Influencing Health Care Policy: Can Medical Providers Do That?

Influencing Health Care Policy: Can Medical Providers Do That?

How can health care professionals/pain management specialists become more involved in shaping health care policy?

Rehabilitation specialists are instrumental medical providers in the management of chronic pain. As a physical therapist I have been specializing in chronic pain for close to 15 years, and doing so, through the use of Complementary and Integrative Medicine methods, namely yoga.

As health care providers, the focus we choose for our clinical work is very important.  As therapists we have the power to directly impact healthcare policy in the US.

How can we influence the future of health care?

We can start by changing the way we deliver therapy services.

When I started out in physical therapy I made a conscious effort to do just that. With deliberation and much thought, during my first year of the Master of Physical Therapy program at The University of North Carolina at Chapel Hill, I sat down and created a mission which I felt would direct and determine the impact of the rest of my career.

Think Outside of the Box

At the time I was in PT school, I was concerned that there were no courses in integrative medicine, prevention, or business, much less alternative business models.  That led me to venture outside the School of Medicine and into the School of Public Health.

After obtaining special acceptance to do graduate work at The University of North Carolina at Chapel Hill School of Public Health, I worked on special projects that would eventually lead me to become a community organizer in eastern North Carolina.  There I was able to create some of the first integrative medicine programs in yoga and Pilates in the US.

Now 15 years later, my clinical focus continues to target public health education and injury prevention through writing and education in evidence based yoga.  My career and work in yoga as medicine stands as a humble offering for anecdotal evidence that as health care professionals, we can improve health care delivery through fostering a paradigm shift toward holistic and preventive therapy care.

In a recent excerpt from Becker Spine Review I gave the following answer when interviewed about influencing health care policy as pain management health care providers:

My mission in PT and chronic management has been to improve health care and health care delivery in the US, for the past 15 years.

My activism to shape health care policy through being a health care provider – led me to integrate a holistic biopsychosocial model of assessment, which I dub the “Pentagon of Wellness,” into my PT practice.  It is the foundation of a method of evidence based medical therapeutic yoga practice called Professional Yoga Therapy.  That model has allowed me to shift pain management and health care from its current medical model, curative based, to a more preventive or wellness based model. The results are very positive.

The model operates on the notion that CAM, a multi-billion dollar industry in the US, can be effective at both preventing and managing disease. The vehicles I use for shifting the health care paradigm include yoga, Pilates, Ayurveda, Native American medicine, Feng Shui, chromotherapy, and music as medicine. I combine all of these modalities with my licenses and experience in physical therapy, manual therapy and soft tissue work, women’s health, and sports medicine.

In less than 10 years, and working outside the current insurance model in order to lower health care costs (and since insurance can routinely deny or cap treatment for those in chronic pain) – I have been able to work with patients of all types – from pediatrics to geriatrics, from low back pain to cancer – and see them for a drastically lower cost through group physical therapy using the PYT model.

Professional Yoga Therapy, Yoga as Medicine Part 1, Module 8 on Emerald Isle, NC

Professional Yoga Therapy, Yoga as Medicine Part 1, Module 8 on Emerald Isle, NC

You Can Be A Change Agent – Build A Better Practice, Lower Your Stress, and Improve Patient Outcomes

My story is a small contribution toward the collectively massive potential we have available to us as medical professionals to create lasting transformation in health care today.  We have a clear and decidedly urgent responsibility as health care professionals to influence health care policy change, particularly in pain management.  The insurance based system, as it stands, frequently denies patients therapy services when the words “chronic pain” are involved.  I have repeatedly empathized and felt the despair and depression that patients bring to me because they felt they had no advocate in their previous health care experiences.  In fact, it is the most common story I hear, other than the shared variable of the pain experience.

But the positive news is we can change. We can improve health care today.  We can empower our patients to take control of their health care, to be an advocate for themselves, to educate them as to their options and rights in receiving therapy services, and finally, to begin to incorporate evidence based methods of Complementary and Integrative Medicine in alternative business models.

