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We are the Maternal Health Learning and Innovation Center, a network of maternal health equity experts and organizations working to make real change for women and birthing people in the U.S.
Our podcast is a series of episodes connecting around culture, lifting voices and stories, exploring innovations in maternal care and discussing ways we can center equity in the way we approach our health and wellness.
Learn more about us, explore our resource center and find support for all maternal health professionals at MaternalHealthLearning.org.
For more podcast information and content, visit MaternalHealthPodcast.org.
Alison - 00:00:03:
Welcome to the Maternal Health Innovation Podcast Season 3. I'm your host, Alison Stuebe, Professor of Obstetrics and Gynecology at the UNC School of Medicine. This podcast is created by the Maternal Health Learning and Innovation Center. Episodes are released weekly, so be sure that you are subscribed. On this podcast, we listen to maternal health innovators about ways we can implement change to improve maternal health in the United States. In this episode, I'll be talking with Tina Sherman, the Senior Campaign Director for the Maternal Justice Campaign at MomsRising. Tina has dedicated her professional life to supporting and empowering moms and families. She has served as a legislative aide in the United States Senate, has worked with several child and women's advocacy organizations, is an active advocate on the North Carolina MomsRising Steering Committee, and is a certified birth doula. Today, we'll be talking about the motherhood career tax and the pursuit of workforce justice for those who give birth. From discriminatory practices based on reproductive age, the complex challenges surrounding access to healthcare, accommodations during pregnancy, and parental leave policies, our conversation aims to unravel the multifaceted aspects of this pressing concern. Thanks for joining me, Tina.
Tina - 00:01:12:
Thank you for having me.
Alison - 00:01:14:
To start out, can you tell us about MomsRising and explain how it's working to address these challenges?
Tina - 00:01:19:
Yes, thank you. So MomsRising is a national on-the-ground and online movement dedicated to improving the lives of families, moms, parents, caregivers alike through public policy and ensuring that all families can thrive. And we are really focused on lifting up the stories and lived experiences of parents, of caregivers, of moms, of dads, granddads, or public policymakers. So anything around their experiences as it relates to maternal health is really what we're focused on doing.
Alison - 00:01:57:
Awesome. So can you start by explaining what the maternal career tax means?
Tina - 00:02:03:
Yeah. So that's a loaded word, isn't it? But so true. Because really, when you look at the challenges that mothers are facing, as soon as you know, they become pregnant, and they're in this country do not have access to paid family medical leave. So they are taking, if they're able to take, most people are not able to take unpaid leave. Most people are not even qualified to take Family and Medical Leave Act. So we were taking that time off unpaid. While your male counterpart doesn't have to take off time to recover from childbirth, to establish breastfeeding. And then there's all the penalties. We already know that women make pennies on the dollar to what their white male counterparts make. So from the lack of access to policies like paid family and medical leave to paid sick days all contribute to the motherhood tax that parents are facing, that mothers are facing.
Alison - 00:03:06:
Can you talk a little bit about how repriestive-age women and birthing people in the workforce experience discrimination, and how does that affect their careers?
Tina - 00:03:14:
Women and people in their reproductive lives, when they are hired in a position, come into it, and there may be an assumption right off the bat that, first of all, that they're going to have a family, because we know that not everyone makes that choice to have a family, so that they're going to have a family. And then if they do decide to have a family, then right off the bat, hiring discrimination right off the bat, because you may become pregnant. And if you are hired, well, then maybe you will want to take time off or need to take time off for pregnancy, and then when doctor's appointments, when you're pregnant, and you need to have different accommodations. So maybe you wear a uniform, and you need a uniform that will accommodate your expanding belly. Or when your doctor insists that maybe you be able to sit at a job that you have to stand pretty frequently. Women are often discriminated in spaces like that.
Alison - 00:04:14:
And then when folks come back to work after delivery, can you talk about the kinds of challenges that folks face? And in my experience, there's something of a double standard between dads leaving work early to participate in child events and moms. And can you talk a little bit about that?
