Birthing Justice Forum 2017 – “No Mas Bebes”

 

2017 Birthing Justice Forum

& Maternal-Child Health  Champion Awards Ceremony

Wednesday, September 27, 2017, 8:30 am to 6:00 pm

California Endowment Center, Los Angeles, CA

SAVE THE DATE! REGISTRATION OPENS JULY 15.

CEUs Pending for LCSW, MFT, RN, CHES, CD, CCE, CPM, CNM

Featuring  the Documentary film by Renee Tajima-Pena and Virginia Espino

NO MAS BEBES/NO MORE BABIES

They came to have their babies. They went home sterilized. The story of Mexican immigrant women who were sterilized at LA county hospital during the 1970s. Alongside young Chicana/o lawyers and a whistle-blowing doctor, they stood up to powerful institutions in the name of justice. 

Vinieron a tener sus bebes. Se fueron a casa esterilizados. La historia de las mujeres inmigrantes mexicanas que fueron esterilizadas en el hospital del Condado de la cada de 1970. Junto a los juvenes abogados de chicana y un medico que soplaba silbato, se enfrentaban a instituciones poderosas en nombre de la justicia. 

Eugenics (u-GEN-icks) (noun): “The study of methods of improving the quality of the human race, especially by selective breeding.”

DESCRIPTION

A forum to discuss issues of perinatal heath inequities from a human rights perspective. Using the film NO MAS The Associatiion for Wholistic Maternal and Newborn Health - http://wholisticmaternalnewbornghealth.orgBEBES/NO MORE BABIES as a springboard for discussion,attendees will hear from an experts A  panel of maternal-infant health researchers, activists, advocates, midwives, doulas, physicians, psychologists and legal experts about the socio-political influences on poor birth outcomes in communities of color. Caucasian maternal-health professionals  can learn what they can do to support the efforts of birth activists and birth professionals of color  and how to effectively work with and advocate for their clients of color and those who are gender non-conforming.

Maternity care providers and childbirth activists, maternal-infant advocates alike are working to make birth safer and more satisfying for pregnant people everywhere. While all agree that all pregnant people ought to have access to quality care during pregnancy, not everyone receives equal treatment or equal caliber of care in America and elsewhere.

Following the panel and film, attendees will participate in a group interactive exercises to work on strategies to impact change in maternity care and birth outcomes.

The Maternal-Child Health Champion Awards Ceremony will follow the forum, to recognize leaders in the community.

AUDIENCE

Lawyers, perinatal health professionals (midwives, physicians, nurses, doulas, childbirth educators), Maternal-Child Health (MCH) professionals, community health promoters/promatores de salud, breastfeeding peer counselors, social workers and psychotherapists, human rights activists, women’s rights activists, and students of midwifery, women’s health, public health, nursing, medicine, law, political science, women’s studies,medical sociology, medical anthropology, etc.

AWARDS CEREMONY

Maternal-Child Health Champion Awards Ceremony will follow the symposium. Exemplary MCH practitioners and activists will be recognized for their ingenuity, audacity, boldness, and potential in making a profound difference in the lives of mothers and infants, and improving maternity care quality. To nominate someone, and learn about each of the categories of awards, please click here.

SCHEDULE OF THE DAY

8:30 am-9:00 am – Registration

9:00 am -Welcome & Introduction

9:15 am to 10:30 am – Film: “No Mas Bebes”

10:30 to 10:45 am -Morning Break

10:45 am- 12:00 pm Panel Discussion

12:00 pm to 1:00 pm- Lunch (on your own)

