Wayne County Health Authority, USA
Dr. Katie Moriarty, PhD, CNM, CAFCI, FACNM, RN is on faculty at Frontier Nursing University and a Certified Nurse-Midwife with the Wayne State University Physician Group CNM Service at Hutzel Women’s Hospital in Detroit, Michigan. Katie serves on the Board of Directors for the American College of Nurse-Midwives as the Region IV Representative. Dr. Moriarty was previously the Associate Director of the Nurse-Midwifery Education Program at the University of Michigan and launched the first Integrative Healthcare and Complementary Therapies Clinic in Pregnancy and Reproductive Women’s Health at the UofM Nurse Managed Center Clinic. Dr. Moriarty earned her BScN at the University of Windsor, Ontario CANADA; MS (Perinatal Nursing and Nurse-Midwifery) and PhD from the University of Illinois at Chicago.
The total amount spent on health care in the USA is greater than any other country in the world yet we rank poorly in international standings with regard to infant mortality. Despite the existence of high quality, nationally recognized health systems in metropolitan Detroit, the appalling rates of death and racial health disparities among the most vulnerable members of our community, infants, and the maternal mortality rate for African American women rival that of third-world countries. The reasons behind these disparate maternal and infant health outcomes in Detroit are complex. Social and economic conditions are intrinsically linked with health and research examining the life-course conceptual model of racial disparity has demonstrated adverse birth outcomes from these effects of stress. As well, there is a lack of support of physiologic childbirth which is the innate, hormonally driven processes that have developed through human evolution to facilitate the period from the onset of labor through birth of the baby along with skin to skin contact and the establishment of breastfeeding. The lack of these critical elements may have long term population health consequences. For the nation we need to address how we give care during pregnancy and how we actually are born. Exemplars of models of care and the mounting research on how we are born with its impact on outcomes will be presented. Strategies on how to support the normal physiologic processes of labor and birth, even in the presence of complications, to enhance both maternal and infant outcomes will be presented.