Rainier Valley midwives offer “culturally competent” care for diverse moms

Midwife Faisa Farole examines Malcolm Stonehill (the author's son) at the new Rainier Valley Community Clinic, which offers culturally competent pre- and postnatal health care. (Photo by Sarah Stuteville)
Midwife Faisa Farole examines Malcolm Stonehill (the author’s son) at the new Rainier Valley Community Clinic, which offers culturally competent pre- and postnatal health care. (Photo by Sarah Stuteville)

I was entering the third day of labor when they told me I’d have to have a C-section. I was exhausted and scared, shaking under bright white lights as a team of masked strangers crowded around the bed prepping me for surgery. Other than my husband, the only person whose face seemed kind in that moment was that of my midwife.

I’ve spent the last two months since that day getting to know my new son. While that time with him has been amazing (if sleep-deprived), the experience of bringing him into this world was one of the most intense of my life.

Then I try to imagine how much scarier it would have been if I’d had nurses, doctors and midwives who didn’t speak my language or understand my culture. That’s what Jodilyn Owen and a team of midwives and health professionals are trying to provide at a new clinic in South Seattle.

“A woman who is from Ethiopia sits with an Ethiopian midwife — she doesn’t have to explain herself,” says Owen, midwife and co-founder of the South Seattle Women’s Health Foundation. “That’s a profound form of health care.”

The clinic, which opened in September and is called The Rainier Valley Community Clinic, looks to provide “culturally competent” pre- and postnatal care to one of our city’s most diverse and medically underserved areas. They also help midwives from other countries become licensed to work in the U.S., as a way of diversifying midwifery in our region.

The midwives who volunteer at the clinic have roots in Ethiopia, Somalia, Brazil, Hawaii and India, and are predominantly women of color. But it’s hard to keep up with the diversity of the neighborhood, says Tara Mudaliar, another midwife and co-founder at the clinic.

Mudaliar explains that they use interpreters and some “outside-the-box thinking” to communicate with families from around the world, sometimes using Google to search photos of healthy foods for pregnant women, or making home visits to demonstrate how to apply treatments for yeast infections.

“There’s 59 different languages spoken in this ZIP code,” says Mudaliar, laughing as she gestures in the direction of the clinic’s large storefront windows and to Martin Luther King Jr. Way beyond.

There’s also a lot of need.

According to Mudaliar, women in Rainier Valley are less likely to have received consistent prenatal care and more likely to have a preterm birth than women in Seattle at large. And the hope is that the location of the clinic can help women access care — especially midwifery care outside a hospital setting, such as home births and birth-center births that are growing in popularity but are often unavailable in poor communities.

Malcolm Stonehill is weighed during the infant exam demonstrated at the Rainier Valley Community Clinic. (Photo by Sarah Stuteville)
Malcolm Stonehill is weighed during the infant exam demonstrated at the Rainier Valley Community Clinic. (Photo by Sarah Stuteville)

Hospitals can be alienating places, especially for low-income women of color and immigrant women, says midwife Faisa Farole, who was born in Somalia and grew up in the U.S.

She offers examples of women who want to request female providers or decline genetic tests that conflict with their religious beliefs, but struggle to do so because of language and cultural barriers. She says it can even be an issue to establish that they’ve given informed consent for exams.

“They’re being treated poorly and disrespected,” says Farole, “to the point where the doctor knows how their body functions better than they do and is not able to listen to or trust the mom.”

The concept of what the clinic’s midwives call “woman-centered care” is at the heart of what they practice. And it’s a philosophy they hope to pass on to new physicians in the medical field. Starting in June, residents with the Swedish Family Medicine Residency at Cherry Hill will be able to do a four-week rotation at the clinic.

“It’s always about approaching it from a place of humility,” says Mudaliar when asked what the key is to her work, “and asking lots of questions of that mom.”

It’s an approach they used on me toward the end of our interview, encouraging me to tell my birth story and asking me about my baby, Malcolm, who was with me when I visited the clinic. They even guided me through an infant exam and fun, new baby rituals, such as inked footprints and a ceremonial bath.

Afterward they offered to perform a “bone closing” ceremony from a Latin American tradition. A midwife moved a tightly wrapped shawl down my body, praising the hard work of new motherhood. As she did so I remember the words, “Because we honor all mothers.”

 “We may not always,” I thought, “but we should.”

Sarah Stuteville

Sarah Stuteville is a print and multimedia journalist. She’s a cofounder of The Seattle Globalist. Stuteville won the 2011 Sigma Delta Chi Award for magazine writing. She writes a weekly column on our region’s international connections that is shared by the Seattle Globalist and The Seattle Times and funded with a grant from Seattle International Foundation. Reach Sarah at sarah@seattleglobalist.com.