Mississippi Today
Q&A with midwife Janice Scaggs
When Janice Scaggs joined the University of Mississippi Medical Center in 2020, she became part of a growing effort by the state’s largest public hospital and academic medical center to reintroduce midwifery into Mississippi’s maternal health care.
Certified nurse-midwives like Scaggs are educated in graduate-level midwifery programs and also hold an active registered nurse credential at the time of certification.
In the last three years, Scaggs, as the hospital’s only midwife, attended a little over six percent of births at UMMC each year.
In June, a second certified nurse midwife, Kim Rickard, joined the team. As part of the nurse midwifery clinical advisory committee, she and Scaggs plan to integrate a minimum of eight new nurse midwives into UMMC hospitals and clinics to offer round-the-clock midwifery care by 2027.
Midwives advocate for autonomy and comfort over efficiency for their patients, and have been proven to decrease unnecessary interventions such as cesareans in low-risk mothers – thereby improving morbidity and mortality, as well as postpartum mental health, and lowering the overall cost per capita of care.
Doctors and OB-GYNs are experts when it comes to abnormal pregnancies, Scaggs explained, but they don’t always know how to stand back and let a normal physiological birth unfold.
“Midwives … are the experts in normal, and have always been educated on a patient-centered model of care, really advocating for the patient and family, and empowering them,” she said.
Unnecessary cesareans and their increased use in Black pregnancies are not only a large contributor of preventable maternal deaths, but also a large contributor of maternal health disparities. Maternal mortality and morbidity after emergency cesarean birth is nearly 5 times than after vaginal birth.
Midwives are proponents of simple, but successful, low-intervention practices during labor – such as mobility and intermittent auscultation, or a technique of listening to and counting fetal heartbeats for a short period of time during active labor.
Editor’s note: This interview has been edited for clarity and length.
Mississippi Today: The term “midwife” translates to “with woman.” How do you see your role as a midwife, and how does it differ from that of, say, a doctor?
Janice Scaggs: We have so many similarities that sometimes that’s a really difficult question, but then on the other hand it’s really not.
If you look at the midwifery-led model of care, it really focuses on the individual, on putting them at the center of care, midwives being advocates for their patients and families – they want to empower the woman.
We focus on normal and healthy, certainly recognizing the abnormal. I look at us as the experts of that normal (births), whether it’s OB care, birthing, or gynecologic care, as well as family planning. I would say that that differs from our physician colleagues, because they really are focused on what the abnormal is, and they are experts when things are not going right.
MT: Tell me about the evidence around midwife-led care in reducing maternal and neonatal morbidity and mortality.
Scaggs: It’s well documented in other countries where midwifery is integrated into the health care system that it improves outcomes. We now have some good evidence in the U.S. to look at those evidence-based benefits, as well, including decreasing unnecessary interventions, improving the overall outcome of health – mental health as well as physical health – and decreasing the cost of health care, as well.
We increase breastfeeding rates, decrease preterm birth rates, and then (use) that approach of not using intervention unless absolutely necessary. We end up not performing interventions that can lead to morbidity, when maybe they didn’t need to be done, such as an unnecessary primary cesarean section.
MT: So, in today’s world, more women give birth in hospitals, and around technology, than ever before. But that hasn’t necessarily led to better outcomes. We know that because of infant and maternal mortality rates, and also high cesarean rates – across the country but particularly in Mississippi. Tell me about your non-pharmacological approach to birth and your philosophy around that.
Scaggs: I look at non-pharmacologic support as being an option that can either be done on its own or can be integrated with medical technology and pharmacologic options for women, as well. So they don’t have to stand separated.
But if we’re focusing on non-pharmacologic, we know from research that mobility, upright positions in the first stage of labor, decreases the length of labor, it decreases other interventions, it decreases cesarean rate. It improves comfort for moms who are trying to cope with labor without pharmacologic methods.
So, giving women permission and opportunity to move in labor – they will and they want to. If we put them in a bed and don’t encourage them to move, they won’t, because they feel unempowered, they don’t feel like they can safely move around.
That non-pharmacologic approach to giving women options, having them understand they are safe options in most settings, and we’re talking about primarily low-risk births with midwives. And then looking at things like acupressure points can be extremely helpful, using heat and cold in different aspects can be helpful. Touch – we know that there’s therapeutic touch for all aspects of health care, and that includes in labor and birth.
Using things like birthing balls when women are either in the bed, when they may be tired, either with epidurals or without epidurals, for positioning, can be extremely helpful in opening the pelvis to its most optimal position so that the fetus can get into the most optimal position. Babies come out a lot easier if they are head down and looking down, in relation to mom’s body, as opposed to what I would call sunny side up or coming down a little bit crooked. Changing the shape of the pelvis and having mom moving, whether it’s in the bed or out of bed, does lead to better outcomes, insofar as getting baby in a good position and having a faster labor.