Tina - 00:04:32:
Yeah. So first and foremost, don't know if most of your listeners know, but One in four mothers return to work within two weeks of giving birth. Which is kind of staggering because I don't know about your, the rest of the audiences at two weeks postpartum, I was nowhere near ready to be walking around my block. Forget being in an office. And so, you know, one of the challenges right off the bat is having to be in the workplace so soon after giving birth. And then the expectation again around going to doctor's appointments and pediatrician appointments, doctor's appointments for yourself, pediatric appointments for baby. The assumption is that, you know, mom is going to be there to do this, not the dad. In fact, most of the time dads are rewarded for taking that time and say, oh my goodness, aren't you being that great caregiver while mothers are penalized and looked down upon for that. God forbid, if you are, have made the decision to breastfeed. And we know that five out of six moms start out breastfeeding, but by six months postpartum, less than half of them are still breastfeeding. We know that recommendations are to breastfeed for up to two years. And, you know, at this point with policies in the United States, many moms find a real challenge to achieve. And we know that some of those barriers, again, discrimination in the workplace, being able to pump breast milk, a new law that addresses that. But definitely prior to this new law, just this past year, that was something that women couldn't do very easily. They didn't have the time or the space to breast milk. Real challenges there.
Alison - 00:06:13:
Let's talk about how things got better because it's great to know there are some bits of good news. What's the PUMP Act and what does that mean for birthing folks who are trying to breastfeed? I know juggle working and parenting at the same time.
Tina - 00:06:24:
Two new bills were signed into law at the end of last year. One is the one you referenced, the PUMP for Nursing Mothers Act. The other is the Pregnant Workers' Fairness Act. Both of these new laws expand the rights of pregnant and lactating people in the workplace, allows for lactating people and breastfeeding parents, breastfeeding moms, to be able to have the time and space to be able to express breast milk. It covers the majority of workers. So if you're listening to this podcast, you are likely covered and your workplace is likely covered. And before some workers were covered, but more than 9 million mothers were left out of the previous law. So this closes that loophole. There are some tiny exceptions. Motor coach operators, their portion of the law goes into effect in just a few years. And we are still, as of right now, still working on getting in-flight crew to be included. But other than that, the majority of workers are included in this law. The other law is the pregnant worker. It's called the Pregnant Workers Fairness Act. It is really a groundbreaking civil rights law for pregnant people, allowing any condition surrounding pregnancy. That's the word in the law. Anything affecting pregnancy, relating to pregnancy, you'd be able to be accommodated for it. So whether that is, again, needing to sit down when you normally stand during your work, whether it is carrying a water bottle with you, or maybe, you know, adjustments to the uniform, very simple accommodations like that. But also, maybe your doctor has insisted that you need to have time off after giving birth. Well, guess what? Now under the Pregnant Workers' Fairness Act, you can do that. Maybe you unfortunately suffered a miscarriage. And so again, under the Pregnant Workers' Fairness Act, anything that relates to any medical accommodation that is needed, your employer must now be able to accommodate you. So it's really a groundbreaking law, and we are desperately trying to get the word out about it. So grateful to be able to talk to you about it today.
Alison - 00:08:30:
So I'm thinking if I'm in the office and the patient tells me, well, my boss won't let me do that or says that they can't accommodate it. How do I go about getting those protections to happen for the patient in front of me? Or if I'm that person, who do I call to say, wait a second, this isn't allowed.
