could reduce 80% of maternal mortality in the US—and advocate for policy change. She also, in December 2023, launched a birthday fundraiser to sponsor one woman’s perinatal and midwifery birth support. The response was so huge, the one-off fundraiser became BirthFund—launched to help provide midwifery care and support for families across the country.

Here, she and fellow BirthFund advocate and CNN anchor Abby Phillip talk candidly about their own labors and their ambitious goals to improve childbirth outcomes.

Abby Phillip: Tell me more about where this idea came from and what made you feel like it had to be done?

Elaine Welteroth: One of my goals with BirthFund is to help change the culture of birth in this country, to help raise the standard of care, and to raise a sense of consciousness about how much better it would be for the whole family unit if midwifery care was integrated into our modern medical ecosystem.

It all started with my own experience of navigating a very broken maternal health care system. It’s like this open secret. We know about it, but nobody wants to look at or talk about it. Everyone’s waiting for someone else to fix it. And then it’s your turn and you feel suddenly like you’re the only one who’s experiencing these things.

It feels like a moment has come where there is a will to do something about it.

A hundred percent. The CDC tells us that midwifery care can help prevent up to 80% of these maternal deaths.

That was the aha moment where I was like, “Wait a minute. So, we don’t have to be dying at three to four times the rate of white women?” And when I learned that 50% of birthing parents in this country consider their childbirth experience to be traumatic…it doesn’t have to be that way.

To me, this is white space. We know that investing in midwifery care in this country would have better outcomes for our families. So, what is stopping us?

—Abby Phillip

I was already thinking about this mother-to-mother community support model where we raise resources to support families on a one-to-one basis. And so I thought, What if we just started super small? What if just by raising enough money for somebody in my own community, I could ensure that maybe one more mom has a better chance of not just surviving her birth but thriving. That’s where it started. BirthFund grew out of that.

You’ve talked about how you’ve cashed in all of your clout built over a long time to get people like Serena Williams and Ayesha Curry and Kelly Rowland behind this. Someone like Serena doesn’t just put her name behind anything. How difficult or easy was it to get people to say, “Yes, I support this idea. I want to do it”?

Surprisingly or unsurprisingly, it wasn’t hard. Because all it takes is a family going through this. Even if they’ve never experienced midwifery, if they’ve had a baby in this country, they’ve seen the insides of how broken this system is. It’s enough for them to say something needs to change.

I just want to make a note about a word that I think is so critical to this conversation: joy. What I wanted from my birth experience was to feel joy, not dread or fear or pain. So much of the way that we catastrophize childbirth tries to steal that joy away from women, especially Black women—because of the statistics.

I remember when I was trying to decide whether I was going to have an out-of-hospital birth, and I had two friends who had done it before. One of them sent me a video of the moment that her baby was born. It was an unbelievably beautiful thing to watch. She was sitting in a pool surrounded by her midwives and her partner and just completely at peace and not screaming and cursing and freaking out. She caught her own baby. I was so blown away. I didn’t think that that’s what it could ever even be like. Those psychological changes are embedded in the midwifery model. But it’s an unlearning of the way that I think society has made childbirth essentially punishment for women.

I would also say the system is designed for women to not make decisions. There are a lot of practitioners who do not necessarily believe that women ought to be empowered to make decisions. They should just put their trust in the system. I think it has just turned out that that is not good enough. There’s a bias toward not encouraging women to be a part of the process.

Look, I’m not a doctor, you’re not a doctor. There are things doctors know that we don't know. That’s obviously the case. But there is so much room for women to have a seat at the table in this conversation, and that has not been the norm until now.

—Elaine Welteroth

I came into childbirth shocked at how little I knew about my own body, what it was built to do, this process. I also felt discouraged by my doctors from asking too many questions.

I mean, I was rushed out of a doctor’s office by a female doctor who told me I had exceeded her two-to-three-question max for a visit. This was the eighth doctor that I met with. I was dismissed and talked down to and made to feel like I was doing something wrong for asking questions about my body.

You want to feel like you’re in partnership with your caretaker. You don’t want to feel like you’re in a battle with them, or have to submit to their authority over you. The beauty of midwifery is that they position themselves as partners, as advocates, and as educators to the birthing families, the whole unit. They’re educating all of you.

By the way, one thing I want to say is I am not anti doctor; neither is anyone that's a part of this BirthFund movement. What we are is pro-choice in the sense that we’re making informed decisions about our birth experiences and about our bodies.

I actually want to ask you a question, Abby. Your original birth plan did not include a home birth. But you not only ended up giving birth at home, you also had complications. You walked out of that experience saying you had a trauma-free, joyful, peaceful birth. Talk to me about that.

