The CHOICES Black Midwifery Fellowship: An Innovative Model for Training Midwives in Reproductive Justice and Community-Centered Care.

Abstract

The CHOICES Black Midwifery Fellowship Program is an exemplar of a transformative postgraduate model in midwifery education that extends beyond traditional training frameworks. The program is designed around 5 core pillars: full-scope reproductive health services education and training, Black feminist thought, leadership and mentorship, neonatal and postnatal care, and community and patient-centered care. By embedding these frameworks into the curriculum, the fellowship challenges the prevailing medicalized approach to birth that often neglects the unique needs of marginalized communities. This perspective equips fellows with a critical understanding of the social, political, and economic factors that influence health outcomes, enabling them to advocate effectively for their patients and communities. In addition to improving clinical outcomes, the fellowship has also played a crucial role in restoring trust between Black birthing people and the health care system. Historical injustices and ongoing systemic racism have led to deep-seated mistrust of mainstream health care institutions among many Black communities. By training Black midwives who understand and share the cultural and lived experiences of their patients, the CHOICES fellowship helps to bridge this trust gap. Fellows are taught to adopt a patient-centered approach that prioritizes informed consent, shared-decision-making, and respect for cultural practices. In this article we outline the structure, curriculum, and training activities of the CHOICES Black Midwifery Fellowship. Additionally, we review the challenges encountered and lessons learned during the implementation process.