Respect in health care

When Aretha Franklin sang Respect, she asked us to “Find out what it means to me.” 

Respect is about individual perception, Aza Nedhari of Mamatoto Village reiterated in White Ribbon Alliance’s webinar Making Respectful Care a Reality through Action and Advocacy

SisterSong, Ancient Song Doula Services (ASDS), and Southern Birth Justice Network help define respect within a reproductive justice framework. Respect is a minimum in health care. It’s a starting point.

Source: WIC

Nedhari said, “We can operationalize reproductive justice as a standard.” 

In response to the urgency of the maternal health crisis in America, maternal child health advocates are shaking out what respect means and what it looks like in practice. 

White Ribbon Alliance’s Making Respectful Care a Reality through Action and Advocacy speakers Jennifer Porter of the DC Mayor’s Office on Women’s Policy and Initiatives, Aza Nedhari of Mamatoto Village, Noelene Jeffers of the National Association to Advance Black Birth, Patricia Quinn of the DC Primary Care Association, Amida Castagne of the New York City Department of Health and Mental Hygiene, and Elena Ateva of the White Ribbon Alliance discussed the priorities that get us closer to the quality of care that parents need. The White Ribbon Alliance is a global advocacy movement for reproductive, maternal and newborn health and rights, comprised of a vast network of affiliated Alliances, networks, coalitions and individuals including Healthy Children Project as a partner organization. 

Speakers shared advocacy and awareness tools that will be summarized in this piece. 

The priorities are plenty, an extensive, daunting list of points that scream for attention in order to save mothers’ lives. We are all stakeholders; the transformation of healthcare happens across  disciplines and includes institutions and individuals. We must arrive with compassion and empathy, an awareness of our own biases and trauma; recognize how capitalism affects care; avoid care provider burnout; affirm strength in Black maternal healthcare; provide support for self advocacy; acknowledge history and all of the “-isms” that influence care; hold one another accountable; promote authentic engagement from community stakeholders; acknowledge women as experts on their bodies… The list goes on.

Photo by Ella Jardim on Unsplash

Noelene Jeffers of the National Association to Advance Black Birth (NAABB) pointed out that these goals are aspirational because “we have a long way to go” but attainable just the same. 

One tool presented was NAABB’s creation of the Black Birthing Bill of Rights which is comprised of 20 rights with seven foundational pillars. The Bill of Rights was designed as affirmations and is a resource for Black, birthing people, a blueprint for individual health care providers and a framework for institutional and structural change. NAABB partnered with artist and doula  Angelica M. Franklin (@wearekarasi) to provide a visual component in order to communicate critical emotions.  

Patricia Quinn presented on District of Columbia Primary Care Association (DCPCA)’s Equity Action Lab. Their work, through deep-dive interviewing, found an overwhelming desire for respectful care. 

In partnership with Ebony Marcelle,  they created a Top 5 Do No Harm Checklist and mini-training. The one-hour, virtual, mini-training is designed to spur dialogue. It begins with Harvard’s Implicit Bias test, goes on to show Vox and  ProPublica’s video on inequality, presents the Top 5 Do No Harm checklist and opens a discussion of scenarios of actual birthing people’s experiences. 

In a test of the mini-training, 100 percent of participants recommend it and continue to do the work. The organization continues to follow-up to evaluate if the training has a long-lasting impact.

Work in New York– the Maternity Health Quality Improvement Network (MHQIN), a five-year mayoral initiative–  seeks maternal health equity through surveillance and quality improvement measures, racial equity training on reproductive justice and respectful care, hospital transformation and community engagement. MHQIN developed a respectful care report card inspired by White Coats for Black Lives Racial Justice Report Cards in addition to the development of their New York City Standards for Respectful Care. 

Photo by Chiến Phạm on Unsplash

Over one million women from 114 countries participated in White Ribbon Alliance’s “What Women Want” campaign. Women’s responses solidified that respect and dignity is paramount in health care. An interactive dashboard of responses was developed offering an “unprecedented level of access to women’s demands to allow anyone, anywhere to see exactly what women want when it comes to their healthcare, and to meaningfully respond.” 

Beyond interacting with the initiatives above, other actionable items include the use of the Mothers Autonomy in Decision Making scale (MADM) and KSA’s Irth app

In closing, the webinar hosts asked participants to consider: “Respectful care must be more than the absence of disrespect and abuse. How do we define success and our vision of the future?”

Photo by M.T ElGassier on Unsplash

Recent work done by the White Ribbon Alliance focuses on self-care and discovery, an important component to building respect in health care. The White Ribbon Alliance reported that a “few months ago, thousands of individuals worldwide participated in the first-ever Self-Care Learning and Discovery Series—a highly interactive, virtual forum organized by White Ribbon Alliance on behalf of the Self-Care Trailblazer Group (SCTG) for participants to exchange and incubate ideas, experiences, and solutions on a variety of self-care topics.” Now, the team has launched a new report that collates content across 16 self-care sessions. You can download that resource here

*A big thank you to Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC, RYT who also attended the webinar and shared her notes and thoughts with me. 

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