1:00 pm to 3:00 pm- Interactive Group Activities

3:00  to 3:30 pm -Wrap Up & Next Steps

3:30 to 4:00 pm – Afternoon Break

4:00 to 4:30 pm –  Reception

4:30 to 6:00 pm – Awards Ceremony

RATIONALE

Worse birth outcomes exist in communities of color, and lower-income communities. During pregnancy, place and ethnicity matters. It shapes how healthy  a mother  will be and how well or poorly her child will fare. Furthermore, reproductive rights and women’s rights in the U.S. have primarily focused on access to contraception and safe abortion, gender-based violence and trafficking. Though the fact that the other aspect of reproduction is pregnancy and childbirth, this aspect has not been the focus of reproductive and women’s rights activists.Woman-abuse not only takes the form of rape and domestic violence, but also obstetrical violence occurs more frequently than one might expect. This is an area where those who are concerned about violence against women must also focus. Additionally, LGBTQ activists have not as often focused on the rights of childbearing persons within their communities. This forum will shine a light on some of the issues faced by LGBTQ persons during childbirth.

Facts:

  • Black women have the highest rates of cesarean section followed by Hispanic women in the USA.
  • Between 1999 and 2004 in Los Angeles County, the Maternal Mortality rate of African-American women rose 157%, to 45.6 per 100,000 live births, more than double the rise among Caucasian women. Over the same period there was also an unexpected 765% surge in the maternal mortality rate of Asian/Pacific Islanders.(LABBN, 2009).
  • There has been a rising cesarean section rate in the USA in the past decade in part due to repeat cesareans and low rates of Vaginal Birth After Cesarean (VBAC). Vaginal birth after cesarean (VBAC) were relatively few and decreased from 3.75% in 1999 to 1.41% in 2005 (p<0.0001). This represents a significant 62% decrease in VBAC over the study period (Maternal Quality Indicators Project, 2011, p. 38 ).
  • In California in 2012-2014, Black women have the highest rates of cesarean section, as they do nationally. In California, the rate is 37.7% for Blacks compared to 32.4% for Whites, and 33.1% overall in the state. The US overall rate is 32.6%, and for Black women it is 35.5% and 32% for White women from 2012-2014. (National Center for Health Statistics, 2017).
    Birth Summit

    Volunteers at 2016 Birthing Justice Forum- Human Rights in Childbirth U.S. Summit

  • The cesarean section rate by Los Angeles Service Planning Area ( SPA ) is 37% in SPA 7 compared to 34.8 in Metro LA (SPA 4), which is the lowest in the county  and 38.3% in the San Fernando Valley, which is 2nd highest. The highest in the county is 39% in San Gabriel Valley(California Department of Public Health, Center for Health Statistics, OHIR Vital Statistics Section, 2003-2012).
  • Maternal Mortality is 4-5 times higher for African-American women than White women in the USA. This is the leading perinatal indicator between Blacks and Whites a disparity has not changed in 5 decades (APHA, 2010).
  • In 2006, African-American women in California were more than three times as likely to die from pregnancy-related causes as Caucasian women.
  • Certain Los Angeles zip codes have 3-4 times higher rate of Maternal Mortality than others.
  • In Los Angeles County, in 2007, 11 Hispanic women and 7 African American women died during pregnancy, childbirth, or puerperium (LABBN, 2009).
  • Hispanic women make up 46% of all women in LA County, but 50% of all maternal deaths.
  • African-American women make up 9.2% of all women in LA County, but 31.8% of all maternal deaths.
  • White women make up 28.9% of women in LA County, but only 4.5% of maternal deaths.(California Department of Health Services, Center for Health Statistics, Vital Statistics, 2007 from: LA Best Babies Network).
  • In LA County, according to LA Best Babies Network’s 2009 report, the leading cause of maternal death is  obstetric hemorrhage.
  • American-born Black women are twice as likely than American-born White women to give birth too early too babies that are too small and who are twice as likely to die within the first year of life. This is not a result of lack of prenatal care, poverty, or unhealthy lifestyles. Even Black women who have healthy behaviors and are have a high level of education and wealth, are twice as likely to give birth too early at a rate  double the rate of  White woman with less than a high school diploma (Lu & Halfon, 2003).

This event will explore the political, social, systemic and historical reasons for maternal-infant health inequities and disparities in communities of color, from the voices of women themselves. There are various factors that contribute to maternal mortality, prematurity and high cesarean rates for women of color. “This is not just a health care crisis–it is a public health emergency” (Amnesty International, 2010).

