Maternal mortality for Black women in Virginia is about two times higher than white women.

One way to address that is through the use of midwives, and especially Black midwives to guide Black pregnant people through birth.

The Virginia Center for Investigative Journalism at WHRO worked with photographer Karen Kasmauski to capture that experience around Virginia.

Here’s part of her conversation with WHRO News Director Mechelle Hankerson:

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This interview was edited for clarity and length.

Mechelle Hankerson: Hi, Karen. Thanks for joining us. So tell me a little bit about how you came up with the idea of featuring midwives and specifically black midwives.

Karen Kasmauski: I did a big book on nursing back in 2009. Midwives as well as nurses and all that. So I wanted to do a project on nurses, midwives and looking at how important they are to generically health care, but also to working with Black women, listening to Black women and getting them to have a healthy birth and birth experience.

And so our decision was to not look at midwives in general, but to look at Black midwives who are working with Black women to see if that is something that would make, you know, are they making a difference? Which in my opinion, yes, they are making a huge difference.

M.H: This year, the American Midwife Certification Board identified 378 midwives in Virginia. So how did you find the midwives you were going to take pictures of and patients that were also willing to let you in like that?

K.K: One was in south Hampton Roads and the other one was in Northern Virginia. So that was how it got started, was finding just finding these women. And then I found Marsha [Jackson’s] group, which she owns Birth Care.

And from Birth Care I was able to then expand out with Ebony [Simpson’s] work there … and then there was a bunch of other midwives, plus a lot of women who came to them because they wanted to have midwifery service. Now, this is a midwife service that deals with both Black and white and any color woman who wanted to be there, doesn't matter. Anybody who wanted to go there.

So then my challenge was to try to find Black women who are willing to be photographed as this is a photo coverage. It’s not just interviewing people, but also being able to be there while they're going through the process of working with the midwife and hopefully in the end delivering a baby.

If it's a wealthier area, interesting enough, there's plenty of midwives, so Northern Virginia has plenty of midwives, though not many Black midwives, they have plenty of white midwives. And then in southeast Virginia, like in the Hampton Roads area, there are a handful of midwives.

What we found that there aren't enough of are Black midwives and a lot of the younger women like Victoria, who is working with the Sentara system, her goal is to get Black women to recognize that they might want to use a midwife, that midwives are maybe the better solution for them rather than going straight into a hospital system.

M.H: What did you learn specifically about health care and Black women through this project? And how do how do Black midwives fit into that?

K.K: I think generally speaking, in the United States, our health care system is pretty uneven because it really is dependent on money. If you have money, you can get whatever health care you want, but if you don't have money, it's a nightmare.

The Black midwives fit into that because they don't care about, you know, what you do for a living. All they care about is your health and whether you can have a healthy birth and the baby will be delivered.

If you look at all the babies in the photo coverage, all the babies look fairly content and healthy. And so the mom is calm when she's giving birth.

The whole thing about midwives is they care for the whole person. The whole family is involved.

[There are some pictures] where a woman's toddler is also in the room with the mom while she's being examined by the midwife. So it's a whole family process.

I would hope that when women see that, they see the value of having that more hands-on care to have more time to speak to a provider.