E2 Show Notes

[SFX: sound of elevator riding down, stopping, ding, doors opening]

[SFX: light chimes fill the lobby]

 

I’m standing in the lobby of a high-rise building in downtown Jacksonville. It’s my second day observing Kim Homer, the midwife who got her calling while she was working at Home Depot.

Kim just finished her first prenatal visit with her client Monica Dorsey. Who walks us out. Before we say our goodbyes, James, the doorman, greets us. 

[MUSIC: Black is Beautiful – Jack Trombey]

[SFX: Chime fades under and out]

 

He has Black don’t crack written all over him: he looks to be in his 40s, but he’s probably my age, late 50s. When Monica introduces Kim as her midwife, James leans back, knits his brow, and cocks his head.  

Midwives? In 2024? He asks. He seems skeptical. I know they used to be popular back in the day, but I didn’t know they were still around. 

Immediately, I want to tell James everything about the visit. My mind is buzzing. 

Because what Kim gave Monica was not just a prenatal visit. It was bigger than that.  In my whole career, I had never before seen love brought into a medical visit. 

All I could think is…James, if only you knew what I saw upstairs. 

[MUSIC: Black is Beautiful – Jack Trombey fades out]

 

I’m Kaytura Felix. You’re listening to Deep Care. 

[MUSIC: Show ID]

 

A podcast about the Black community midwives transforming Black families and futures.

[MUSIC: Show ID under and out]

 

Like James, I didn’t know much about midwives before this project. There were lay midwives in Dominica where I’m from and many of my friends were born at home. But my mother had me and all her children in the Roseau hospital with a doctor. She was proud of it. It was a mark of our class. 

I didn’t hear about midwives in medical school or my OB-GYN rotation. When I was pregnant, I didn’t look for one. I didn’t think it was relevant to me. It all sounded outdated.  

After watching Kim and Monica’s visit, I realized how misguided I had been. The care Kim provided was not just for the pregnancy, but more importantly, for life, Monica’s life.  

[MUSIC: Jimit – Baba]

 

It feels good to be back in Florida. It’s where I came for college in the mid-80s. 

The landscape, the vibes, the weather — it all feels like home.

It not only looks like the Caribbean, it’s full of Caribbean immigrants. Like Kim. Her family is from Haiti, and I’ve never met a Haitian I didn’t like.

My time with Kim taught me a lot. About midwifery yes, but also about work and play.  

[MUSIC: Jimit – Baba fades under and out]

 

KLF: All right. Whoo. I kept thinking, this is my third day with you, right? The first day we were at that gathering. Yesterday, we did that home visit. And then we interviewed, and today we did another –

 

Kim Homer: And we did line dancing.

 

KLF: We did line dancing like [inaudible] time.

KLF: So, this is me talking to Kim. 

 

Oh my God. That was a big experience for me. I’m definitely going to take that back with me. 

After Monica’s visit, she invited me to a line dancing class. Soul line dancing. Boots-on-the-ground: Where-Them-Fans-At dancing.  

Kim has this joy inside of her. It keeps her moving through the work, even when things are tough. I came to see this more and more as she told me about her early days as a midwife.  

[SFX: Cicadas, motorcycle revving]

 

After Kim left Home Depot, she was a midwifery student in Miami. 

[MUSIC: Colin Kiddy – Club Love]

 

Besides her classes, she worked all kinds of jobs to learn as much as she could about birthing babies.

 

Kim Homer:  I was a nanny. And I was a receptionist at the Birth Center. And I would do placenta encapsulation. And even showing up for on-calls. And I was doing all those things without a vehicle.

 

Miami, like many cities in the US, doesn’t have dependable public transportation. Even though Kim struggled getting around, nothing was going to keep her from her clients. 

 

Kim Homer:  I’m catching a bus and I’m riding my bicycle all over Miami.

[SFX: Bicycle pedaling and traffic]

 

If I missed the bus, then I would have to ride my bike 10 miles, riding in tough neighborhoods, in the middle of the night to get home.

[SFX: Bicycle pedaling and traffic up and out]

[MUSIC: Club Love – Colin Kiddy fade down and out]

 

Kim realized if she was having a hard time getting around, so were the Black families looking for prenatal care. 

Studies have shown that when pregnant people have to travel far for their care, it increases their risk of poor outcomes. 

The distance also puts more strain on their finances and mental health.  

For families in the Sunshine State, this is overwhelmingly so. 

[MUSIC: Dreamy drum loop muffled beat]

 

About one in five counties in Florida are “maternity care deserts”. 

