I met Belcore in her home office on a quiet street in Evanston. Artwork of pregnant women decorates the walls, candles and aromatherapy devices sit on windowsills and a sign reading "the witch is in" sits prominently on her packed bookshelf. I asked about why she chose a certification that wouldn't allow her to practice legally in her home state and why she fights so hard for Illinois to recognize her certification.
How did you decide to be a certified professional midwife, as opposed to the certified nurse midwife?
Becoming a nurse midwife is just not affordable. It can run about $100,000 or more in Illinois. And having that amount of debt is not conducive to community midwifery because it will not pay enough for you (compared to hospital midwifery) to continue to pay your college loans back. I knew I wanted to work [outside] of the hospital. I knew I wanted to work in communities. I knew that home birth was where my heart was. I knew that for me, learning how to be a good nurse midwife in a hospital was not going to prepare me for the challenges of being an out-of-hospital midwife. So the only program that is exclusively training midwives in out-of-hospital work is a CPM program.
How does the certification situation in Illinois affect a CPM like you?
It's a horrible business practice for Illinois. They're running business out of the state and driving midwives into neighboring states. We had a study done in 2012 that proved that by licensing CPMs, the state can save over $5 million a year in health care costs by just providing CPMs with the ability to bill Medicaid for service.
In Wisconsin, if I were to transfer with a mom or a family into a hospital, I could walk in, hand the doctor that took over the care the folder of information, discuss their case with the doctor with the clients' permission and they would see me as a trained professional—we could work together for continuous care. But here in Illinois, that same practice would put a midwife at risk for having a report filed by the doctor, which could lead to anything from being brought before the Illinois State Medical Society, being brought before the licensing committees, or at worst, being prosecuted as a felon.
It's so funny that just across the border, I would be considered an equal professional to any nurse midwife. But here in this state, I'm concerned I would be considered a felon if I did the same thing.
When clients come to you typically, why are they seeking out your services?
I'd say half of my clients come to me late in their pregnancies, looking for somebody who will take over their care, because they are not feeling that they are being respected and listened to in the hospital environment.
The hospitals have protocols. There's all these rules that are not necessarily medically founded, they're not medically research-based. They are liability-based. They are ease-of-use-based. A hospital has a business model of trying to get as many babies in and out of there as quickly as possible, so people don't feel like there's individualized care. Because of these hospital protocols, they just say that's it, I can't handle it anymore, they won't let me have this birth experience that I want. They're seeing my birth as a medical problem as opposed to just a natural part of my life.
Could you tell me a little bit about the Illinois Council of CPMs and the advocacy work to have Illinois recognize CPMs?
The Illinois Council of Certified Professional Midwives is a professional organization that offers membership to certified professional midwives and their students. We are also a chapter of the National Association of Certified Professional Midwives. We have a commitment to diversifying our midwifery membership. I feel like the biggest challenge in Illinois, and I think a lot of the states that don't have licensure are facing, is diversifying. It's hard enough to get people to want to practice in a state that considers you a felon, but then the additional risk of that places on person of color, it makes it like a challenge to open up our ranks.
Right now in the state legislature there's a home birth resolution, which calls for a committee of doctors, midwives and community members to get together and come up with a solution for the lack of resources for home births. [Note: The bill was approved by both houses last month and is waiting for Gov. Pritzker's signature.]
The home birth crisis is real. There are over 1,000 babies born in Illinois at home every year and the number keeps going up. And there are not enough licensed providers to provide services for those people. The state knows what's happening but they don't recognize certification, because in their opinion, people just shouldn't have home births. But that doesn't matter, right? It happens anyway.
Is there a focus among the community of CPMs to serve communities of color in the meantime, until becoming a CPM is a more viable option for people of color?
In my experience, in the last maybe five years, the number of families of color who have sought out home birth care has easily tripled. I feel like families of color are feeling safer at home. So the need for midwives of color is extraordinarily high. So I think that CPM are actually filling a huge gap. They're serving those families and providing better care because they are providing compassionate, whole body care, whole health care, not just, you know, measurements and weights, but emotional and as well as physical support. I do believe that this is a huge part of the answer.
What is the solution to the maternal health crisis in Illinois?
I know that we need more compassionate care, we need to face, head-on, racism as it exists socially, and how the medical system is a racist system. And because of that, moms and babies are dying. And so from the top, instead of fighting to keep midwives from practicing, the medical society needs to focus on the problems that they have created. They need more education on their own racism and how it impacts moms and babies. They need to do their own work, recruiting and bringing on more providers of color in communities that deserve to have those professionals.
This story was produced by City Bureau, a civic journalism lab based in Woodlawn. Learn more and get involved at www.citybureau.org.
Read all stories in our special Maternal Health Issue here.
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