One of the many ways you can start to be a change agent today is to start by taking the Medical Therapeutic Yoga series that HomeCEUConnection.com currently offers in partnership with Professional Yoga Therapy.  The entire premise of the program is built upon empowering the patient and managing stress and inflammation in both the patient and therapist in order to reduce health care costs and improve health care in the US. I believe holistic self-care techniques, steeped in prevention and compassion, can truly change the landscape of American health care today.

More Resources

The methodology of the biopsychosocial model used in the Medical Therapeutic Yoga coursework is both evidence based and fiscally responsible. It offers an affordable business model which has enormous potential to reduce overhead costs in medical practice, health care, improve patient outcomes in therapy, and reduce health care provider burnout. Read patient testimonials here and read student reviews of the program here.

As therapists today, I believe we have overlooked our potential to be powerhouse agents of change. The health care provider as legislative change agent starts now – one patient at a time. If we as health care providers begin to embrace proven and safe holistic and integrative therapies then I strongly believe we can incite massive change in US health care and improve not just the health of our patients, but our health as well.

American Childbirth Needs Change

Ginger Garner MPT, ATC Practicing Empowering Prenatal Yoga During her First Pregnancy

American Childbirth Needs Change

The Birth Experience As Empowering

Childbirth in America needs to change.  America has the highest infant and mortality rates of any industrialized nation. Additionally, women are scared of birth and being scared into making fear based decisions about childbirth, rather than being respectfully informed and supported in their birth decisions.

We need to start acting like birth is valuable. We know full well it gives rise to our entire future. There is power in a woman’s ability to give birth to that future.

As women, we need to reclaim that power. As women, we have given up that power and allowed ourselves to be pushed into a corner. That corner is an operating room where birth is a procedure. Birth is a beautiful life enriching rite for the women who choose the road less traveled.

Giving Birth in the USA is Disempowering

Birth is not a pathologic event. It is a natural rite of passage. Birth is not a sterile, capitalistic business owned by hospitals and medical professions from which to generate profit. Birth is the private, nurturing business of women and belongs in the hands of women.

Unfortunately, prenatal care and hospital birth are an astoundingly profitable business for ob/gyns and hospitals. For the mother, hospital births are very expensive, between $5000 – $10,000 for a simple vaginal delivery. The cost of a midwife, in contrast, is a fraction of that. (Plus, when my I gave birth to my first child [in 2005], my midwife stayed with me throughout my labor). In addition, I knew that when using an ob/gyn, my chances for a c-section would increase to 33%, roughly, or 1 in 3. Most of my friends who ended up with c-sections labored a fraction of the time I did (about 1/3) before their ob/gyns emphatically stated they must have a c-section because of “failure to progress.” Additionally, many hospitals still have antiquated policies in place, such as requiring lithotomy position for birth or blocking mothers from using alternative methods for pain relief.

Obstetricians are trained as surgeons and should attend high risk, not low risk, births. Midwifes have all privileges and training that a physician has, except to perform major surgery. We are taxing an already burdened health care system by using health care providers who are not needed. Obstetricians are stretched extremely thin and are responsible for more work and more liability (and higher malpractice costs) than any other physician subspecialty. We need to utilize ob/gyn’s only when they are needed, so they may attend to higher risk births and provide the critical care that is needed for those high-risk expectant mothers.

The Value of An Empowered Birth Experience

We could ensure a future generation of women who will be strong, empowered mothers who trust their own bodies. Our views on birth are being shaped by an overly technocratic maternity system, when what we really need is a humanistic return to holistic birth. If we do not act, the next generation may completely lose the experience of birth.

Robbie Davis-Floyd, in her book Birth as an American Rite of Passage describes birth as it can be, as “wholistic” women’s health, rather than the medicalized “technocratic” process that currently defined birth in America. Women should be fully educated and informed about all of their birth choices, and not scared into making decisions based out of fear or belittlement.

Improving the Status of Women in America

We have only an illusion of control and choice when we birth in a hospital.

There are serious cultural implications for women’s social status if women reclaim the right to birth on their own terms. Women gave up their rights to birth in the early 20th century. Instead, they fought for medical intervention as a way to liberate themselves from the biology of giving birth. However, what happened was the opposite of liberation.