Tina - 00:08:45:
So if it is your patient, I would love for you to write a note to say and to be explicit. You don't have to be explicit. I want to be clear, but it wouldn't hurt to be explicit. So if you were the doctor or you were the other health care provider that must insist, because it does not necessarily have to be the OB. If you are the health care provider that notes that an accommodation must be made, all you have to do is write the note. And that person would be able to take it to their employer. And hopefully they would then comply. If they do not, they have legal course as well as they can file a complaint with the EEOC. That's the Equal Employment Opportunity Commission. The EEOC is who is overseeing the implementation of the Pregnant Workers' Fairness Act. They are heavily in employees' corners in ensuring that this law is being enacted as Congress has intended. So if you reach out to the EEOC, they're going to do their best to make sure that your employer is complying with the law and has to do so without retaliation. Let's be clear. You cannot lose your job based on an accommodation that you need or the fact that you're requesting accommodation. If your request includes that you would like to change a position, that's That is one thing. But if your request is to just have an accommodation so that you can continue your current employment at the rate and the time and all of that, your employer is legally required to comply.
Alison - 00:10:17:
Awesome. That's fantastic.
Tina - 00:10:19:
Can I speak to the PUMP Act?
Alison - 00:10:22:
Please do. Yes.
Tina - 00:10:23:
While the EEOC is over Pregnant Workers' Fairness Act, the PUMP Act and enforcement around that, also, your employer is legally bound to comply. That is under the wage and hour division of the And they, the Department of Labor, has been doing a phenomenal job of sending out information and holding webinars so that employers know what it means to be able to provide accommodations for pumping and lactating people. And so really, really, really critical that if you have any questions, you reach out to the Wage and Hour Division, Department of Labor. And if you're having any compliance issues, they will investigate as well.
Alison - 00:11:06:
That's super helpful. And I know I've turned to the Pregnant Work website to look for some of this. Is that information there? I know there's sample letters for doctors to use and stuff like that. Is that a good resource for folks?
Tina - 00:11:17:
Yes, actually, MomsRising has a great blog that has compiled many of the resources and we're constantly adding to it. So we'll make sure that we include that in the show notes so that folks have access to that.
Alison - 00:11:29:
That sounds great. Because I think sort of in that moment of, I remember my first day of residency, I had to pump, I had a two and a half month old, and I was told that there was a pumping room on the 16th floor of the hospital, and it was lunch hour. So the elevator took 10 minutes, and I got up to the 16th floor of the hospital, and nobody knew anything about a pumping room. And I almost burst into tears. And some nurse was like, just come in my break room, you can pump there. And I was like, so in that moment, one is not in one sort of best. To say, oh, let me quickly look up this congressional legislation and take action. So a quick list of here's who to call to get this fixed right now.
Tina - 00:12:07:
And also, also, yes, absolutely. So we'll make sure that's there. But also, a good point to say, we want to be having these conversations when you're pregnant, so that you can be planning so your employer can plan so that you are aware, because it does have to be a reasonable accommodation, let's be clear. And so, you know, maybe 10 floors up when it's going to take 30 minutes to get there on your 45 minute lunch break, isn't a reasonable accommodation. Combination. That is also part of the law. But you just noted for folks that are listening, if you are pregnant, or you know, someone someone else, you know, is pregnant, and they're looking at scoring, definitely give them this resource and start having these conversations now with your employer.
Alison - 00:12:49:
Heck yeah. And I think that when I'm talking to patients who are already postpartum, I will encourage them to maybe go the day before they're going to start and figure out the lay of the land and not have that be when they are about to explode and they have to pump right now and there's confusion.
Tina - 00:13:02:
Or you can do what I did, leave your pump at home and be like, Oh my god, what do I do now?
Alison - 00:13:07:
Oh yeah, I had a pump parts left at home incident that my husband had to bring. Yeah, anyway, all of those things. So is there anything that is on the future wishlist? Are there any shortcomings to the PUMP Act or to the Pregnant Workers' Fairness Act? What else could we do in that space?