Socioecological Model

At this event, we will use the Socioecological Model  to explore the reasons and a opportunities for intervention to improve birth outcomes and quality of care. In this model, various domains of influence are described, both macro and micro, upon a disease condition or health problem. Understanding of these spheres of influence allow the practitioner or advocate to develop specific interventions geared at each or some of these domains.

These include:

Intrapersonal/individual factors: influence behavior in predisposing ways such as knowledge, attitudes, beliefs of the individual childbearing person..

The Socioecological Model as  applied to violence against women and girls, however it applies to Obstetrical Violence as well. (Source: The Lancet, retrieved from: http://www.thelancet.com/cms/attachment/2020894921/2041097832/gr2.jpg)

Interpersonal factors: these are family members, peers, health professionals, teachers, counselors, etc. that either foster or hinder interpersonal growth or healthy behavior.

Institutional and organizational factors: these are hospitals, schools, churches, workplaces, etc. that create rules, regulations, policies, and informal structures that constrain or promote healthy behaviors or foster diseases or health disparities.

Community factors: these are formal or informal social norms and customs or cultural practices that exist among groups, families or organizations such as workplaces, schools, religious institutions, that can hinder or   help individuals perform healthy behaviors or perpetuate a disease or health problem.

Society Factors: These are public policies, laws, political climate or political ethos,  that regulate or support health actions and practices for fostering or inhibiting changes in health behavior, health problem or disease.

Using a the Socioecological Model and a human rights framework, as developed by Hermine Hayes-Klein of Human Rights in Childbirth,  participants  will   learn about each of the fundamental rights of childbearing persons, including the right of informed consent and refusal, privacy, equal treatment, and discuss opportunities for intervention at various levels and domains of influence. The panel discussion by legal and maternal health leaders will discuss the historical and cultural factors which have kept ethnic perinatal health disparities intransigent for decades Participants will participate in exercises to explore with practical strategies and increase awareness of how to foster respectful and inclusive care and engender a more equitable maternity care system for all. Thus this will be an intervention is into hopeless, despair, and futility. When people have a sense of hope about their ability to change their world, they become encouraged and hopeful and this improves health and well-being by lowering the stress and anxiety that arises out of hopelessness and feelings of helplessness. A model of community empowerment that links all three levels–individual, organizational/institutional and community– provides the most effective means to collectively provide the support and control necessary to develop needed skills, resources, and change (Isreal, et. al. 1994). Furthermore, what is most effective in alleviating the effects of stressor exposure is when individuals perceive greater control over the stressor (Compass et al. 1991, as reported in Brenner, 2013).

We will be featuring the documentary film NO MAS BEBES/NO MORE BABIES, as a springboard for our dialogue

Synopsis:

They came to have their babies. They went home sterilized. The story of immigrant mothers who sued county doctors, the state, and the U.S. government after they were pushed into sterilizations while giving birth at the Los Angeles County-USC Medical Center during the 1960s and 70s. Led by an intrepid, 26-year-old Chicana lawyer and armed with hospital records secretly gathered by a whistle-blowing young doctor, the mothers faced public exposure and stood up to powerful institutions in the name of justice.

In another yet another example of institutionalized racism, the court sided with LAC+USC and Dr. Quilligan, but the case set the precedent for Informed Consent Forms to be provided to persons receiving health care in their native language.

This sad chapter in American and specifically Los Angeles history, shows what communities of color, attorneys, advocates for mothers and children,  and medical professionals can do when they are empowered and build alliances to stand up to injustice and bring about change.

We will ask the following questions at this event:

  1. What injustices in maternity care do we know are going on today?
  2. What can we do about it?

If you care about women and children, birthing rights, human rights, social inequities, health disparities, racism and oppression, please come be part of this meaningful conversation. Together, we will join forces to bring about real solutions and improve health care for all childbearing persons.

