Insights

RESPECTFUL MATERNITY CARE: SHIFTING POWER THROUGH PARTNERSHIP

By Carmen Green, MPHNovember 03, 2022

 “We are in a revolutionary time for reproductive justice and maternal health. Our bodily autonomy is being attacked while there is a reckoning in our community to take back power and create equitable systems of change.” -Joia Crear-Perry, MD, Founder & President, National Birth Equity Collaborative 

 

Obstacles stemming from systemic racism and sexism that affect birthing people require advocates, healthcare leaders, and community organizations to approach maternal health differently.

 

Earlier this year, the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization reversed Roe v. Wade, leaving more than half the country with limited or uncertain access to lifesaving reproductive care. This ruling violates the human right to bodily autonomy and disproportionately affects Black birthing people, who embody the historic reality of racial and reproductive oppression.

 

Did You Know…

  • Black women are disproportionately affected with a mortality rate of 55.3 deaths per 100,000 live births, compared to 19.1 deaths per 100,000 live births for White women and 18.2 deaths per 100,000 live births for Hispanic women.
  • Black babies born in the United States have nearly double the infant mortality rate (10.8 deaths per 1,000 live births) compared to the overall population (5.6). 
  • Black women disproportionately lack necessary reproductive health care, including access to affordable contraception, abortion, STI screenings, and reproductive cancer screenings. 

Despite the current climate of reproductive rights, change is happening across sectors, whether through policy change or developing successful partnerships. Shifting power through partnerships that value lived experiences, build trust, and provide a seat at the table allow communities, organizations, and healthcare systems to authentically and effectively advance respectful maternity care and health equity. 

As part of the National Birth Equity Collaborative’s Respectful Maternity Care initiative, funded by the Robert Wood Johnson Foundation, birthing experts gathered to discuss how partnerships between communities, community-based organizations, and hospital systems can improve outcomes through respectful maternity care. Five key insights from the conversation follow.

  • Tanay Lynn Harris, Director and Co-Founder of The Bloom Collective
  • Tamela Milan-Alexander, Founder of Bridges to Bonds
  • Rev. Deneen Robinson, State Policy Strategist at the National Birth Equity Collaborative
  • Moderator: Carmen Green, Vice President of Research and Strategy at the National Birth Equity Collaborative

Watch the event recording.

 

Insight 1: Valuing lived experiences builds trust, which is essential for good healthcare.

In pursuit of encouraging communities to rally behind initiatives that make progress on health equity, organizations often ask people to share their stories. Sharing lived experiences can be traumatizing and/or triggering, so understanding community needs and valuing experiences and time make people more open and willing to share and support community partnerships. There are ways to compensate people and show value that aren’t monetary.

“This is where you build connections. As someone who’s had to navigate a healthcare system that was not very friendly—especially for Black women—it’s very important that voice, that experience is carried out through the different areas in healthcare.”

—Tamela Milan-Alexander

“Oftentimes you don’t get to see the people behind the scenes, just the administrations. Transitioning from in-person to COVID, I knew we had to do that. We restructured our budget so that we could send them things.”

—Rev. Deneen Robinson

“Maybe you can’t give money because of how your infrastructure is set up, but you can give them pots and pans. When I was in the projects and had one pot, I was so happy someone realized I had no utensil to cook with.”

—Tamela Milan-Alexander

 

Insight 2: Acknowledge and support the community’s gifts and talents.

There are institutions that have the means and bandwidth to implement strategies to improve community well-being but fail to identify the community’s existing talents and resources. Acknowledging ideas and solutions from the community reflects an organization that is intentional about cultivating a healthy partnership, as opposed to using ideas from the community without recognizing that the community is a part of the solution.

“The more we begin to look at our community—the gifts, the talents, and the genius that already reside in the community—how much better we are to meet the demand of the community in a real way.” 

—Tanay Lynn Harris

“The shift will come when we have ecosystems that allow families to feel like if they check the box Black they won’t be treated differently.”

—Tamela Milan-Alexander

“A lot of institutions and organizations come to the community under the guise of wanting to have conversations because they have the money to put things into implementation more quickly; but they got the gifts, talents and geniuses from the community, so we have to work together and cross sectors.”

—Tanay Lynn Harris

 

Insight 3: Create a seat at the table.

Creating a seat at the table for marginalized communities includes voices from different races, cultures, and lived experiences to help make decisions; one person of color does not speak for all. This also includes acknowledging shifting power does not mean having power over the people, community, or organization you’re in partnership with, but using the power you have to collaborate and make change.

“We have to think through the ways we socialize, come to the table and co-create to achieve it [respectful maternity care].”

—Tanay Lynn Harris

“A diverse group of people have to come together to restructure what research looks like when it comes to including community voices.”

—Tamela Milan-Alexander

 

Insight 4: Reexamine beliefs that do not support an equity mission.

When it comes to equity, organizations must walk the walk, not just talk the talk. There are organizations whose mission is to help advance health equity in the communities they serve, but core values or principles—sometimes centered around religion, for example—allow biases around reproductive rights and sexuality to influence partnership or funding decisions. This leads to inauthentic partnerships, at best, and often prevents partnerships from moving forward, and being impactful and intentional.

“Some organizations don’t want to work with queer people or those outside of their religion.”

—Rev. Deneen Robinson

“Because they know that I support access to abortion care, [some organizations] are reluctant to work together. I’ve had to navigate that, making sure I watch the language I use with them to continue our partnership.”

—Rev. Deneen Robinson

 

Insight 5: Hands-on community services need more funding and less red tape.

Relatively large amounts of funding are often awarded to conventional hospital settings or research-based organizations, leaving critical, hands-on community services to find other resources and ways to improve health equity. For smaller organizations, especially those that are Black-owned, funding is minimal and comes with stipulations that may not align with community needs.

“When there are moments of money, there’s this idea that we’re supposed to partner with folks that we’re not in the right relationship with. And other folks are dictating how we do the work that we know how to do.”

  —Tanay Lynn Harris

“If we had more, we’d do more. Our communities would grow and thrive.”

—Rev. Deneen Robinson

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