Tina - 00:13:22:
So we know that all legislation has unintended consequences. So we know that while we try to ensure that all people who are going to be affected by any policy are engaged, we know that there are unintended consequences. We also know that sometimes we have to compromise before we get what we really need. So in that compromising for the PUMP Act, I already shared that in-flight crew, airline crew are not included in the original law. So we are fighting for that. The other thing that is not included is pay time. Pay time. And so that is something. Well. So know that that is on the horizon. We're not there yet. But know that that's on the horizon, because we know that, you know, those are dollars. So those still might be time that you need to take to express personal, but that's time that you should offer me.
Alison - 00:14:13:
And I think there's just the mechanics of that with if one isn't getting paid during that time pumping, then one has to work a longer day, which means one has to pay for more childcare, which, that's a feed forward loop, not in a good way.
Tina - 00:14:25:
Absolutely.
Alison - 00:14:26:
So I think I want to zoom out a little bit and back to this pregnancy tax. Can you talk a little bit about sort of lifelong earnings for folks who've had children versus folks who haven't had children and what that looks like across somebody's career?
Tina - 00:14:37:
Yeah. So we do know that between having to take time off, whether it's just a few days or longer, if you do have paid family and medical leave, we know that over the lifespan of men versus women, that women still earn significantly less than men because of the pregnancy tax.
Alison - 00:14:59:
One of the founding mothers of breastfeeding medicine, Ruth Lawrence is a neonatologist and she was a neonatologist for I want to say this was in the 1930s. And when she had her first child and came back to work, she was told, well, we don't need to pay you now. Because when she got married, they said, we don't need to pay you now because you're married. And she was like, no, actually, actually, you still need to pay me. My understanding is there's some data on what happens to people's salaries after they have the mom's salary and the dad's salary. Can you speak to that at all?
Tina - 00:15:25:
Yeah, they typically stagnate at best. Drop at worst while men's soar again, because they are the quote unquote caregivers. So men's salaries will soar while, while women's at best again, stagnate, but usually decline.
Alison - 00:15:44:
And we still have lots of work to do. I think that you talked about that the majority of leave is unpaid for folks in the United States. How does that impact folks, particularly those in communities that have been made marginalized?
Tina - 00:15:55:
Know that one out of four moms return to work. When we're looking at communities of color, that looks even higher disproportionately, that those numbers are disproportionately represented by communities of color. Only 21% of working adults have access to paid family medical needs. And when we're looking at low wage earners, that number is at 5%. So we know that when we're looking at the sectors, you know, if you just look at what sectors typically have paid family medical leave, if we just leave it up to the business community, thankfully, folks have adapted paid leave, some companies have. But when we look at what those businesses are, they typically are in tech or in banking, banking, but they're not in hospitality or childcare, where the majority are women and particularly women of color. The disparities between who is adopting it and who is not is just wide. So when we're looking at the need for a national policy. It's kind of amazing. The United States is one of the only industrialized countries that does not have paid leave. The other is Papua New Guinea. And last I heard, they were actually working on policy. So it is us and Papua New Guinea that do not have paid leave for working families.
Alison - 00:17:19:
We are outliers and not in a good way. How much do you think this American concept of bootstraps and doing it all on your own contributes to our weird outlier failure to support birthing the next generation?
Tina - 00:17:31:
American rugged individualism and pulling us up by our bootstraps. It's real. And you can do it on your own. But the reality is, is that we know that when a whole society is affected by not having the supports that they need, then it is not the individual personal failing. It is a problem that should be and could be easily addressed by a policy solution. We see other countries have adopted. If they can do it, why can't we? Rugged individualism, I might argue, is not good for public health.
Alison - 00:18:11:
Or humanity. Right.
Tina - 00:18:13:
Or humanity.
Alison - 00:18:17:
So what are some of the policies that are out there or legislation that's under consideration? And what are the pros and cons of the approaches that folks are pursuing?