References

Amnesty International USA (2010). Deadly Delivery: The Maternal Health Care Crisis in the USA. Retrieved from: http://www.amnestyusa.org/sites/default/files/pdfs/deadlydelivery.pdf

Brenner, A. B., Zimmerman, M. A., Bauermeister, J. A., & Caldwell, C. H. (2013). Neighborhood context and perceptions of stress over time: An ecological model of neighborhood stressors and intrapersonal and interpersonal resources. American Journal of Community Psychology, 51(3-4), 544-556.

Boumediene, S, Chow,J,  Fridman,M, Gregory K, Korst, L., Lu, MC, et. al.(2011). Trends in Maternal Morbidity in California 1999-2005, Retrieved from: https://archive.cdph.ca.gov/programs/mcah/Documents/MO-CAPAMR-TrendsinMaternalMorbidityinCalifornia-1999-2005-TechnicalReport.pdf

California Department of Public Health, Center for Health Statistics, OHIR Vital Statistics Section. (2003-2012). Cesarean Section, Retrieved from: http://publichealth.lacounty.gov/mch/fhop/FHOP2012/C-section_2012_FINAL.pdf

California Department of Health (2016). 1991-2012 Birth Cohort and Birth Statistical Master Files State of California DPH. Retrieved From: http://www.ipodr.org/dashboard/dash.html

Los Angeles Department of Public Health (2017). SPA Areas by zip code. Retrieved from: http://publichealth.lacounty.gov/

Israel, B.A., Checkoway, B., Schulz, A., & Zimmerman, M. (1994). Health education and community empowerment: Conceptualizing and measuring perceptions of individual, organizational, and community control. Health Education and Behavior, 21(2), 149-170.

Lu MC, Halfon N (2003) Racial and Ethnic Disparities in Birth Outcomes:A Life Course Perspective.  Maternal and Child Health Journal; 7(1):13-30.

Boumediene, S, Chow,J,Fridman,M, Gregory K, Korst, L., Lu, MC, et. al.(2011). Trends in Maternal Morbidity in California 1999-2005, Retrieved from: https://archive.cdph.ca.gov/programs/mcah/Documents/MO-CAPAMR-TrendsinMaternalMorbidityinCalifornia-1999-2005-TechnicalReport.pdf

California Department of Public Health, Center for Health Statistics, OHIR Vital Statistics Section. (2003-2012). Cesarean Section, Retrieved from: http://publichealth.lacounty.gov/mch/fhop/FHOP2012/C-section_2012_FINAL.pdf

California Department of Health (2016).  1991-2012 Birth Cohort and Birth Statistical Master Files State of California  DPH. Retrieved From: http://www.ipodr.org/dashboard/dash.html

Los Angeles Department of Public Health (2017). SPA Areas by zip code. Retrieved from: http://publichealth.lacounty.gov

Journal of Perinatal Education, Supplement (Winter, 2007), Evidence Basis for Mother-Friendly Childbirth Initiative, Retrieved from http://www.motherfriendly.org/Resources/Documents/CIMS_Evidence_Basis.pdf

Kozhimannil, KB, Vogelsang,CA,  Hardeman, R,  Prasad, S (2016).Disrupting the Pathways of Social Determinants of Health: Doula Support during Pregnancy and Childbirth, J Am Board Fam Med vol. 29 no. 3 308-317 doi: 10.3122/jabfm.2016.03.150300, Retrieved from: http://www.jabfm.org/content/29/3/308.full.pdf+html

National Center for Health Statistics, final natality data. Retrieved January 16, 2017, from www.marchofdimes.org/peristats.

Racial and Ethnic Disparities in Birth Outcomes (Fact Sheet), Retrieved from: www.marchofdimes.org/Racial-and-Ethnic-Disparities_feb-27-2015.pdf

Reese, P. Interactive: See C-section rates at every California hospital (2011). The Sacramento Bee,  Office of Statewide Health Planning and Development. Retrieved from: http://www.sacbee.com/site-services/databases/article4129666.html

 

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