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Commonsense Childbirth

Jennie Joseph, LM, CPM, RM(UK)
Link to The NPTF Maternal Task Force Report 2018

The JJ Way® is a comprehensive maternity care model that was designed by midwife Jennie Joseph, owner and executive director of Commonsense Childbirth Inc. to address healthcare disparities in maternal and child health, and perinatal outcomes in Orange County, Florida.

The JJ Way® is implemented through the Easy Access Clinic and ‘The Birth Place’ birthing center in Orlando, which provides high quality prenatal and postnatal care, birth services and support, as well as educational and social support services to women, regardless of their choice of delivery site or practitioner, their citizenship or insurance status, or their ability to pay.

 

Overview of the JJ Way®

The goal of The JJ Way® is to achieve positive pregnancy outcomes for all. However, particular efforts are made to reach low-income and marginalized people who are uninsured or underinsured; or who are at risk for a poor birth outcome due to the social determinants of health, and the institutional and structural discrimination inherent in current health care systems in the USA.

We achieve this goal through consistently applying four cornerstones: access, connection, knowledge, and empowerment. 

The JJ Way® provides 100% access by turning no one away from care. This is true even in the 3rdtrimester when women seeking prenatal care for the first time are often refused by other healthcare practitioners.

Practice

The Birth Place is a freestanding birthing center but The Easy Access Clinic specifically provides care for women who choose an in-hospital birth and will deliver with resident physicians, or staff nurse-midwife and physician hospitalists/laborists teams. The clinic provides all prenatal, postpartum care and some interconception/well-woman care inside of this collaborative model, but our own midwives do not have hospital privileges.

Over the last three years, between both sites more than 900 unduplicated new patients were seen and approximately 5000 individual health care visits were delivered annually. The birth center provides continuity-care and on-site delivery for an average 60-80 low-risk patients annually from this population.

Data

Link to The JJWay 2018 Evaluation Report

Our data has shown a consistent reduction in preterm and low birth weight babies among African American women in the practice, compared to women of similar demographics in Orange County and the state of Florida.

Additionally, Black women in the program have had less morbidity through their pregnancies even when presenting with chronic medical conditions such as obesity, diabetes or hypertension. Reaching full-term, prepared for labor, postpartum and breastfeeding, fully educated and empowered, with support for their own choices has shown that such agency creates the difference between life and death for women who are at-risk.

Among a population of women who typically experience a 13-20% prematurity rate, we have succeeded in maintaining a less than 5% prematurity rate since 2006. Our average gestational age at birth is 39 weeks, and average birth weights are 7- 8 lbs. Our cesarean section rate is 10% lower than others delivering at local hospitals, suggesting that our patients are able to advocate for themselves when their goal is a natural birth.  92% of the women have breast-fed at birth and our African American rate surpasses that of white women in the state of Florida and the USA.

Impact

The impact of turning around perinatal statistics that have been consistently intractable is huge. Our program speaks to the difference in outcomes when a model focused on health equity, cultural-humility, and respectful patient-centered care is implemented.

Reducing Perinatal Outcomes Poster JJWay

Here is the youtube of a recent CBS news piece.

https://www.youtube.com/watch?v=47m9P7eqv44&t=30s

 

Jennie Joseph LM, CPM Executive Director
Commonsense Childbirth Inc.

 

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