Tina - 00:18:26:
Paid family medical leave is something we would love to see. I think we are currently at 17 states across the country that have adopted paid family medical leave. And that's phenomenal. But I live in North Carolina. I shouldn't have to live in New Jersey or New York or California or Washington state. I really like North Carolina. I should have access to a paid family and medical leave policy. If I lived in one of those states and have adopted, then I would have access. Shouldn't matter where you live. And we've already talked about that some employers offer it and some do not. It shouldn't matter who your employer is, who your boss is. At the national level, there is the Family Act, paid family medical leave bill sponsored by Senator Kirsten Gillibrand for New York, that we really hope sets the floor, like states can adopt their own policy. We wholeheartedly endorse that. But it's also a great policy to be a great equalizer, offering 12 weeks of paid family medical leave and allows folks to take time off, whether it's for the birth of a child, for their own personal health care reasons. Caregiving for a spouse or partner who might be recovering or going through cancer treatment. Really the wide range of caregiving needs, and that's called the Family Act. We know that paid leave polls great nationally. Paid leave also, when we talk about it, has really broad bipartisan support, but not every policy is the same and is equal. And some of the bad policies, Rob's Peter to pay Paul and says, oh, well, you can borrow from your Social Security earnings, later to take paid leave now. It's not a policy that'll work for several reasons. One, we need to have any policy cover the full range of caregiving needs. Secondly, we're really making people to make a choice at a really vulnerable point in their lives of saying, oh, no, no, I will take the paid leave now and I'll just work longer. That is a false choice that we don't need to have. We need to just offer a reasonable solution that we are seeing working in other states that is an insurance paid leave model that is the family.
Alison - 00:20:40:
Can you talk a little bit about how Social Security treats folks who are primary caregivers and are not working full time when their kids are little and how that impacts their what happens when they reach social security already.
Tina - 00:20:54:
Yeah. So Social Security, if you are not working, you are not earning those quarters to contribute to your Social Security retirement income. And so when you go, I don't know how many of you know, you can sign up to get your annual earning statement from the Social Security Administration that tells you where you're on track when you retire. And you will see that if you do that, and you're another birthing parent who has not worked for a period of time, you will see gaps. And so that immediately affects your future retirement income versus if you had paid family and medical leave, you would not have a similar gap because you would be earning.
Alison - 00:21:35:
I think another place where I wasn't totally aware of the policy implications I'd love for you to share with our listeners is around temporary aid for newbie families and what happens to folks in terms of their eligibility for financial assistance when they have a child and the variation by state. Can you talk a little bit about that?
Tina - 00:21:52:
Yeah. So once you have a child, first of all, you're income limited. If you earn even a penny over, you can fall back into not having the support that you need. So if you have a child and then maybe get a raise, you would not be able to receive the same. You could have a decrease, if not completely lose eligibility in TANF. And that's a real slippery slope and can set so many families back in poverty because, again, we're talking pennies. And these are dollars that help pay for food and help pay for clothing. And a roof over our heads. So when we're looking at where folks lie with eligibility to have that drastic of a swing based on slight deviations in income or a birth of a child can be and has been devastating.
Alison - 00:22:45:
So we've talked about pregnancy accommodations in the workplace. We've talked about PUMP Act. We've talked about paid family leave. Implied in being in the paid workforce is that somebody is taking care of the child. So can you talk a little about child care and what challenges that poses to families?
Tina - 00:23:02:
Yeah, so childcare right now is in a really challenging spot. As we're coming out of the pandemic, Are we coming out of the pandemic as we are in a new phase of the pandemic? We have an influx of dollars in a lot of ways, actually, right? We have an influx of dollars coming from the federal government to the state. One of those influx of dollars helped to really shore up our child care infrastructure. And so whether that was providing dollars for wages and earnings for the mostly represented by women and mostly women of color, in addition to ensuring that places didn't shut down, ensuring that there was enough money so that children can come off wait lists. That was all happening during the pandemic because we had this big drive, this big influx of money that came in from the federal government. Our childcare infrastructure was really, really tenuous prior to the pandemic. And so these dollars really helped to shore up the system. And now literally just in the last few weeks, those dollars have been playing out. Really stressful place of not knowing what's going to happen. We saw at the beginning of the pandemic what could happen. Childcare centers are closing, less people are entering the profession because they're just not being paid enough and more people are leaving the profession because they're not being paid enough. And so there's just less workforce. And then... When we don't have the childcare centers, how are families going to be able to return to work? They didn't even touch on the fact that child care is really expensive. Child care costs more than the state university. And that's on an annual basis. And that's outrageous. And then on top of that, the workforce isn't being compensated well. And so we have some real work to do around the child care workforce and how to ensure that our child care workforce is fairly compensated and is able to meet the needs of the remaining workforce.
