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An Interview with Jennie Joseph of Commonsense Childbirth, Inc.

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Aspen Ideas: Health in Aspen, Colorado 2019

Jennie Joseph is a midwife and the founder of Commonsense Childbirth Inc., in Florida. This interview took place in August, 2020 and has been edited and condensed.

How did your journey into reproductive justice and founding Common Sense Childbirth Inc. in Florida begin?

Jennie Joseph: Common Sense Childbirth is the nonprofit organization that I founded in 1998. I’m a midwife, but the organization was founded to provide prenatal care, maternity care and support for marginalized women and women of color and for people who were suffering poor birth outcomes.

The work has been founded in community-based access to prenatal care through midwifery, as well as postpartum care and support through midwifery.

Groundswell Fund has helped me through the course of the past 10 years or so. They were one of the first organizations to fund our program and to recognize the work we were doing with community midwifery.

In 2015 we added the National Perinatal Task Force, which is an organization on a national level to support birth workers who are working inside of marginalized communities of need. [Groundswell] was able to help us as we’ve built this grassroots movement to recognize that for us to fight disparities we need to do that collectively.

Why do you think the best way to support the reproductive justice movement is through wealth redistribution and how do you see that connected to our collective liberation?

JJ: Well, without a doubt, the dearth of true community support, the lack of even understanding why or how the community needs support has been detrimental. These social determinants of health exist simply because of the historical, structural, deeply embedded institutional racism, classism, sexism, and power dynamics that exist.

One of the things that I think that helps in terms of really transforming communities, transforming individuals’ lives, and reaching that liberation that we are searching for is that we recognize that we can’t get anywhere if we don’t dismantle the system as it is. Opening up access points where there were none before. Making a way where there was no way.

It basically comes down, in my opinion at least, to decolonizing every institution and finding a way in that we can be at the table, that we can be a part of the decision making. That we can have power in policies and in advocacy. Those areas are where we can get in and make those changes. And if we can’t get in, then we will continue to build access points in different approaches outside of those broken systems, and therefore empower ourselves that way.

Why is it critical that we focus on putting women and babies first in healthcare, particularly low income and uninsured women?

JJ: We work with women across the entire spectrum. A majority of my patients and clients actually are Medicaid eligible or have Medicaid or on managed care Medicaid, depending on how they get signed up. And then I have quite a large number of undocumented women who are not able to apply or to receive Medicaid or government support. And then we have self-pay patients who are earning too much to be Medicaid eligible but not enough or not in jobs where they’re getting insurance through their work and so they are uninsured.

Across that entire spectrum of people who are looking for care and support, we’ve had to figure a way to make it work and our way was simple: we’ll take you anyway and we’ll figure it out later. Having got people on board, we’ve noticed that they trust us, they trust the system. And that’s the real key here.

Having trust comes from feeling safe, feeling safe comes from seeing people who are working with you, who look like you, who understand you, who don’t judge you. That gets all of that work done. As long as mother, baby, family remain in the center in all decisions and all care, all transactions, they are safe.

It has become apparent that many people have used this time that we’re in to reflect. How have you and/or your vision transformed over the past year?

JJ: This year has taken me to a place that I never thought I’d go. I’ve spent these decades that I’ve been in the United States, 31 years at this point, being blindsided about the impact of racism, classism, sexism, on the work that I do. On maternal health, on maternal child health. Blindsided is the adjective I use a lot because I’m reeling still from just the fact of what I’ve now learned and what I’ve seen and have had to practice inside of it.

With the Covid-19 pandemic, that was just an additional layer and it took me to my knees because I’ve felt that all these years that we’ve worked, we were already fighting a pandemic. It was just an additional layer to an existing pandemic of racism that is lethal and has been killing people in the same way that a virus is killing people.

And the same people who have been suffering the same outcomes because to me Covid-19 has just laid bare what we already knew, what we were already working with, what we were already dealing with, what we were trying to overcome.

At this point, my vision has changed in a positive way because it confirmed for me that what we were doing was exactly right. But what we had to do was to pivot and convert that same work into Telehealth and I’m pleased to say that we have really hit on something in the last 3 months. We have literally turned this entire program, both the clinical care, the community support, the provider support and the recognition of the need for strong collaborations.

We’ve turned all of that into a Telehealth product doing the same exact work with the same exact clients. We’ve managed to get reimbursement for Telehealth visits for midwives in Florida and all of that has happened because we’ve built this foundation of providing care a certain way, obviously in-person care, and now we can see that we can not only provide that in-person.

Hopefully, we’ll go back to that one day, but we can equally, if not better, provide that care through Telehealth. That in and of itself has just blown my mind.

On the one hand, it’s been quite grueling to take in a very large practice — when it first happened we had 180 patients on board — and transform that practice into completely, almost 90 percent telehealth. In the times since March, (mid-March to mid-July) we had 88 patients deliver babies of which only one baby was weighed 5 lbs 1 oz which is considered low birth weight and only one baby was born at 34 weeks, but both babies are thriving and survived.

My vision is that I want to scale that model, I want to scale this across this nation where all of us can work together collaboratively and provide healthcare, maternity care, and support services, to any and every community that has a need.

We need to reach the women and men that are mostly struggling in communities that are not even interested in midwifery. The justice piece has really developed over the time that Groundswell and I started working together. Realizing that the strong community-based prenatal care piece is the key to transformation. The strong postpartum support is the key. It’s not all about the birth room every time. You know, that’s only one day in that continuum.

In its tenth year, Groundswell’s Birth Justice Fund is at the heart of reproductive justice. As a leading funder of the U.S. reproductive justice movement, Groundswell Fund created the Birth Justice Fund (BJF) to support organizations and projects that challenge the huge disparities in pregnancy and birth outcomes experienced by women of color, low-income women, young women, queer, and transgender people.

Through the Birth Justice Fund, Groundswell supports community-based efforts that promote dignity for parents, families, and communities by reclaiming the sacredness of the birth process and the power of choice around how, when, and where birth will happen.