Meaning these areas have no birth centers or hospitals, little access to OBs, and pregnant people have to travel almost AN HOUR to receive care or give birth. 

When the time came for Kim to launch her own midwifery practice, she was already thinking about this problem. She wanted to serve her people. 

There were already black midwives in Miami, but she didn’t see ANY above Central Florida. 

[MUSIC: Dreamy drum loop muffled beat ends on reverb]

 

so Kim moved north. 

[MUSIC: Whistle – Mikhail Galkin]

 

Once she got a car, Kim would travel three hours in every direction to see clients. And she made sure to cover rural areas.

That’s why the National Black Midwives Alliance gave her an award, at their 2024 conference. And that’s where I first  heard of Kim.

 

KLF: Narration – KH moving over and getting settled in Jacksonville

Kim Homer: I wanted to grow something here in Jacksonville because they’re so, so deserving of it

KLF: Jacksonville, where Kim ultimately landed, is a sprawling city of 1 million people, about a third of them Black. 

 

When I arrive, Jacksonville feels more like a small town. I like seeing the roadside food stands and smoking BBQ pits while driving around.

While Jacksonville isn’t technically a maternity care desert, Kim was intentional about WHERE in the city she decided to set up shop.

 

Kim Homer: There is the north side and the south side. And the south side is the predominantly unmelanated side. And the north side, which is above Interstate 10 is a melanated space. There are no midwives, no office of a midwife, north of I-10. They’re all six or seven under I-10.

KLF: Wow. And they’re all white?

Kim Homer:  Yes. And I intentionally moved to the north side so I can be where I’m going to serve. 

[MUSIC: Whistle – Mikhail Galkin ends]

 

KLF: And that brings us back to Kim’s first prenatal visit with her client, Monica.

The three of us settle in Monica’s living room.  They take the sofa, while I’m sitting on a salon stool to the side. 

Behind us, I see a couple of mannequin heads with wigs. 

[MUSIC: Tropical Nights – Yestalgia]

 

Monica was a hairstylist in Miami. For several years, she’s been making tutorials online.

When we arrived at her apartment, her camera was already set up. She’s making a few videos to post on TikTok later.   

 

TIKTOK Monica: Come with me to my first midwife appointment. 

Kim: Hi!

Monica: This is my very first meeting with midwife Kimberly after talking on the phone for months. We’re preparing for a homebirth and I’m 28 weeks. 

 

KF: At 28 weeks, Monica is in the beginning of her THIRD trimester. Before Kim, she was seeing an OB for prenatal care. 

[MUSIC: Tropical Nights – Yestalgia under and out]

 

She felt dissatisfied. She was not getting educated about her pregnancy. She didn’t feel connected to her providers. 

And as her pregnancy progressed, she realized that she wanted a home birth. So she transferred her care.

When she broke the news to her girlfriends, they had a lot of questions. 

[MUSIC: Jimit – Feel Better]

 

They wanted to see what a prenatal visit at home was like.  Monica tells us these videos are really for them to see for themselves. 

 

TIKTOK Monica: If you guys are considering an at home birth or having a midwife or a doula then go ahead and subscribe, follow…

 

Even though Monica left conventional care, it’s important to note,   she never left medical care. 

As a midwife, Kim is a trained medical provider, an expert in low risk pregnancy and childbirth. 

During home visits like these, Kim performs physical exams, fetal assessments, and various lab tests to ensure parent and baby are healthy.

 

TIKTOK Monica: She wanted to do a glucose screening which is taking bloodwork to send to the lab to check for gestational diabetes, iron levels, oxygen levels, and so much more. …(duck under) 

 

These home visits pick up throughout the third trimester. 

 

TIKTOK Monica: She asks me questions about my diet, my mental, my exercise routine and what I can expect from that week of pregnancy. (clip fades out)

[MUSIC: Jimit – Feel Better ends]

 

Clients seek Kim out for two reasons. 

[MUSIC – Miraculous – Vince Gabriel]

 

Some, like Brittany whose water birth you heard last episode, have traumatic hospital births or bad experiences in hospitals. Others, like Monica, have a different vision of childbirth; they want a more intimate, comfortable, spiritual experience at home. 

 

TIKTOK Monica: She really informed me on everything that I need to know, it was very intimate…not to mention the spiritual and emotional support I got from her… 

 

As I watch the visit, I notice the way Kim talks to Monica. She always starts with an open-ended question. 

Their conversation seems like a chat between girlfriends, At times, they are laughing and joking with each other. But serious work is happening here. Kim is taking a detailed medical history. And she’s coaching Monica on how to assess her own health.