Alison - 00:25:08:
So just sort of thinking about the moving parts here, let's imagine we had paid family leave. How does that affect demand for childcare?
Tina - 00:25:18:
It would certainly help. In many states, child care providers do not accept newborns. What that means is that there's this timeframe in which a parent has returned to work two weeks after giving birth doesn't actually have a safe place. Place to take her child to. So if we had paid family medical leave, she'd be able to be home past those two weeks. But also if we had it for 12 weeks, much more expensive to take care of a newborn. Then it is to take care of an older child. And so just imagine if we had at least 12 weeks of paid leave. And then imagine on top of that, if it happens to be a... Minimum a two caretaker home, you may even be able to get through six months. And then again, if it's paid family medical leave, you might be able to include extended family point being is that if we had paid family and medical leave, we would need less available childcare slots for those early, early months.
Alison - 00:26:23:
And in the many ways that this is so convoluted, many childcare workers can't afford to bring their own children to the childcare where they work because they're paid so little. So we're creating uncared for children and then paying people not enough. I think the technical term for this is hot mess.
Tina - 00:26:41:
It's a hot mess. Yes.
Alison - 00:26:44:
The other thing that I remember being totally stunned by, and this kind of gets back to the not earning social security when you're not in the paid workforce, is that When we think about what counts for the gross domestic product, which everyone is all excited about what direction it's going. If I go back to work at six weeks postpartum, and if I'm lucky enough to get six weeks and put my child, my baby in childcare, the money I'm paying to childcare counts as gross domestic product and the money I'm being paid counts as GDP. But if I stay home and take care of my same child, that is zero because there's no money in my hands.
Tina - 00:27:16:
Yes. Yes. So for GDP purposes, yes. Wouldn't this be wonderful? Absolutely.
Alison - 00:27:22:
And it comes down to, you know, care work is not counted, but when care work doesn't happen, it sure doesn't feel great. And yet we incentivize work that's in the paid workforce and we don't recognize the nurturing work that we need as humans to exist.
Tina - 00:27:36:
Care workers is completely hidden, right? Like it is completely hidden. We don't talk about it. It's mainly done by women, mainly done by women of color. So we don't talk about it. And I know that there are studies out there that put those dollars to the hidden cost. But caretaking is real and it is happening every day in so many households. It is why some folks are able to step outside of the home or are maybe fortunate to be able to work inside their home, but they're able to work.
Alison - 00:28:05:
Is it Norway that puts breast milk in the GDP? You know, when we think about when a formula company sells formula and person buys a can of formula and gives it to their baby, that counts as gross domestic product. But when a lactating person makes milk and gives it to their baby, that doesn't count. So that's another place where. Wow, I didn't know that. Yeah.
Tina - 00:28:24:
I want my breast milk to be counted in the GDP, especially when I was doing the twins.
Alison - 00:28:28:
In Norway, production is valued at 907 Million per year at 60% of its potential value. So yes, Julie Smith, who's an Australian economist, has talked about what it would look like if we counted breastfeeding in the GDP. I believe it is Norway that is the one that counts that in the gross domestic product. And so... And I can imagine heads spinning if that was introduced and people making all sorts of comments that are inappropriate. However, a product which is feeding the next generation is being produced and someone is doing work to make that happen. And that labor has value or should have value, but it is not valued or counted in our current economy. And that is not good for the humans. We touched a little bit about working at home and with the rise of remote work, there is this expectation that parents can manage their professional work and their nurturing work simultaneously. How realistic is that?