Now, 100 years later, the medical establishment owns birth. Hospitals require FM (fetal monitoring) and other medical interventions and insurance companies refuse to allow women to try for a VBAC (vaginal birth after cesarean) or to cover costs associated with VBAC’s.

We have only an illusion of control and choice when we birth in a hospital. I had a hospital birth, and had to drive 2 hours to get to a hospital which would even “allow” me to use a birthing ball or a midwife whose hands weren’t “tied” by antiquated hospital policy.

When we give up our rights to birth the way we choose, we devalue birth, which is the ultimate feminine act. We thus simultaneously devalue ourselves. Millions of women through all of history have been strong and confident enough to trust their bodies. We can return to that place of trust.

Modern medicine saves lives during truly high risk births, and ob/gyn’s are an absolutely necessary and very valuable part of the process; however the fact remains that the majority of births are low risk.

If we can reestablish ownership of our own bodies, then we can foster improved social status for women in every way: physically, financially, emotionally, psychologically, spiritually, and intellectually.

See the post on Modern Mom

 

Do American Mothers Need a Bill of Rights?

Pictured with my newborn son, James June 2012

Do American Mothers Need a Bill of Rights?

As mothers, it is imbedded in our very nature to take care of others. What mothers should know is that society has taken advantage of this fact for centuries. And while they continue to take, mothers continue to give.

How does society take without giving to mothers?

I think the National Association of Mothers’ Centers Advocacy Coordinator Valerie Young says it best,

“Alone among industrialized nations, we (mothers) have no guaranteed paid leave policy for childbirth, adoption, illness, or even the occasional sick day. Our federal pension system only accounts for paid work, leaving women with the short straw after time out bearing and raising children, tending to ill parents, spouses, or other family members. We do most of the unpaid work in the home, and when we are employed outside the home, our income trails men’s by as much as 40%. We lack anything near equitable political representation, we don’t occupy our fair share of board room seats, CEO suites, or participate proportionately in the distribution of financial assets around the world.”

A Harvard study firmly places America at the bottom of the barrel for mother support. The study found:

“Out of 168 nations in a Harvard University study last year, 163 had some form of paid maternity leave, leaving the United States in the company of Lesotho, Papua New Guinea and Swaziland.1”

http://thinkprogress.org/health/2012/05/24/489973/paid-maternity-leave-us/Mothers receive very little support, not only from our own government but also from society. And the proof is in the proverbial pudding.

Society gives lip service to the value of parenting, motherhood, and child rearing. After all, the children are the future of our country; yet, childcare workers typically earn at or minimum wage. Further, if you are a mother working from home to raise up the future of our country, you get nothing. Not even a social security credit. You must depend entirely on your partner’s wages and retirement. You in effect become a financial dependent, unable to qualify for credit or loans.

This poor show of support must change. Women have historically banded together to fight for their rights. Now mothers need to do the same. Mothers need support urgently or else the well being of our children and the future of the family unit in the US will be jeopardized.

But wait, our children’s health already is being jeopardized by this lack of support.

Women and mothers suffer from depression at nearly twice the rate as men.2,3 The CDC reports women suffer from postpartum depression (PPD) between 10-30% of the time, but that over 85% of mothers suffer from some type of depressive or mood instability in the postpartum period. Further, studies support that PPD occurs, and may even be worse, during the toddler years, and is (PPD) now not only pulling fathers into its grip but also responsible for adversely affecting toddler and teenage academic performance and psycho-emotional well being.4

Are you a mother who has felt depressed, alone, tired even exhausted, overwhelmed, and unable to cope with the mountain of responsibilities? Mothers do have more responsibilities than ever with more mothers working both outside and inside the home. We live in a two income society now where it has become almost impossible for a family to get by on one income. In addition, 75% of household management and child rearing still falls to mothers who also work outside the home.5

Further, families members often no longer live in proximity to one another because of job availability, choices in education, personal, or professional decisions or requirements. This means mothers can’t drop their children off with a relative to run important errands, go to work, go to a doctor’s appointment, or even to get a moment of silence to deal with existing problems or trauma. The FMLA may be in place in the US, but it is for a finite amount of unpaid leave and is reserved only for employees of large companies.

