In recent years, the maternal mortality crisis in the US has entered into more people’s consciousness. You may have heard that this country has the highest maternal mortality rates of any industrialized nation in the world, for example, and that Black women are three times more likely to die of pregnancy-related causes than white women.
But those statistics become all the more real when you are a pregnant person navigating the healthcare system. Such was the case for Elaine Welteroth, a journalist and author of “More Than Enough,” who gave birth to her son in February of 2023. Welteroth’s own experience opened her eyes to how “demeaning” and “undermining” the healthcare system can be to pregnant folks, she says – and it wasn’t until she started working with a midwife that her own birth experience significantly changed for the better.
As Welteroth points out, the Centers for Disease Control and Prevention estimates that 80 percent of maternal deaths are preventable, and research has shown that midwifery care could close that gap by about 40 percent. Coupled with her own experience with midwifery care, Welteroth was spurred to action. In May, she launched BirthFUND with funding partners like Serena Williams, Chrissy Teigen, and more. The organization aims to expand midwifery services nationwide by providing need-based grants to selected mothers and families.
We recently caught up with Welteroth to talk about her midwifery experience, what she wants all pregnant people to know about their birthing choices, and the inherent joy of parenthood.
PS: What’s one anecdote that illustrates what you saw as being a problem with the traditional health-care system when you first got pregnant?
Elaine Welteroth: It’s honestly hard to pinpoint just one crack in the system. I would say number one is the limited amount of time you get with the doctor that is responsible for one of the most vulnerable moments of your life. I wouldn’t have known until I became pregnant how many questions one has as a first-time parent, and how important it is to build trust with your care provider.
I didn’t realize that the limited amount of time that you have with your doctor with your prenatal visits was an issue until I was quite literally rushed out of one of my visits by a doctor who stood up in the middle of our conversation and walked out and who told me I had exceeded her three question max per visit. It was demoralizing, to say the least. That’s just level one.
PS: And how did that contrast with what you experienced with a midwife?
“It was this a-ha moment of, why the hell have we always seen women on their backs pushing a baby out?”
EW: Once I found midwifery and pivoted to midwifery, I was shocked that not only did my midwife come to my bedside in my own home for my prenatal visits, but she was with me for an hour or more, depending on whatever I needed. She invested in getting to know me and my family. She Zoomed with my mother and mother-in-law to help answer their questions about midwifery and home birth. She spent time counseling my husband about his role as my advocate. She spent time asking me questions about what exactly I was eating, how exactly I was feeling, what my stress levels were as it related to my job, my husband, parenthood. She was there to answer my very specific, detailed questions about birth and pain management. I felt like I went from being scarily under-served to being abundantly over-served, in a way.
One of the biggest benefits of midwifery is that they partner with you not just as your physical care provider, but as your holistic care provider – as in, they are your educator, your advocate, your family’s advocate. They are your emotional and mental companion. There’s just a much more holistic approach that they take to equip you in this massive transition into motherhood.
PS: What else did you learn about the birthing process through your own experience?
EW: I didn’t realize that a lot of doctors don’t even allow full range of movement during delivery, which was shocking to me. As I was educating myself about birth choices, I had a friend who had a home birth tell me, “Elaine, just think about it this way. If you were trying to push a bowling ball out of a pinhole, would you rather be upright and use gravity to help, or would you rather by laying on your back against gravity to push that bowling ball out of the pinhole?” And I’m like, “No question, I’d rather be upright.” So it was this a-ha moment of, why the hell have we always seen women on their backs pushing a baby out?
That was a wakeup call for me to rethink everything I’ve ever been taught about birth in this country and what constitutes a normal birth. Why was I scared away from giving birth in a comfortable environment, in my own home, where I have the freedom of movement, where I can eat food that I’m comfortable with, where I can control the environmental factors that play such a role in whether or not my body can relax and expand and allow a baby to come through? I’d never really factored in how important lighting is, and energies in the room and the number of people and who those people are. Like, all of those things contribute to whether or not your body can relax and allow the baby to come through.
When we do hear about the option of mood lighting or candles or bathtubs, it’s presented almost as luxuries or that women are being overly demanding, but the reality is that these things have physiological implications on our ability to give birth – and our pain. They directly impact the pain: the tighter your body is, the more pain you’re in during every contraction. So whatever you can do environmentally to appeal to a woman’s senses is actually aiding in the birth process. It’s not at all a luxury. It’s actually essential and vital.
PS: There are a lot of organizations trying to tackle the maternal mortality crisis. What makes BirthFUND’s approach different and impactful?
EW: I know there are many organizations that are working to expand accessibility to midwifery care through systemic initiatives, through policy change. But all of that is taking too long. We need that work to continue, but in the meantime, we need more direct funding sources that are helping families get the support they need in real time. So that’s the call to action from BirthFUND to the everyday individual who has a mom, who is a mom, who loves a mom, who will one day become a mom – to get activated in creating these pathways to empowered, safe, dignified birth experiences for other families in real time in this country.
“I really want to elevate joyful birth stories and experiences of motherhood that give us something to fight for.”
We can also no longer just be measuring our success through survival rates – by that measurement alone, we are the last in the industrialized world. But beyond that, our standards of care across the board need to be elevated. I think that can only happen through education and through storytelling, which changes the conversation and culture around birth. Part of what BirthFUND is here to do is not just raise resources for families to get this life-saving access to quality holistic birth care, but it’s also a cultural and narrative change program that is going to equip a whole generation of mothers with a better sense of what their choices are. We’re not here to push midwifery or out-of-hospital birth on anybody, but we are here to illuminate the benefits of it for those who have found, like me, that the medical system is under-serving them.
PS: What’s been the most surprising part of parenthood so far?
EW: The joy! The overwhelming, all-consuming levels of joy. This child that I didn’t even know I needed came into my world and reoriented my outlook on everything, in the best possible way. He’s the biggest ball of joy, and I am so, so grateful to be his mom. I never thought I would be this person – motherhood was not on my radar, maternal health was not on my priority list. And having this baby has added a whole different level of purpose to my life, in my work and my personal life.
That’s the thing I wish we talked about more, because I think the narrative out there is just about how hard it is to be a mom and how scary it is to be pregnant and all these traumatic birth stories. But I really want to elevate joyful birth stories and experiences of motherhood that give us something to fight for, that give us something to dream into. I think that’s equally as important as equipping people with the scary statistics. We can’t look away; we need to know what we’re getting into when we sign up to be a mom in this country. But at the same time, we need to give moms a north star – the best of what’s to come, the best of what they can expect, the best of what they can ask for.
We want people to think of BirthFUND as a joyful movement, a hopeful movement. We can do something. Here’s one human rights crisis that’s raging in this country that we actually can do something about. Like, let’s do it. Let’s fucking go.
This interview has been edited and condensed for clarity.
Lena Felton is the senior director of features and special content at POPSUGAR, where she oversees feature stories, special projects, and our identity content. Previously, she was an editor at The Washington Post, where she led a team covering issues of gender and identity.