Tina - 00:29:23:
Oh, that's not realistic at all. I shouldn't say it all. But when someone is taking care of a newborn or an infant or toddler, they are taking care of a newborn, an infant or a toddler. To assume that they can work on top of that is just not a realistic expectation. People make choices to do so, but it is multitasking. And we all know that multitasking is not good.
Alison - 00:29:52:
I've been pleased that after COVID, wasn't there something where like a little kid ran across a room in front of a male broadcaster for national television and everyone was like, oh, that's so adorable. And so a consequence of COVID that is potentially positive is that it's understood that a cat, a dog, a child may walk through the middle of your Zoom meeting and people are no longer totally shocked and stunned by that. However, there's also this expectation that, you know, your childcare fell through too bad, just call in from Zoom and somehow latch your baby and, you know, deal with all the things at the same time.
Tina - 00:30:25:
The expectation should definitely not be there. I was one of the folks who sat and had my kindergartner sitting behind me doing school. And it was a real challenge. But I did it to normalize, right, that there were kids in the room. There were kids in my home. But I also had a five-year-old. And that was a choice I was making. It should not be the expectation.
Alison - 00:30:45:
I wanted to shift gears a little bit and talk about the implications of everything we've talked about in terms of the motherhood tax. Prior to Dobbs v. Jackson and how the implications of changing access to regular termination services are going to affect families.
Tina - 00:31:02:
Well, can we start with four spurts or never? Okay.
Alison - 00:31:06:
I'm down with that.
Tina - 00:31:08:
Yeah. You know, I think that there were so many people who didn't think that gobs could happen that ROE would be overturned. And now that it has been, and folks are seeing the realities, We're seeing it a little differently. And I can only hope that we will reverse policies to ensure that anyone who needs access to it after all. It's not going to happen. While people are living in this moment and are having to make decisions. Really difficult decisions about carrying a pregnancy to term that they did not want to and are having to then deal with the financial consequences of such. And so our childcare system, what we just talked about, is already tenuous. It's going to be in that much more of a tenuous state. Many of the states that have banned abortion already do not offer additional family support. So there isn't paid family medical leave. Many of them haven't even extended postpartum Medicaid coverage. And so we're living in this new world in which there's a lot of discussion around supporting families. But the realities aren't showing up. In fact, we're seeing the reverse. And it's hard. It's really hard. And I think when I talk to folks who live in St. Blake, Texas, Because again, I live in North Carolina, so I'm going to talk to folks from Texas or Mississippi. They tell me they've been here for a while. So this is just their reality. One of our members shared her story from Texas that she was miscarrying and she, Basically, almost had to bleed out. Before her doctor was able to provide care. In a wanted pregnancy that she was already heartbroken about, but then to realize that she had to be sick. And her partner was terrified that she was not going to survive. Thankfully she did. They were trying to get pregnant again. But these are impossible situations that we're putting families in. And I can only hope that people, elected officials, will see and hear the stories of real families.
Alison - 00:33:35:
I want to bring it back to kind of how MomsRising brings folks together. When I talk about MomsRising, I love the concept that MomsRising is where moms and the people who love them go to change the world. For folks who are concerned about these issues, who want to see changes, who want to see conditions that are more fair and just and supportive of families, how can folks get involved?
