By: Binta Niang, LM, NACPM Board Member
My journey with my third baby — from pregnancy through labor, delivery, and recovery — has given me a new perspective on the meaning of support.
As a midwife, I have spent years helping families navigate pregnancy, birth, postpartum recovery, and the healthcare systems that influence their care. But experiencing pregnancy from the other side of the clinical relationship has made me ask: What does it really mean to support someone?
In healthcare, we often focus on services and resources: insurance, transportation, education, and access to providers. These matter, but so does understanding the circumstances people face, including racism, implicit bias, language barriers, cultural misunderstandings, and financial hardship.
Support Through the Lens of a BIPOC Midwife
My roots in West Africa and my experience practicing midwifery in the United States have shaped my understanding of care.
In many West African communities, maternity care is deeply connected to family, culture, community, and trusted birth workers. These relationships remind us that care extends beyond clinical services to include emotional reassurance, shared knowledge, and cultural continuity. Yet, families may also face financial limitations, long distances to healthcare facilities, and shortages of skilled providers.
In the United States, advanced technology and specialized care do not guarantee that people feel supported. Someone can have insurance but struggle to afford care, have an appointment but not feel heard, or be surrounded by healthcare professionals and still feel alone. The presence of services does not guarantee that people have what they need.
The Childbirth Education Class That Changed My Perspective
Several years ago, I held weekly childbirth education classes. During one session on nutrition and postpartum preparation, I shared practical, evidence-based recommendations about balanced meals and nourishment. One participant told me the information was helpful, but obtaining nutritious food was not as simple as we had made it sound. Her words stayed with me.
It is easy to recommend eating more protein, choosing iron-rich foods, or preparing meals for postpartum. But, what happens when someone works long hours, struggles to pay bills, cares for children, or lacks help at home? This participant was also navigating diabetes, high blood pressure, and anemia. We were asking her to make significant nutritional changes while she was already carrying a tremendous physical, emotional, and financial load.
That experience reminded me that healthcare recommendations exist within people's lives.
Instead of simply asking people to follow our recommendations, we must ask what would help make them realistic. Sometimes that means connecting someone to food resources, identifying affordable options, involving family members, or coordinating care. It also means recognizing the challenges people face rather than assuming they simply need more information.
Support Is Also About Being Seen
Support is not only physical or financial. It is also emotional, cultural, and relational.
It means feeling safe enough to ask questions, trusting that concerns will be taken seriously, and knowing that pain will be believed and cultural practices respected. It means receiving care without assumptions based on skin color, accent, income, or background.
My own pregnancy has reinforced that even healthcare professionals experience vulnerability as patients. We can understand the risks and recommendations and still need someone to listen, explain, and ask, “How are you really doing?” Patients come to us as whole people, bringing their families, histories, fears, responsibilities, and hopes for their babies. Recognizing those experiences helps us respond with compassion, whether that means advocating for someone, connecting them with resources, or simply listening without judgment.
Building a Culture of Support
My journey between West Africa and the United States has taught me that no healthcare system has all the answers. Both contexts offer lessons in community, cultural continuity, research, technology, and collaboration.
We need maternity care that considers housing, food security, transportation, childcare, employment, language, and mental health as part of the broader picture of health. We need midwives empowered to practice to the full extent of their education and training, stronger partnerships among healthcare professionals, and systems that give patients meaningful voices in their care.
These changes require collaboration among providers, communities, institutions, and policymakers. Families should not have to navigate every challenge alone.
We can begin by asking simple questions: “What would be most helpful to you right now?” What makes it difficult to follow this recommendation? Do you have enough food, reliable transportation, or help at home? Do you feel heard and respected? What would make your care easier to navigate?
The answers may lead to a community referral, a different appointment time, culturally relevant education, or broader advocacy. The important thing is to ask, listen, and respond in partnership with the people we serve.
What Support Means to Me
My experience as both a mother and a midwife has taught me that care is more than providing services or sharing information. It requires a willingness to understand people's circumstances and work alongside them as their needs change.
Every person moves through pregnancy, birth, and postpartum carrying something different: financial stress, trauma, discrimination, caregiving responsibilities, exhaustion, or fear. Some carry all of these things at once. As midwives, we have an opportunity to notice what people are carrying — to listen, adapt, advocate, and collaborate. Because caring for people means more than telling them what they need or offering what is available. It means understanding their circumstances, respecting their humanity, and helping ensure they do not have to carry the weight alone.