It als just helps mom to cope better. When you’re hurt, you want to move. And if women stay in one position and don’t move, then we know that they’re not going to cope as well. I always talk to students and moms about how part of my job is to help you recognize when you’re suffering and to help you cope and to limit suffering. We know that doing that for women in labor actually improves our mental health outcomes and in the postpartum period it decreases anxiety and depression. And we know that that is something we should all be focusing on, and we’re just beginning to see more attention to that mental health aspect of the process of labor and birth.
MT: So, midwives primarily use intermittent auscultation, as opposed to electronic fetal heart monitoring, to listen to fetal heartbeat. Can you explain the difference between the two and how EFM can increase one’s chances of an unnecessary cesarean?
Scaggs: Continuous electronic fetal heart monitoring has two small, round devices – plastic devices that fit on mom’s belly. One graphs on a computer system to show when (the mother) is having a contraction. The other one is a little ultrasound piece. It’s not an ultrasound visually; it’s for hearing. We hear the heart rate, or auscultate the heart rate. And on these monitors, you can have continuous monitoring of the fetal heart rate, as well as uterine contractions.
We introduced this thinking we were going to decrease the overall cerebral palsy rate and we didn’t quite have the evidence to support that. And we have found now, 25, 35 years later, that for high-risk women, it’s extremely advantageous to have continuous electronic fetal monitoring. But for low-risk women, who are in spontaneous labor, who don’t have risk factors, we many times actually offer or perform interventions that aren’t necessary because (the continuous electronic monitoring) really sometimes provides more information than we need to have.
If we use intermittent auscultation, which is using either a handheld little Doppler which is another ultrasound device to hear heart tones, or even the old fashioned fetoscope that looks like the ear trumpet, that we can use to listen on mom’s belly. We listen before a contraction, throughout a contraction and one minute after the contraction, and we do that every 15 minutes during labor and five minutes during active labor and every five minutes when they’re pushing. And in doing that, if we hear anything abnormal we then can transition to more continuous monitoring to find out how the fetal heart is and to assure that we actually have a healthy baby. But you’re not having to be strapped down and continuously monitored. It may be that if everything sounds good and normal, that you never have to utilize the continuous electronic fetal monitoring.
MT: Tell me more about that relationship between a traumatic birth and postpartum depression.
Scaggs: Well, I can’t define trauma for somebody else, but if I don’t ask the right questions I’m not going to know if there’s been trauma.
I’ve had women who have come to postpartum visits, who I thought had the most beautiful birth and labor experience ever, and who seemed wonderful, and I find out a couple weeks later that there was something that caused them a trauma – whether it was terminology that was used, whether it was moving forward with a plan that maybe was not clear to them.
I’ve seen women have emergency cesarean sections who really needed them who show no signs of trauma, and then women who have planned cesareans who have trauma related to that. I think there are so many small things we can do to decrease trauma for women and that’s going to be, number one, communicating and finding out what helps them the best, not necessarily ourselves.
And as a provider, of any kind, whether you’re a midwife, a physician, a nurse, you can love your job so much and impose what you think somebody else should need. Being very self aware and self reflective, having humility of the process of labor and birth, is one of the best ways I think we can eliminate severe trauma.
MT: Do you think Mississippi will ever have a birth center? Would that be helpful here?
Scaggs: I think it would be wonderful if we could have regional freestanding birth centers that are supported by nurse-midwives with, you know, appropriate consultation, collaboration and referral to OB-GYNs and maternal-fetal medicine physicians for care as needed.
It would give us a better sense of community support in places where we don’t have as good of access. It could provide prenatal care, as well as care for labor, birth and postpartum period, as well as family planning.
MT: What do you think is needed to shift the paradigm from the hospital model of birth, which relies so heavily on technology, to a model of fewer interventions for low-risk pregnancies and empowering women to give birth according to their own plan when safe?
Scaggs: That’s a big question and I think it has a multifaceted answer. I think it always comes down to: what is the culture for supporting intended vaginal birth? What is the culture for putting women in the center of care? And what the relationships are between health care providers and nurses within a hospital, and support from administration for the type of training that is needed to be able to do things like intermittent auscultation. There’s a specific way to do that. So there needs to be education for nurses to be able to learn that; there needs to be a better nurse to patient ratio. So, we have some workforce issues. There’s also financial issues, educational issues. The bottom line is it’s really difficult to change culture. It takes time.
The more we can lean into family-centered, patient-centered, care, the more we can use the evidence that we currently have around us to improve outcomes.
If Mississippi can integrate midwifery into the health care system, that’s going to be the simplest answer. Who better to change the culture than midwives, who are the experts in normal, and have always been educated on a patient-centered model of care, really advocating for the patient and family, and empowering them, as well. The more we can empower women to have these choices and to understand they have these choices is really going to help.
