by Wendy Swat Snyder, College of Nursing

To her patients, Delores Grant Kirkland is the epitome of the care-giver; to the general public, she’s a throwback to a bygone era. Kirkland is a member of the faculty in the College of Nursing at the Medical University of South Carolina. Her specialty is nurse midwifery.

“I don’t know what compelled me to join another minority group,” muses this upbeat, down-to-earth Charlestonian. “Maybe it’s the maverick in me. I knew I wouldn’t make a lot of money, and I’d be giving a lot of my time, and it may not be rewarding. I was in two minority groups racially and professionally. I would be one of a few black women in midwifery.”

Why join the ranks of midwifery?

“As a nurse, you have a good deal of personal interaction with the client through the assessment process, in prenatal and postnatal education and in evaluating her for social services. But the physician actually manages the client, delivering the baby and completing the postpartum evaluation,” explains Kirkland.

“I wanted to be the one who worked with the woman, and that literally is what the definition of midwife is—‘with woman.’ I realized that once I put that midwifery piece in, I could have it all.”

Kirkland practices full-scope midwifery at the MUSC Nurse Midwifery and Pediatric Center, 159 Rutledge Ave., in the heart of one of Charleston’s most medically underserved neighborhoods.

“At the center, we are molding attitudes about health care starting early--in the prenatal period before the child is born. It’s an easy way to introduce lower-income women to middle-American values they should live with but were never taught.”

Sabrina Crawford and her husband, Dwyn, have returned to Kirkland for the upcoming birth of their second baby.

“I was happy with her six years ago. She makes you feel comfortable. The midwife sits down and lets you know what’s going on.”

Bringing in the mother, especially a young mother, for early prenatal care also benefits the unborn child and improves its chances of survival. South Carolina’s infant mortality rates are among the highest in the country, and residents in the center of Charleston’s hospital district—the Enterprise Community—have some of the poorest medical statistics in the county. The center addresses the needs of these women and children by providing a user-friendly health care system.

“Teen motherhood has become more acceptable in our culture,” says Kirkland. “When I was a teen it was not. The pattern has been to cater to the unplanned baby to make it feel wanted. The child was raised by the mother’s family as a little sister or brother. It was natural that the mother shared some of the baby’s spotlight and, over time, girls started to think, “Well, why not?”

“Now these kids use pregnancy to become more independent. I get a little frustrated with the system. Sometimes we help in such a way that actually hinders progress.”

Kirkland spends alternate days commuting to clinics in Walterboro, Hampton and Ridgeland, working for the Department of Health and Environmental Control’s Lowcountry District. She says she doesn’t mind traveling to distant practice sites.

“I’m helping to meet a need. It’s something I grew up with professionally as a nurse-midwife, you learned to go where the need is. It’s more of a challenge to me compared with the hospital where you have a captive audience. In prenatal education, I have to learn how to help my patient identify what needs to be changed in her life. A lot of times it’s a change in attitude before any other issues can be addressed.”

Over the years, Kirkland has had negative encounters as both a black and a nurse-midwife.

“I wondered sometimes if I were going to get the respect I needed to function effectively as a CNM (certified nurse-midwife).’

But she’s always been able to work through those problems. Kirkland recalls a particularly poignant experience.

“This patient had gone into labor and I was the midwife on call. When I met her at the hospital, the patient had an issue with me being a black woman. I gave her the chance to go with the back-up physician, but he was a man so she opted to stay with me. I helped her get through a frightening labor experience and during it we related, woman to woman, and we bonded. We eventually became good friends and she requested me for her next two children.

“If I can change the attitude of one person in 20, it’s worth it to me. Then that mother will teach her child the new value, and so on. It gives you incentive to keep on going.”

Kirkland’s drive to succeed began when she was a child.

“From the beginning, you’re taught that you may have to work twice as hard to earn the same credit in the work place as your white counterpart. You’re told that you need to push yourself. Don’t stop at a (bachelor’s or master’s degree), go for your Ph.D. That kind of philosophy was ingrained in us. My mother started getting us career-oriented in junior high school.”

After receiving a master’s degree in nursing in maternal-child health at Boston University, Kirkland returned to Charleston and completed an additional course of study at MUSC to get her certificate in nurse midwifery.

“For the most part, physicians at MUSC have been able to foster a positive attitude. I think what has made it easier for me was my experience working at Franklin C. Fetter Health Center right before I became a CNM. Many of the doctors I now work with were moonlighting there during their residency, and I was the nurse in charge.”

Kirkland believes she’s in a growing field. “

Women are demanding us now. Midwives are available now as health-care providers not just to poor women in rural areas, but to upper-income women who want that one-n-one with another woman. It’s hard to relate the pain of labor to men.”

What does Kirkland get out of it?

“I get satisfaction from knowing that someone has learned how to take care of themselves and a newborn baby. It’s exciting to be part of the birth. the profession I’ve chosen is God’s way of using my hands and my mind on earth. I guess for me, it’s more of a spiritual thing.”

Editor's note: Article and photo reprinted with permission from The Post and Courier.