Nadia Gramby, a dedicated midwife, travels extensively across Alabama, attending to pregnant women and delivering babies. Her commitment is crucial as the spread of maternity deserts across the United States has left many without adequate maternity care. The latest March of Dimes report highlights these growing challenges.
Gramby treasures moments with her baby girl, River Emmanuel. Despite her roles as a mother and wife, she dedicates much of her life to providing essential midwifery care. Over 52% of U.S. counties lack hospital-based labor and delivery services according to the March of Dimes’ ‘Nowhere to Go’ report, emphasizing the necessity of Gramby’s work.
The Importance of Midwives
Dr. Michael Warren from March of Dimes notes that women in maternity care deserts often experience worse pregnancy outcomes. Every year, the CDC reports over 20,000 infant deaths before their first birthday, alongside approximately 600 maternal fatalities from pregnancy-related complications. Women of color face increased risks, with Indigenous and Black women encountering much higher maternal mortality rates compared to white women.
Midwife on the Move
Gramby, a certified professional midwife, tirelessly drives hundreds of miles to offer her support. She operates in places ranging from cities to rural Alabama towns. Based in Chelsea, Birmingham’s suburb, Gramby is driven by the joy she brings to families. Her travels recently included a 302-mile journey to Anniston, Montgomery, Helena, and Alabaster for prenatal care appointments.
With a supportive husband, Shamar, who she describes as a ‘superdad,’ Gramby founded ‘Crown of Glory Birth Services’ in 2018. Her goal was to provide care to women in maternity deserts, assisting them through the stages of pregnancy, labor, birth, and postpartum.
One of the few Black midwives, Gramby provides a personalized approach that considers emotional, spiritual, and physical health. Her holistic care includes post-birth home visits, aiming to ensure mothers receive continued support.
The Impact of Midwifery
Research shows that midwife-led births reduce cesarean sections and complications. Midwives work in close collaboration with physicians and doulas, offering services at homes, birth centers, and hospitals. Gramby has extended her practice into a new Birmingham office, complementing her home visits.
The March of Dimes report notes that midwives significantly enhance access to maternity care, yet many areas remain starkly underserved. The highest proportions of maternity care deserts are in the South and Midwest.
Overcoming Barriers
The March of Dimes identifies legislative challenges as additional obstacles to care. The ‘One Big Beautiful Bill Act,’ impacted Medicaid funding, exacerbating issues. Workforce shortages worsen the situation, alongside the closure of over 500 hospital maternity wards since 2010.
To combat these challenges, March of Dimes advocates for policy changes that would empower midwives with more autonomy and support.
Gramby envisions a future where comprehensive maternity care is accessible for all mothers and is committed to bridging the gaps caused by historical and systemic disparities. Her passion and dedication embody the mission to improve maternal and infant health across the nation.
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