MT: Is there anything else you’d like to add about midwifery in Mississippi?
Scaggs: I would like to say that I have been very supported within the university and from the chair of the department (Dr. Marty Tucker), to be able to grow midwifery. He’s the one who initially reached out to me when I had moved to Mississippi and was trying to navigate and figure out where jobs were and not finding many. He believes in midwifery being integrated into our model of care.
And I think if we had more physicians and administrators who understood midwifery and were open to hearing about it and really looking at the evidence, that we would have more midwives in Mississippi. But it takes us partnering to do that. I need them, and I need for them to realize also that they need my profession in order to best care for women in the state.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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Mississippi Today
Trump nominates Baxter Kruger, Scott Leary for Mississippi U.S. attorney posts
President Donald Trump on Tuesday nominated Baxter Kruger to become Mississippi’s new U.S. attorney in the Southern District and Scott Leary to become U.S. attorney for the Northern District.
The two nominations will head to the U.S. Senate for consideration. If confirmed, the two will oversee federal criminal prosecutions and investigations in the state.
Kruger graduated from the Mississippi College School of Law in 2015 and was previously an assistant U.S. attorney for the Southern District. He is currently the director of the Mississippi Office of Homeland Security.
Sean Tindell, the Mississippi Department of Public Safety commissioner, oversees the state’s Homeland Security Office. He congratulated Kruger on social media and praised his leadership at the agency.
“Thank you for your outstanding leadership at the Mississippi Office of Homeland Security and for your dedicated service to our state,” Tindell wrote. “Your hard work and commitment have not gone unnoticed and this nomination is a testament to that!”
Leary graduated from the University of Mississippi School of Law, and he has been a federal prosecutor for most of his career.
He worked for the U.S. Attorney’s Office in the Western District of Tennessee in Memphis from 2002 to 2008. Afterward, he worked at the U.S. Attorney’s Office for the Northern District of Mississippi in Oxford, where he is currently employed.
Leary told Mississippi Today that he is honored to be nominated for the position, and he looks forward to the Senate confirmation process.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post Trump nominates Baxter Kruger, Scott Leary for Mississippi U.S. attorney posts appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
This article presents a straightforward news report on President Donald Trump’s nominations of Baxter Kruger and Scott Leary for U.S. attorney positions in Mississippi. It focuses on factual details about their backgrounds, qualifications, and official responses without employing loaded language or framing that favors a particular ideological perspective. The tone is neutral, with quotes and descriptions that serve to inform rather than persuade. While it reports on a political appointment by a Republican president, the coverage remains balanced and refrains from editorializing, thus adhering to neutral, factual reporting.
Mississippi Today
Jackson’s performing arts venue Thalia Mara Hall is now open
After more than 10 months closed due to mold, asbestos and issues with the air conditioning system, Thalia Mara Hall has officially reopened.
Outgoing Mayor Chokwe A. Lumumba announced the reopening of Thalia Mara Hall during his final press conference held Monday on the arts venue’s steps.
“Today marks what we view as a full circle moment, rejoicing in the iconic space where community has come together for decades in the city of Jackson,” Lumumba said. “Thalia Mara has always been more than a venue. It has been a gathering place for people in the city of Jackson. From its first class ballet performances to gospel concerts, Thalia Mara Hall has been the backdrop for our city’s rich cultural history.”
Thalia Mara Hall closed last August after mold was found in parts of the building. The issues compounded from there, with malfunctioning HVAC systems and asbestos remediation. On June 6, the Mississippi State Fire Marshal’s Office announced that Thalia Mara Hall had finally passed inspection.
“We’re not only excited to have overcome many of the challenges that led to it being shuttered for a period of time,” Lumumba said. “We are hopeful for the future of this auditorium, that it may be able to provide a more up-to-date experience for residents, inviting shows that people are able to see across the world, bringing them here to Jackson. So this is an investment in the future.”
In total, Emad Al-Turk, a city contracted engineer and owner of Al-Turk Planning, estimates that $5 million in city and state funds went into bringing Thalia Mara Hall up to code.
The venue still has work to be completed, including reinstalling the fire curtain. The beam in which the fire curtain will be anchored has asbestos in it, so it will have to be remediated. In addition, a second air-conditioning chiller needs to be installed to properly cool the building. Until it’s installed, which could take months, Thalia Mara Hall will be operating at a lower seating capacity of about 800.
“Primarily because of the heat,” Al-Turk said. “The air conditioning would not be sufficient to actually accommodate the 2,000 people at full capacity, but starting in the fall, that should not be a problem.”
Al-Turk said the calendar is open for the city to begin booking events, though none have been scheduled for July.