 

Kim Homer: So it’s about connecting the dots when it comes to your body because we’re so disconnected. We go to these medical systems and we say, “Here, you tell me what to do with my body. And if you say I’m okay, I’m going to believe I’m okay. If you say take that pill, I’m going to just go ahead and take that pill.” But I want you to understand everything that’s going on.

Kim works with her clients to strengthen their intuition, a skill they’ll lean on for the first nine months, during delivery, and all the days after.  

 

Kim Homer: I want to make sure with first-time moms, they’re connected. Because, especially if they started off with an OB, nobody’s asking them that. So that’s also a way to affirm them. Because with your first pregnancy, being that every sensation is new, you have a lot of questions. You just don’t know what they are until you’re engaged in conversation. And then it’s like, “Oh, really? That makes sense.”

[MUSIC: Miraculous – Vince Gabriel ends]

 

Prenatal care helps keep a pregnancy healthy. It gives a medical provider a chance to screen for conditions, like diabetes, or behaviors, like drinking, that could harm the birthing person or their baby. 

Not receiving prenatal care or getting it later is linked to having complications in pregnancy. 

Nationally, Black women are nearly twice as likely as white women to give birth with late or no prenatal care. 

Many of us face barriers to accessing quality prenatal care, including cost. And the way hospital doctors, nurses, and staff often treat — or mistreat — Black women can discourage us from seeking and continuing care altogether.

What makes Kim’s care so powerful is how warm and open Kim and Monica are with each other even as they venture into what could be uncomfortable territory… 

Like when Monica tells Kim about her smoking history. I get the sense it was weighing on her. She smoked  before she knew she was pregnant,  and that upset her. 

Kim reminds Monica she did her best; she quit as soon as she knew she was pregnant. 

[MUSIC: Fine Detail –  Paul Lawler]

 

What is going on between these women blows my mind. First, Monica feels safe enough to share this. Second, Kim doesn’t scold her. She validates Monica. 

See, shame and fear of judgement are reasons why pregnant people don’t share sensitive personal information with their providers.  

That shame can lead to isolation and higher rates of depression and anxiety. It can also prevent providers like Kim from being able to fully care for their patients.  

 

Kim Homer: You have to acknowledge.And then give them a safe space to talk about it. Because that’s their story. Let them tell their story.  

[MUSIC: Fine Detail – Paul Lawler fades under and out]

 

Once the subject turns to nutrition, my ears perk up. Monica mentions that she stopped taking her prenatal vitamins because they made her constipated. 

She replaced them with vegetables and herbal teas. 

After getting a full picture of Monica’s diet, Kim supports the decision. It’s one Kim would have recommended herself. 

Nutrition comes up a lot during my interviews with Kim. She cooks with her clients, calling it culinary support. It’s her way of helping her clients improve their health. 

[MUSIC: Sundrops – Megks]

 

As much as pregnancy can be an exciting time for a family, it can also stress them out, stretching or breaking their relationships and finances. Kim is sensitive to this. 

During the visit, she asks Monica about her mental health and her marriage. Monica says she and her husband have been together since high school. 

Like Kim, they recently moved from Miami to be back home in Jacksonville.  

Her husband was able to find work nearby at the docks. They were finding their footing again and looking forward to having their first baby 

This is not small talk. Kim is taking in all of the details, trying to understand Monica’s world — and the support she will need as a new mom. 

It makes sense that these home visits are an hour, sometimes two, sometimes more. 

Because in this moment, Kim is offering more than medical services.  She’s offering love and support. Deep care.

 

Kim Homer: I was her guide. I was her midwife. I was her friend. I was the auntie. I was whatever she needed me to be in whatever moment.  erdf

[MUSIC: Sundrops – Megks ends]

 

Watching Kim and Monica’s visit made me look back at my pregnancy. I can’t help thinking: damn, no one gave me that kind of care. And almost no one gets that kind of care today.   

[MUSIC: Imagined Reality – Paul Lawler]

 

My prenatal appointments were in and out, 15 minutes max . They checked my weight, my blood pressure, measured my belly, and sometimes they did blood tests.

My doctor didn’t ask me about my diet or exercise. I don’t drink alcohol now, but I did in the first month of my pregnancy. Though I stopped for the sake of my baby, I didn’t want to. 

But my OB and I never had that conversation about my drinking or my family history of alcoholism.  

There was no space for it. And that prevented me from getting the care that could have helped me years later.  