I’d planned to give birth in a hospital and sought out a great Black doctor who practiced at one of the best hospitals in Washington, DC. But I did not have any preexisting conditions, and I believed strongly that an unmedicated birth was the right thing for me. I felt like I couldn’t get that if I entered the hospital system.

Obviously, there’s a lot of planning that goes into this, and you’re not just showing up one day. I took a six-week birth class with my husband. We learned everything there was to know about what would happen in our labor. We talked at length with our birth team about under what circumstances I would go to the hospital.

When my daughter came and I started to bleed, I didn’t really know that I was having a hemorrhage. But then I realized my midwife was doing what she told me she would do if that happened. I didn’t panic. I knew what was going on. Within a few minutes it was completely resolved, and I was literally sitting in the bed while this was going on holding my baby. I wasn’t rushed anywhere. There wasn’t any panic.

And so, it’s just to say that midwives are trained to deal with complications that occur, and they’re also trained to get you to care before anything that they cannot treat occurs. I felt so safe. I was up and walking around within minutes of my labor. It was honestly a great experience. I think people do need to understand that we’re not trying to sugarcoat what can happen in childbirth, or that this is something we did without planning or thinking about it, or that there are not precautions.

—Abby Phillip

Everything you said is what happened to me too, and I can only imagine how different the experience would’ve been under the exact same circumstances if I were in the hospital.

What I know is I would not have been able to peacefully hold my baby through that experience. I probably would’ve been wheeled out of there and given blood transfusions. My midwives handled my complication with such tenderness and expertise that I literally did not know that we were experiencing what a hospital would definitely identify as an emergency. Hemorrhages, they are serious, but midwives are trained to deal with them. They’re also trained to know when to make that call for a hospital transfer.

I was really nervous to speak publicly about that part because I worried that it would feed into these narratives that it’s unsafe and it’s too risky and scary. I hope that what people take away from our stories is that midwives are equipped to handle the complications that come with birth, and they are meant to work as part of a larger ecosystem that’s inclusive of doctors.

Doctors, doulas, and midwives can all coexist in a functional maternal health care ecosystem. Unfortunately, right now midwives are being forced out of that equation. In most places in this country, midwives are not admitted into hospitals. They don’t have the ability to attend to births in hospitals. Some hospitals allow this, and that’s amazing. I wish I had access to that kind of a hospital. I don’t think out-of-hospital births are for everybody. There should be a hybrid model that embraces both.

—Elaine Welteroth

Just understanding that there’s a role for all of these different forms of care is crucial. I’ll take this as an opportunity to pivot to the postpartum part of this because I think that’s the other difference between what happens in a medical model versus what happens in a midwifery model. In a medical model, you spend two to three days in a hospital, then you’re discharged and sent home, and that’s that.

A midwifery model is more community-based. There are more touch points with the patient and the mother and the family. There is more postpartum care that I think is not just a luxury, but actually a life-saving thing. Because, Elaine, as you and I know and talk about all the time, more than 60% of deaths that occur as a result of childbirth happen in the postpartum period.

So it is actually a medical necessity for there to be more postpartum care. And even patients who need more medicalized care for the lead-up to labor and delivery might benefit from something closer to a midwifery model in the postpartum period.

Postpartum is so hard. In a way, labor and delivery has a beginning and an end. But then once it's over, the real work begins. I remember struggling with breastfeeding my daughter. My midwife had come to my house for a checkup, and she noticed and immediately reached out to one of her lactation colleagues, who called me the very next day and had a session with me and showed me what to do over Zoom. I didn’t have to call a 1-800 number, deal with a bunch of bureaucracy. It was a people-to-people kind of thing, which made it accessible.

Just from my experience, I didn’t really know how to account for the support I would need postpartum. We make the biggest sacrifice ever to continue expanding the population. The least we could be given is some postpartum support. But it feels that the way that our medical industrial complex is setup, it’s really as if it’s focused on, “Let’s get the baby out and then we forget all about the mom.”

But how can a mom nurse a baby when no one’s nursing her back to health? Who’s going to nourish and nurse the mother who is responsible for nourishing and nurturing the next generation of our population? To me, it makes sense to invest in the health of the mother in order to sustain a healthy ecosystem.

The fact that America, one of the most supposedly advanced societies in the world, doesn’t recognize that is inhumane and it’s actually very regressive. To your point, Abby, these shouldn’t be considered luxuries that are only afforded to the privileged. These are necessities. These are essentials that we need to figure out how to bake this kind of care into our culture and into our medical practices.

Elaine Welteroth is a mother, journalist, TV host, and founder of BirthFund.

Abby Phillip is a mother, and the anchor of CNN’s NewsNight With Abby Phillip.

Originally Appeared on Glamour

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