Guest Blog Post By Tanya Smith-Johnson, Midwife, Visionary, Strategist 

Introduction: A Story of Erasure

When Americans talk about the Gulf Coast, the conversation almost always turns to New Orleans. We talk about jazz, parades, Mardi Gras, and, of course, Hurricane Katrina. The storm’s devastation in New Orleans twenty years ago remains etched into the national memory.

But what about Mississippi? What about Alabama? What about the small coastal towns that never made it to the headlines, where whole communities were wiped away?

Katrina’s story, as it is told in the national imagination, is one of water rising in the Lower Ninth Ward when the levees broke. We rarely, if at all,  hear the story of coastal Mississippi or that it was the eye of the storm and where it came ashore. We forget that the storm surge in Mississippi reached 28 feet and destroyed entire counties. Families lost not just homes but livelihoods, schools, and ways of life. Many coastal Black communities, including historically Black neighborhoods in Biloxi and Gulfport, were devastated and slow to recover if they did at all. Alabama’s Gulf Coast also suffered, yet their grief was quickly overshadowed.

Mississippi, Louisiana, and Alabama are part of the U.S. “Black Belt”, a region with deep historical roots in Black life, culture, and political history due to enslavement, Reconstruction, and the Great Migration. These states remain central to Black Southern identity and political power. They are also the Blackest states in the nation . With Mississippi being the state with the Blackest state by percentage .

This is the pattern: when the Deep South , in particular in the Black Belt, suffers, the nation looks away. That erasure is not only geographic. It is medical. It is maternal. It is happening right now in the lives of women and babies across Louisiana, Mississippi, and Alabama.

Part 1 : The Forgotten States of Maternal Health

The statistics are devastating.

- Mississippi has the nation’s highest maternal mortality rate: 64 deaths per 100,000 live births. For Black women, the rate is nearly three times higher.
- Louisiana is close behind, with a maternal mortality rate of about 58 per 100,000—again, with Black mothers disproportionately represented.
- Alabama reports more than 40 deaths per 100,000, and in many rural counties there are no maternity services at all.

Behind every number is a birthing person , a child, a family. In the Deep South, it means driving hours for prenatal appointments or going without care altogether. It means babies born too soon because their mothers couldn’t access consistent support. It means preventable deaths that rarely make the news.

In recent news cycles , a report was shared about the state of maternal and infant health in Mississippi. It has many people shocked and surprised but doe those of us on the ground this wasn’t news. There have been canaries in the coal mines for decades.. centuries even. But we fail to listen or care . 

When and if national media and policymakers talk about the “maternal health crisis,” they often focus on Texas, Florida, or Georgia if they talk about the South at all.  Those states deserve attention, but the story of maternal health in the Deep South.. the Black Belt and especially along the Gulf Coast, is just as urgent and far more neglected.

Part 2 : The Midwives Who Carried Us

Ironically, the Black Belt is also the cradle of Black midwifery. For centuries, “granny midwives” tended to births in Louisiana, Mississippi, and Alabama. These women were the precursors to doctors, nurses, counselors, and pharmacists for their communities. They were the healers, care providers , herbalists, spiritual guides and anchors of our communities.

Their practices drew on African knowledge, Indigenous plant medicine, and generations of lived experience. They delivered babies in cabins and cottages, by lamp and candlelight. They listened, prayed, and cared for women who had no access to hospital…because hospitals excluded us.

By the 1970s, state legislatures and medical boards began passing laws that effectively criminalized midwifery. Framed as “modernization,” and told they were unsanitary and untrained, although doctors sat at their feet to learn their ways. These restrictions stripped communities of their primary birth workers. What was lost was more than a workforce, it was a culture of respect for women’s bodies, a trust in natural processes, and an anchor of communal care.

The maternal health crisis we face today in the Gulf Coast is not an accident. It is a direct result of dismantling the systems of care that sustained us.

Part 3 : Storms and Systems

Disaster is not only natural—it is political. Katrina made that clear. The storm revealed what happens when the states abandon their communities. That lesson applies equally to maternal health.

Every hurricane since has shown how fragile our health infrastructure is in the Gulf South. Hospitals close, clinics shutter, and families are left to fend for themselves. Maternal health is like the quiet storm : devastating, ongoing, and ignored.

Just as with Katrina, the people most affected are Black, poor, rural, and already marginalized. And just as with Katrina, their suffering is too often invisible to the rest of the nation.

Part 4: Why the Deep South Midwifery Initiative Exists

I am a midwife, a mother of six, and consumer of midwifery care. I know what’s possible . I have been on national stages talking , presenting and begging for attention , interest and resources for the Deep South. But after too many blank stares , I knew it isn’t enough and I have to just do what I feel needs to be done . So I visions , creates and birthing the Deep South Initiative. My role as the President of a midwifery college enables me to birth what we need. This work was created because I could not ignore what I was seeing :

- Families forced to drive two or three hours for prenatal care.
- Black women dismissed when they described symptoms.
- Aspiring midwives who wanted to serve their own communities but had to leave the state to get trained.

The Deep South Initiative exists to change this. We must train midwives where they are needed. We must reclaim the legacy of Black midwifery. We must build infrastructure for maternal health equity in the very places long left out of the national conversation.

This is not charity work.. it is justice. It is what is owed to the Deep South. It is what I can give . If we can transform maternal health outcomes in Louisiana, Mississippi, and Alabama, we can prove that change is possible anywhere.

Part 5 : Why the Nation Should Care

Some may ask: why focus on the Deep South? Why not center the places already receiving attention and resources?

The answer is simple: because the Deep South is the frontline.

If we cannot save mothers and babies here… where poverty, racism, rural isolation, and political hostility intersect…then we cannot claim to be serious about saving them anywhere.

The Gulf Coast is not disposable. The Deep South is not expendable. If maternal health equity means anything, it must include the forgotten and neglected states of Louisiana, Mississippi, and Alabama.

Conclusion: Remembering the Gulf Coast

Twenty years after Katrina, the national narrative still leaves out Mississippi and Alabama. The anniversary brings back the images of flooded streets in New Orleans, but not of entire counties in Mississippi flattened by storm surge.

The same erasure plays out in maternal health. The nation remembers certain stories, certain places, certain women. But it forgets the women of the Deep South, whose lives are just as precious, whose babies are just as worthy, whose communities are just as deserving.

We cannot afford to keep forgetting.

As a midwife, mother, and descendant of the enslaved on this soil, I know the truth: we are not forgotten. It will take lots of work and investment to make a dent in things. But we can follow the blueprint of those who came before us laid out for us.  Fannie Lou Hamer taught us! 

Mississippi, Alabama, and Louisiana, has been a powerhouse of Black activism that shaped the national Civil Rights Movement, Black freedom struggles, and grassroots organizing traditions. Resistance and activism movements were forged in the Deep South with Mississippi being the darkest and bloodiest battleground. And that remains the same today. 

But through focused strategic intention and a willingness to fight  where we are needed the most can ensure that every mother and every child in the Deep South is remembered and properly cared for .