It's Time to Eliminate Racism and Fragmentation in Women's Health Care

McCloskey, Lois; Bernstein, Judith; Goler-Blount, Linda; Greiner, Ann C.; Norton, Anna; Jones, Emily J.; Bird, Chloe E.

doi:10.1016/j.whi.2020.12.007

Cited by 5 publications

(7 citation statements)

References 30 publications

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“…Accelerating health care system transformation as discussed elsewhere in this article could advance maternal health equity. Without incentives for high-quality care and maximum financing for the full range of providers in the perinatal workforce, disparities will not be reduced, and equity will not be achieved (McCloskey, Bernstein, Goler-Blount, et al, 2021).…”

Section: Quality Safety and Equitymentioning

confidence: 99%

Optimizing Medicaid Extended Postpartum Coverage to Drive Health Care System Change

Zephyrin

Johnson²

2022

Women's Health Issues

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Section: Quality Safety and Equitymentioning

confidence: 99%

Optimizing Medicaid Extended Postpartum Coverage to Drive Health Care System Change

Zephyrin

Johnson²

2022

Women's Health Issues

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“…Whereas there is nothing that makes being in Black skin a clinical risk factor, the real risk factor is anti-Black racism. [4][5][6]17,23 After careful consideration, some of our patients are identified as requiring collaborative management of medical conditions, and sometimes the pregnancy becomes complex. We are thorough and offer the available options as well as collaborative management with an obstetrician or with a maternal-fetal medicine (MFM) physician.…”

Section: Choices Model Operations and Patient Populationmentioning

confidence: 99%

“…Risk factors often associated with Black pregnant and birthing people include gestational diabetes, hypertension, and obesity, as well as Blackness itself; some health systems list Black race as an indication for antenatal testing. Whereas there is nothing that makes being in Black skin a clinical risk factor, the real risk factor is anti‐Black racism 4–6,17,23 . After careful consideration, some of our patients are identified as requiring collaborative management of medical conditions, and sometimes the pregnancy becomes complex.…”

Section: History Of Choicesmentioning

confidence: 99%

“…Public investment in pregnancy only goes so far as offering Medicaid coverage for pregnant persons that often ends after 6 weeks postpartum 2 . Although that is changing in some states, 3–5 extending postpartum coverage for Medicaid beneficiaries is not enough to combat the racism‐driven maternal mortality crisis 6 . The objective of this article is 2‐fold: to describe the development of the midwifery‐led model of care used at CHOICES: Memphis Center for Reproductive Health, a nonprofit, comprehensive reproductive and sexual health clinic located in Memphis, Tennessee, and to share our experience in order to assist other health professionals who are interested in implementing this model of care.…”

Section: Introductionmentioning

confidence: 99%

“…2 Although that is changing in some states, [3][4][5] extending postpartum coverage for Medicaid beneficiaries is not enough to combat the racism-driven maternal mortality crisis. 6 The objective of this ORCID Nikia Grayson https://orcid.org/0000-0002-9240-7136 Nicole Quinones https://orcid.org/0000-0001-8055-8546 article is 2-fold: to describe the development of the midwiferyled model of care used at CHOICES: Memphis Center for Reproductive Health, a nonprofit, comprehensive reproductive and sexual health clinic located in Memphis, Tennessee, and to share our experience in order to assist other health professionals who are interested in implementing this model of care.…”

Section: Introductionmentioning

confidence: 99%

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A Model of True CHOICES: Learnings from a Comprehensive Sexual and Reproductive Health Clinic in Tennessee that Provides Abortions and Opened the City's First Birth Center

Grayson

Quinones

Oseguera

2022

J Midwife Womens Health

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CHOICES: Memphis Center for Reproductive Health staff is passionate about ensuring that everyone has access to the full continuum of comprehensive reproductive health care (including abortion, gender‐affirming care, miscarriage management, and community birth) regardless of race, gender identity, sexual orientation, HIV status, economic status, or religious beliefs. Memphis, Tennessee, has a history of limited community birth options (birthing outside of hospital walls). In 2017, when home birth services were added to CHOICES and plans for opening Memphis’ first freestanding birth center were being imagined, it was intentional to create a model in which midwifery care could be accessible for patients who may be eligible for state‐funded health care services, those considered at higher health risk than traditional low‐risk midwifery patients, or both. In fact, individuals and their families with limited out‐of‐pocket funds and those historically marginalized would purposely receive holistic, individualized care based on their unique health care needs and personal desires, driven by a reproductive justice framework. In this article, we outline the success and challenges of addressing the reproductive health needs of marginalized communities, including the benefits of a nonprofit business model, operationalizing reproductive justice concepts, and the reclamation of Black midwifery. We also discuss the challenges of caring for Black birthing people and providing abortion and gender‐affirming care in a politically hostile environment. Although individuals have complex needs, at its core, CHOICES believes that every person must be seen as whole human beings and that each can be cared for by a midwife. The CHOICES approach is informed by evidence‐based information, clinical judgment, and an intentional partnership with and investment in a people who have historically been and are presently pushed to the margins, neglected, and blamed for poor health outcomes and demise. Striving to adapt the CHOICES model of care in other parts of the country is important now more than ever following the Supreme Court decision to overturn Roe v. Wade.

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Commentaries Help Set Agendas for Women's Health Research and Policy

2021

Women's Health Issues

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It's Time to Eliminate Racism and Fragmentation in Women's Health Care

Cited by 5 publications

References 30 publications

Optimizing Medicaid Extended Postpartum Coverage to Drive Health Care System Change

Optimizing Medicaid Extended Postpartum Coverage to Drive Health Care System Change

A Model of True CHOICES: Learnings from a Comprehensive Sexual and Reproductive Health Clinic in Tennessee that Provides Abortions and Opened the City's First Birth Center

Commentaries Help Set Agendas for Women's Health Research and Policy

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