[MUSIC: Imagined Reality – Paul Lawler ends]

 

Throughout my prenatal care, it truly felt like my doctor didn’t have time for my questions.  

Heck, I was a doctor, and I didn’t know what questions to ask. My guide was the book, “What to expect when you’re expecting.”

I felt alone. 

In a typical medical practice, the doctor is the sun and the patients are the planets that orbit them. 

[MUSIC: Molecules – James Spilling]

 

The doctor acts like the sole expert on the patient’s health and patients are expected to depend on doctors. 

So you can understand how as a physician, this prenatal visit between Kim and Monica stood out to me! It was a different approach to care than anything I was taught or knew to be true. 

In the community midwifery model, the client is the sun, and midwives and their collaborators orbit them. The midwives see themselves as support for their clients. 

Midwives have their expertise on healthy pregnancies, but the clients also have expertise. Clients are experts on their bodies, on their lives, and what they want for their pregnancy and childbirth.  

[MUSIC: Molecules – James Spilling ends]

 

Kim is providing for more than just Monica’s physical needs during her pregnancy. She’s caring for Monica’s full self. 

In addition to following state regulations for who she can care for, and who is eligible for a home birth, Kim has additional standards for the clients she takes on. 

She wants clients who will take responsibility for their health, who will see her as a partner and level with her. 

[MUSIC: Land of Dreams – Vince Gabriel]

 

Kim Homer: I had a mom in care. And I remember it was in October when she took her kids trick-or-treating, and she fell and didn’t tell me. She literally fell on her abdomen and didn’t tell me. Didn’t even go to a hospital. And she didn’t tell me that until one of her kids told on her at a visit we had three weeks after the fall. So you don’t have the same intention that I have when it comes to making sure that you’re okay. So therefore, this isn’t going to work out

 

This is a delicate balance between patient autonomy and safety that Black community midwives fiercely protect.

[MUSIC: Land of Dreams – Vince Gabriel ends]

 

When Kim does have a collaborative partnership with her clients, like Monica, 

[MUSIC: Jimit – Feel Better]

they work together to build a healthy, safe pregnancy.  

 

TIKTOK Monica: I will say I feel so much more comfortable about having this at-home birth after visiting with her…

 

Before the prenatal visit wraps up, Kim and Monica develop an emergency plan. Monica and her husband are planning for a water birth at home; Kim is preparing for every outcome. 

 

Kim Homer: We  establish an emergency care plan that we go through at the beginning of the third trimester. And it has their closest hospital in case of an emergency where we really don’t have much time, or we have a favored hospital that we both agree to. I give them like a hour bootcamp class of what to expect and how to advocate. 

[MUSIC: Jimit – Feel Better ends]

 

Together with their clients, Black community midwives hold all of the stress of pregnancy, and plan for all of the potential risks.

This takes some of the pressure off of Monica. She’s in control of her pregnancy, but she knows someone has her back. 

[MUSIC: Adam Amalfi – Knowledge]

 

TIKTOK Monica: And I’m not gonna lie y’all I did good this entire pregnancy but this last month is really taking me out!

 

At the end of the appointment, Kim gives Monica a fetal doppler exam right there on her couch. 

She presses the wand to Monica’s belly, and the sound of her baby’s heartbeat fills the room. 

[SFX: Ultrasound heartbeat fades in]

 

From where I sit, I see Monica’s face light up with tenderness. I can almost cry. 

Kim is preparing Monica for more than birth, but rather for a new chapter in her life and legacy.  

[SFX: Heartbeats fade out]

 

Kim Homer: It means a lot to be able to connect with the families and also see the families connect with themselves … the most human thing someone can do is bring life into this world. And how you come into this world is a major part of your foundation. And for every mom, I’d tell them that you’re not just birthing your baby, you’re rebirthing yourself. 

[MUSIC: Adam Amalfi – Knowledge ends]

[SFX: Chime tone from top returns]

 

After the visit, Monica, Kim, and I head to the elevators. We ride down to the lobby. That’s where we run into James., the doorman.

I try my best to describe to James what I saw. The depth of the care that flowed from Kim to Monica. The kind of care I wish I learned as a physician. Care I wish I had during my pregnancy. Care I want for all pregnant people. 

[MUSIC: Deep Care gentle theme]

 

James says that he remembers hearing of midwives back in the day.

He also remembers they used to take care of the whole family. 

Until now, he didn’t even know midwives were still around. 

And that’s when Monica gives it to him straight: Midwives, They’re coming back. 

 

In the next episode, we’ll head to a birth center in Los Angeles, where Black community midwives are taking care of the whole family.

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