January 2011: Tamara Taitt '98
Tamara Taitt ’98 has had a long-standing interest in women’s issues, but while at Princeton University in pursuit of her B.A. in psychology, she had what would become a pivotal experience when she was asked by her married and pregnant roommate to come to the baby’s birth. Taitt says, “I spent the entire time talking to the midwife and found the whole event fascinating.” Thereafter she searched for a graduate school that offered a direct-entry midwife program and found one that fit her urban upbringing at Florida’s Miami Dade College.
Taitt chose direct-entry midwifery rather than nurse midwifery because she wanted to learn through the apprentice model the way midwifery has been practiced for centuries. While nurse midwives typically practice under the supervision of physicians and hospitals, direct-entry midwifery is autonomous and home-centered with collaborative care only if necessary. Halfway through Miami Dade’s two-year program, buoyed by an underlying belief in patient-centered care and the wraparound approach to midwifery (tailoring comprehensive care services to youth with multi-dimensional problems), Taitt decided to pursue a master’s in marriage and family therapy and found an accredited program at Nova Southeastern University. She began her pursuit of her master’s while simultaneously obtaining her A.S. in midwifery. “Midwifery is to obstetrics as marriage and family therapy is to psychology,” says Taitt, who believes the two professions complement each other.
After finishing midwifery school and while still working on her master’s, Taitt took a job at a non-profit agency that provides services to mothers and babies. She became particularly concerned about perinatal health disparities that disproportionately impact black women and their families. Infant mortality and morbidity rates for black families are two to three times higher than those of others. These disparities are not attributed just to socio-economic conditions. The research substantiates that the experience of “living black” has a cumulative effect and causes a degree of stress that results in such things as low birth weight and infant mortality. Even when a black woman and a white woman have similar socio-economic protections (marriage, health insurance, higher income, and education), the black woman still has a much greater chance of a poor outcome. For college-educated women, there are four deaths per 1,000 births for white women, and ten deaths per 1,000 for black women. Identifying risk factors, Taitt believes, can significantly affect the health and well-being of infants and families and give black families reason for hope.
Midwifery has been slow to catch on in the U.S. Though midwives deliver 85 percent of the babies worldwide, they deliver only 8-11 percent in the U.S. In contrast, Caesarean rates are higher in the States than in most other industrialized countries. According to the National Center for Health Statistics, in 2007, 32 percent of U.S. births occurred by Caesarean. From 1996-2007, Caesarean rates rose 53 percent, and six states, including Florida, saw increases of over 70 percent. The reasons for this dramatic increase include clinical causes, legal pressures, demographics such as age and multiple births, and a tendency to induce labor before a woman’s due date for reasons of convenience. But the costs of Caesareans are almost double those of a vaginal delivery. Furthermore, there is increased risk of surgical complications, and critics will add that Caesareans generally do not improve the health of mothers and newborns.
“Health disparities in infant mortality are the battleground on which midwifery will be proven to be the gold standard of maternity care,” says Taitt. Midwifery and birth-center models of care have been shown effective in reducing disparities in birth outcomes. For example, Jennie Joseph, (LM, CPM) a British-trained midwife now living and working in Florida, has developed a very effective model of maternity care. According to a study conducted by the Winter Park Health Foundation, no babies of African American women in Joseph’s practice were born preterm or low birth weight. A second example, Ruth Lubic (CNM), inspired to act by Washington DC’s alarming infant mortality rate, established the Developing Families Center through a grant from the MacArthur Foundation. The Center utilizes a community-based approach and is a collaborative effort between the Family Health and Birth Center, the Healthy Babies Project, and the United Planning Organization Early Childhood Development Center. The results are impressive: After caring for 800 babies in eight years, Lubic and her team have never lost a child in childbirth and have cut the rate of premature births – the biggest risk factor for infant mortality – in half.
According to Taitt, women don’t always have the support of extended family during pregnancy. Many women work up until the birth, and the experience itself sometimes leaves women traumatized. She says, “We treat pregnancy like an illness in the U.S. Where is the logic of a horizontal position for women giving birth? Women are not fed but are expected to do the hardest work of their lives on ice chips. No caffeine for pregnant women, only the possibility of narcotics during birth. Babies are taken from their mothers immediately, separated from the only sounds they have known during gestation.”
Taitt received her master’s in marriage and family therapy from Nova in 2008 and is now a Ph.D. candidate. Her keen interest in the sustainability of the midwifery profession has led her to serve on the boards of the Midwives Alliance of North America and of Florida Friends of Midwives. In 2009, Taitt started her own company, Mind, Body & Baby, LLC, and runs infant and pregnancy-loss bereavement and postpartum support groups for two different not-for-profits in Miami. She remains an advocate for change on the topic of birth. “While the U.S. spends more dollars on care associated with childbirth, more women die in the U.S. than in 39 other countries, and we have a high infant mortality rate as well.” But Taitt feels that it is the women themselves who will demand change. She notes that better access to information is leading to improvement.
Taitt valued her time at Hotchkiss, where she feels that she received a strong foundation for independent thinking. “The level and rigor of the education I received there was without comparison. I was already ‘me’ when I left Hotchkiss.”