Tina - 00:33:59:
Thank you for that. Please, first of all, come check us out at momsrising.org. And we are just what you said, a place for moms and people who love them, building a world where families can thrive. Our focus is really on centering the voices of families. So that when we are in the rooms with policymakers and other decision makers, that they aren't making decisions in silos, that they know what real families are going through. We strongly believe that they know what real families are going through. Then families will be centered in the policy outcomes. And we do that in a wide variety of ways. But one of those is, you know, asking our members to share their stories. We also try to make it really easy for folks to engage because I don't know about you, I've got four boys. I am busy. If I get a gazillion emails, somebody was talking to my office, say about 340 something thousand emails in their inbox. I'm a zero invite kind of person. So that blew my mind a little bit, but We try to make it easy. And so we'll send emails with updates on where legislation is and how you can take action. We deliver those petitions to lawmakers and also try to talk with the media because we do have some education to do with the public at large and the media in general about what families are going through. And so I'm really grateful for those outlets who reach out to say, you know, we are running the story today on the GDP. Tell us, you know, what does this look like for real families? And so because we have families who share their stories, we can give anecdotes. We can also connect one of our members if they're willing to speak with the media. So, yeah, we try to make it simple, but offer just a wide range of ways for folks to engage. But first and foremost, we want to make sure you're educated around the issues and what's going on. So please come join us. And follow us on social media. We're on all the social media at momsrising.org across social media platforms.
Alison - 00:36:04:
A lot of what we've talked about is really hard stuff. And I think that I've increasingly aware of the extent to which for families, it's, it's traumatic to live through these things and for healthcare team members and for folks doing advocacy to hear these stories is traumatic. And I'm struck by the work of Dr. Shawn Ginwright, who has thought about kind of reframing this concept of trauma-informed care, which is something we've talked a lot about in social services to instead talking about healing centered engagement. And he talks about the fact that trauma-informed care sort of suggests that somebody's trauma should be the center of everything. And they're, you know, you're kind of a broken piece of pottery that you have to carry carefully so you don't lose any of the pieces that is forever flawed. And instead of thinking about that, how might we think about how we can heal and a metaphor that I love is Kintsugi, which is in Japanese ceramics, this idea that you take something that's broken and you put it back together and you use gold for the glue. So the reformed object is more beautiful than it was before it broke and its imperfections are part of what makes it beautiful. So, How can we be the gold glue? And then there's this wonderful quote from Dr. Ginwright who says that the healing center approach comes from the idea that people are not harmed in a vacuum. And well-being comes from participating in transforming the root causes of harms within institutions. So part of what I love about organizations like MomsRising is there is a way when I have a patient who is on the wrong end of not having paid parental leave or of, you know, arguing with their employer about where to express milk or what accommodations they have is to say, we're going to try to fix this. And here's how you can be part of transforming the root causes of a harm within institutions. I think the more we can build that civic muscle and participate in the solutions, that's part of the gold in between the broken pieces.
Tina - 00:37:51:
Absolutely. And we are also incredibly sensitive to the fact that retelling stories can can be both empowering and also traumatic. So we follow our members leads. We'd like to hope that we are always the gold. I love that analogy. Thank you, I'm gonna use that. That we are always the gold. But sometimes we recognize that we're not. And then whether you told your story once and that is all, or whether you've told it a million times and you can't do it one more time. We meet our members where they are and respect them. Where they are in their cycle of healing.
Alison - 00:38:36:
Absolutely. Well, thank you so much for taking the time to join us today to share your experiences. And thank you all for listening. For more podcasts, videos, blogs, and maternal health content, visit the Maternal Health Learning and Innovation Center website at maternalhealthlearning.org. We want to hear from you. Tell us what you want to hear more of, review our podcasts, and share with like-minded innovators. We've got some great episodes recording now. Be sure that you're subscribed. Let's keep talking. Tag us in your posts using hashtag maternal health innovation. I'm Alison Stuebe, and we'll see you next week on the Maternal Health Innovation Podcast. This project is supported by the Health Resources and Services Administration, HRSA, of the U.S. Department of Health and Human Services, HHS, under grant number U7CMC33636, State Maternal Health Innovation Support and Implementation Program Cooperative Agreement. This information or content and conclusions are those of the author and should not be construed as the official position or policy, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government.