In 2023, Affinia Healthcare launched a campaign to encourage the state legislature to extend Medicaid coverage for new mothers from three months to a year postpartum. Missouri has one of the worst maternal mortality rates in the country and research shows that most deaths occur in the 12 months after childbirth, and most can be prevented.

The legislature voted to extend coverage up to a year postpartum to new mothers but there are still challenges. In North St. Louis County, DePaul Health Center is the only hospital where women can deliver their babies.

This leaves a void for women – many who are African American – for women’s health care, especially prenatal and gynecological care. When Affinia Healthcare opened its new Ferguson location, it added midwifery to its service offerings to help close this gap in care.

“We hear a lot of talk about health disparities and ‘closing the gap,’ but we have to do something about it,” said Dr. Kendra Holmes, Affinia Healthcare President & CEO. “Our recent community needs assessment showed that the demand for services in North County outweighed the supply, especially for women’s health. The addition of midwifery increases healthcare resources for women and infants in this community.”

Certified Nurse-Midwives Tirae Abernathy, Hali Ledet, and Marsha Hill joined Affinia Healthcare in 2023 and have hit the ground running. Abernathy and Ledet are working at the new Ferguson location; Hill is seeing patients at Ferguson and the S. Broadway locations.

“Midwives are trained healthcare professionals who take care of people from ‘menarche through menopause (or from their first period through the rest of their life),’ and specialize in caring for people during pregnancy, birth, and the postpartum period,” said Abernathy, Certified Nurse-Midwife and Family Nurse Practitioner with Affinia Healthcare. “Midwives also take care of healthy newborns through 28 days of life.”

The Certified Nurse-Midwives provide birthing services, along with prenatal, well-woman, gynecological, and infant care. And since Abernathy and Ledet are also family nurse practitioners, they can also provide general medical care for children and adults.

Abernathy grew up in North St. Louis County, and earned her bachelor’s degree at Vanderbilt University in Nashville, Tenn. While an undergraduate, Abernathy discovered her passion for working to address and eliminate racial disparities in maternal and infant health. This led her to return home to pursue a master’s degree in Public Health with an emphasis in Maternal Child Health at Washington University in Saint Louis. She then earned another master’s degree, this time in Nursing from Vanderbilt University School of Nursing and became a Certified Nurse-Midwife and Family Nurse Practitioner.

     Originally from Lafayette, La., Ledet received her bachelor’s degree in public health and her master’s degree in Public Health/Maternal Child Health from Tulane University in New Orleans. In New Orleans, she developed her passion for reproductive justice and health equity and found her calling as a birth worker. She then earned her second master’s degree, this one in nursing from Vanderbilt University and became a Certified Nurse-Midwife and Family Nurse Practitioner. Ledet is committed to meeting the holistic health needs of individuals and families across the lifespan, addressing racial disparities in health outcomes, and providing compassionate, high-quality care for LGBTQIA+ folx.

Hill is a St. Louis native who earned bachelor’s degrees in Nursing and French from Missouri Southern State University. She continued her studies in Nursing (specializing in Midwifery) at the University of Illinois-Chicago where she earned her master’s degree. A healthcare professional with more than 20 years in maternal-child healthcare including 15 as a nurse-midwife, Hill has extensive experience in hospital and birth center settings.

With the need for more midwives in the Midwest region growing, adding Midwifery was a logical addition to Affinia Healthcare’s services for women and families.

“There’s definitely a shortage of midwifery care in the Midwest in general and has grown in St. Louis over the last six to eight years,” Hill said. “There are more women of all colors asking for midwifery services. Women of color have been stepping up to take hold of their health care, pregnancies and families and are demanding something better,” she added.

In addition to Midwifery, the Affinia Healthcare team includes obstetricians/gynecologists, family physicians, nurse practitioners, nurses, medical assistants, community health workers, and doulas. Affinia Healthcare also offers both traditional prenatal appointments and group prenatal care. The Affinia Healthcare OB/GYN team was awarded the 2023 Standing Up for Black Moms and Babies Award from Generate Health St. Louis.

Research shows that many Black and Brown women experience poor medical treatment based on one primary reason – racism. Maternal deaths for Black women cross age, income levels and education attainment. The addition of the Midwifery services is one way Affinia Healthcare is demonstrating its commitment to eliminating the health disparities for women by beginning with a simple act – by honoring their humanity.

“[Birthing people] deserve to be listened to,” said Ledet. “They deserve to be heard.”

For more information about the Midwifery program with Affinia Healthcare, visit www.affiniahealthcare.org. To schedule an appointment, call 314.814.8700.

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CAPTION #1: Certified Nurse-Midwife Hali Ledet examines a patient at the Affinia Healthcare location in Ferguson. Midwifery is offered at the Ferguson and South Broadway locations.

CAPTION #2: Certified Nurse-Midwives Tirae Abernathy, Hali Ledet and Marsha Hill shown here with Affinia Healthcare CEO & President Dr. Kendra Holmes at a recent event at the Missouri History Museum. Midwifery care is now offered at Affinia Healthcare at the Ferguson and South Broadway locations.