“We’re very proud,” he said. “This took a little bit longer than what we anticipated, but we had probably seven or eight different contractors we had to coordinate with and all of them did a superb job to get us where we are today.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post Jackson’s performing arts venue Thalia Mara Hall is now open appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Centrist
The article presents a straightforward report on the reopening of Thalia Mara Hall in Jackson, focusing on facts and statements from city officials without promoting any ideological viewpoint. The tone is neutral and positive, emphasizing the community and cultural significance of the venue while detailing the challenges overcome during renovations. The coverage centers on public investment and future prospects, without partisan framing or editorializing. While quotes from Mayor Lumumba and a city engineer highlight optimism and civic pride, the article maintains balanced, factual reporting rather than advancing a political agenda.
Mississippi Today
‘Hurdles waiting in the shadows’: Lumumba reflects on challenges and triumphs on final day as Jackson mayor
On his last day as mayor of Jackson, Chokwe Antar Lumumba recounted accomplishments, praised his executive team and said he has no plans to seek office again.
He spoke during a press conference outside of the city’s Thalia Mara Hall, which was recently cleared for reopening after nearly a year of remediation. The briefing, meant to give media members a peek inside the downtown theater, marked one of Lumumba’s final forays as mayor.
Longtime state Sen. John Horhn — who defeated Lumumba in the Democratic primary runoff — will be inaugurated as mayor Tuesday, but Lumumba won’t be present. Not for any contentious reason, the 42-year-old mayor noted, but because he returns to his private law practice Tuesday.
“I’ve got to work now, y’all,” Lumumba said. “I’ve got a job.”
Thalia Mara Hall’s presumptive comeback was a fitting end for Lumumba, who pledged to make Jackson the most radical city in America but instead spent much of his eight years in office parrying one emergency after another. The auditorium was built in 1968 and closed nearly 11 months ago after workers found mold caused by a faulty HVAC system – on top of broken elevators, fire safety concerns and vandalism.
“This job is a fast-pitched sport,” Lumumba said. “There’s an abundance of challenges that have to be addressed, and it seems like the moment that you’ve gotten over one hurdle, there’s another one that is waiting in the shadows.”
Outside the theater Monday, Lumumba reflected on the high points of his leadership instead of the many crises — some seemingly self-inflicted — he faced as mayor.
He presided over the city during the coronavirus pandemic and the rise in crime it brought, but also the one-two punch of the 2021 and 2022 water crises, exacerbated by the city’s mismanagement of its water plants, and the 18-day pause in trash pickup spurred by Lumumba’s contentious negotiations with the city council in 2023.
Then in 2024, Lumumba was indicted alongside other city and county officials in a sweeping federal corruption probe targeting the proposed development of a hotel across from the city’s convention center, a project that has remained stalled in a 20-year saga of failed bids and political consternation.
Slated for trial next year, Lumumba has repeatedly maintained his innocence.
The city’s youngest mayor also brought some victories to Jackson, particularly in his first year in office. In 2017, he ended a furlough of city employees and worked with then-Gov. Phil Bryant to avoid a state takeover of Jackson Public Schools. In 2019, the city successfully sued German engineering firm Siemens and its local contractors for $89 million over botched work installing the city’s water-sewer billing infrastructure.
“I think that that was a pivotal moment to say that this city is going to hold people responsible for the work that they do,” Lumumba said.
Lumumba had more time than any other mayor to usher in the 1% sales tax, which residents approved in 2014 to fund infrastructure improvements.
“We paved 144 streets,” he said. “There are residents that still are waiting on their roads to be repaved. And you don’t really feel it until it’s your street that gets repaved, but that is a significant undertaking.”
And under his administration, crime has fallen dramatically recently, with homicides cut by a third and shootings cut in half in the last year.
Lumumba was first elected in 2017 after defeating Tony Yarber, a business-friendly mayor who faced his own scandals as mayor. A criminal justice attorney, Lumumba said he never planned to seek office until the stunning death of his father, Chokwe Lumumba Sr., eight months into his first term as mayor in 2014.
“I can say without reservation, and unequivocally, we remember where we started. We are in a much better position than we started,” Lumumba said.
Lumumba said he has sat down with Horhn in recent months, answered questions “as extensively as I could,” and promised to remain reachable to the new mayor.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post 'Hurdles waiting in the shadows': Lumumba reflects on challenges and triumphs on final day as Jackson mayor appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
The article reports on outgoing Jackson Mayor Chokwe Antar Lumumba’s reflections without overt editorializing but subtly frames his tenure within progressive contexts, emphasizing his self-described goal to make Jackson “the most radical city in America.” The piece highlights his accomplishments alongside challenges, including public crises and a federal indictment, maintaining a factual tone yet noting contentious moments like labor disputes and governance issues. While it avoids partisan rhetoric, the focus on social justice efforts, infrastructure investment, and crime reduction, as well as positive framing of Lumumba’s achievements, aligns with a center-left perspective that values progressive governance and accountability.
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