Film Screening of 'American Delivery' Marks National Nurses Week

More than any other wealthy nation, American women and their infants are more likely to die before, during, or after childbirth. And well over half of all deaths - by some estimates, as many as two-thirds - occur during the postpartum period.

Those facts, as well as how nurses, midwives, and doulas are central to solving the American maternal mortality crisis, were discussed after a May 6 screening of the film, "American Delivery: Solving the Maternal Mortality Crisis in U.S. Healthcare," by director Carolyn Jones, at UVA School of Nursing's McLeod Auditorium, which drew nearly 90 attendees.

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More than half of maternal and infant mortality deaths occur during the postpartum period

The challenges driving the American conundrum of maternal and infant mortality, said the panelists, are many: suspicion and fear of traditional healthcare systems, stressors brought on by social determinants of health, and a pervasive belief that giving birth requires heavy intervention from the medical establishment, even in case of normal, healthy pregnancies.

"Many people, when they get pregnant, their automatic response is, 'I'll go to an OBGYN,'" said midwife Kate Becker, division director of UVA Health Midwifery, a care team of seven midwives that works in concert with other maternal health team members, one of six panelists at the event. "We're fortunate here at UVA that we have a robust midwifery service with tons of support and OBGYN colleagues who help get patients the best provider for them, which is often a midwife."

Other panelists, including Doreen Bonnet, co-founder of Birth Sisters of Charlottesville, a doula collective serving women of color, expressed appreciation for UVA Health's midwifery team and the supportive approach that they champion that, she said, "says, 'I'm here, but the mother can do this,' and taking a step back."

"In our community," said panel moderator Pamela Cipriano, president of the International Council of Nurses, two-term president of American Nurses Association, past dean of UVA School of Nursing, and a professor emerita, "we're fortunate that we're enlightened to recognize that the team of doulas and midwives are really important."

Panelist Emily Evans, assistant professor and a maternal health nurse practitioner, pointed to the positive example of other countries' deployment of midwives to support people before, during, and after giving birth. She also said in the United States, there aren't enough midwives and doulas.

"Unfortunately, as the film points out, people are limited to the providers available to them in their areas," said Evans, "and, because of that, my focus is to help the individual feel empowered and educated, so while they're going through the [birthing] experience, regardless of the provider they're connected with . . . [they're] understanding the process their bodies are going through and feeling confidence about their ability to deal with it, and learning to kind of trust the process."

"Sometimes, you see the medical community try to exert control over [birth]," Evans added, "and moms try to exert control over it, but by its very nature birth is an uncomfortable process where you're following something and trying to catch up, rather than direct it. [Physicians and the healthcare community] have to have it within them to make it a great experience regardless."

Assistant professor Karen Jefferson from the UVA Health Department of Obstetrics and Gynecology, called out her colleagues' "spirit of excellence," and "desire to give the best care to their patients," while noting that "there needs to be some more collaboration with the patients who are seeing the physicians and medical students and residents" and "more mental health support in the postpartum period especially."

"Teaching nurses who are already practitioners about this relationship building" is also key, as is "listening, listening, listening to the mothers we care for."

Karin Skeen, associate chief nursing officer, UVA Health

Associate chief nursing officer Karin Skeen acknowledged that, while UVA Health and American healthcare systems have room to grow and improve, "it's a journey."

"I'm proud of how we're doing now, compared to a decade ago, but we haven't caught up yet," said Skeen. "There's a lot of relationship-building that has to happen. We work hard to have doulas, but we need more of them. We work hard to have diversity on our nursing team, but that isn't always easy, because we often don't have diversity in nursing schools in many areas."

"As Black women, because of what we've faced being in this country, we're not accustomed to having people take care of us," said Bonnet, when discussing how best to connect with clients about receiving postpartum support. "So we're learning how best to support them and meet them where they are while at the same time helping them understand that they really do need the help and support."

Initiatives panelists posed seemed small, but had potential to be mighty. In addition to awareness and funding, they focused on trust and connectivity.

"As Black women, because of what we've faced being in this country, we're not accustomed to having people take care of us. So [our organization is] learning how best to support them and meet them where they are while at the same time helping them understand that they really do need the help and support."

Doula Doreen Bonnet, co-founder of the Birth Sisters of Charlottesville, a doula collective for women of color

"Continuous care and social support from a practitioner can take a lot of different shapes," said Evans, who studies prenatal and postpartum support. "It might be a home visit, it might be a routine check-up, it might be more frequent care, it might be a simple telephone call. The important thing is that continuous effort to connect . . .  and any way we can provide that, whatever works for the community and individuals, there are a lot of creative ways to do it."

"My biggest role is teaching new nurses," added Evans, "and helping them understand the pivotal role they play in whatever place they interface with a client in. And to understand that they're one piece of the picture. Often, the most important care they give is the interpersonal piece: 'I'm here for you. Don't be anxious. I'm not going anywhere.'"

Added Skeen, "Teaching nurses who are already practitioners about this relationship building" is also key, as is "listening, listening, listening to the mothers we care for."

Panelists

• Kate Becker, CNM, midwife and division director, UVA Midwifery, UVA Health Department of Obstetrics and Gynecology
• Doreen Bonnet, co-founder of Birth Sisters of Charlottesville
• Emily Evans, PhD, RN, WHNP-BC, assistant professor and women's health nurse practitioner, UVA School of Nursing
• Karen Jefferson, MD, assistant professor, UVA Health Department of Obstetrics and Gynecology
• Karin Skeen, PhD, RN, UVA Health associate chief nursing officer
• Pam Cipriano, PhD, RN, FAAN, International Council of Nurses president, professor emerita, UVA School of Nursing, and event moderator

The screening - which marked the School's celebration of National Nurses Week 2025 - was co-sponsored by the UVA School of Nursing, UVA Health University Medical Center chief nursing officer Kathy Baker, and the UVA Health Department of Obstetrics and Gynecology. 

About

In the U.S.—where more women die in childbirth than any other wealthy nation—the joys of pregnancy and motherhood are often overshadowed by fear. Amid a growing maternal health crisis, especially for women of color, American Delivery is a documentary that tells the story of the glimmers of hope: women finding their voice and autonomy; nurses listening to women and offering birth choices; and hospital leaders welcoming the community as the patient. The film interweaves the stories of women and their families across the U.S. as they navigate the challenges of pregnancy, mental health, childbirth, and the postpartum period. It paints a joyous portrait of the moment babies come into the world, and the heroic efforts of families and communities to catch new mothers before they fall through the broken maternal health safety net.

Our filmmaking team has spent the last 12 years uncovering stories of nurses dramatically impacting our health and healthcare in the United States, using personal storytelling to help the public understand the impact of nurses as a collective professional body. We have an opportunity right now to shine a light on the catalysts who are changing the global landscape of maternal and infant health.

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