Where does that leave those women who own or work for small businesses?

When will there be change in America to support mothers, parents, and all childcare givers?

Change usually starts at a grassroots level with the persons who are being adversely affected by the situation. That would mean mothers organizing themselves to become active in policy by:

1. Joining together and supporting one another through communities of support like National Association of Mothers’ Centers, my blog here on, Fit and Fearless Birth, Modern Mom, and others.

2. Entering the political arena to create change. However, this is difficult to do if we cannot garner any support to re-enter (and remain) in the work force. I often say that the best I can do, failing aspiration to a political office where mothers’ rights was high on my agenda, is raise sensitive, intelligent sons who will fight for their mother and the rights of all mothers. (I currently have three sons who are already learning the ropes.) The bottom line is, we must find (and fight for) a way to be agents of change.

3. Getting involved with existing organizations who are already working for mothers’ rights. See the Resource List below for more information on depression, postpartum depression, and the movement to create what could be called a “Mothers’ Bill of Rights.”

What would be included in a “Mothers’ Bill of Rights?”

There is not enough space in a blog forum to discuss discrimination against parents (both mothers and fathers) in our workplace and social forums today. However, a mothers’ bill of rights might just as well be named the “Parental Bill of Rights” because it would help eliminate workplace and social discrimination against American families. It would implement a paternal leave policy, breastfeeding rights, inclusion of caregiving (for both the young and elderly) social policies (such as Family Friendly Jury Duty Laws) and include caregiving in the GDP (gross domestic product) as put forth by Ann Crittenden in her book, The Price of Motherhood. It would implement policies suggested in Dr. Riane Eisler’s bestselling book, The Real Wealth of Nations, and in her Caring Economics Campaign. Lastly, it would set up social security credits or related policies to safeguard those who have sacrificed to spend a life in caregiving.

As it stands now, women and their children are the poorest segment of society.4 They unfortunately have to depend on the handouts of others (usually their spouse’s retirement). In fact, just being a woman means you are most likely to be poor in your old age, based on the number of “zero income” years that women have on their social security statement compared to men.6

It is time for change. Value must be given to parenting objectively instead of forcing us (parents) to be deafened by the continual din of empty lip service that rises from the streets of our hometowns and inside the political beltway of Washington D.C.

Read the entire post as featured on Caring Economy
Read the entire post as featured on Modern Mom

Americans Need Family Friendly Social Policy

American Families Need Family Friendly Work Policy

Americans Need Family Friendly Social Policy

“Women will never achieve equality until mothers do.” – Joan Williams

Motherhood is esteemed as valuable in the US, after all, women give birth and nurture to the future leaders and citizens of our great country. Further, women do most of the caregiving and miss most days from work associated with pregnancy, childbirth, and childrearing.  Why, then, is a woman discriminated against, belittled, and made to feel incompetent and uncommitted in the workplace just because she becomes a mother?

Perhaps all the talk about the value of mothers is just lip service?

Birth is a transforming, empowering, life changing experience. Yet, once a woman becomes a mother society gives her less opportunity.

Studies show that mothers earn less than women without children. Controlling for all other factors which could otherwise explain the gap, there remains a 5% average decrease per child in a woman’s pay,” says National Association of Mothers’ Centers Advocacy Coordinator Valerie Young. “Women with children are viewed as less competent, less committed, and deserving of lower salaries. In contrast, men with children generally earn more than men who are not fathers and are perceived as more reliable, steady, and motivated to do well.”

With this stark wage gap, one could even say that society cheats mothers out of hard-earned wages, despite the fact that they are raising the future of America.

To support fit and fearless birth and the rite of passage that transforms a woman into a mother, the American workplace must change. What’s in it for me, someone without children might say? What’s in it for you is future economic security. Studies support that early childhood education and quality childcare is critical for development and ultimately produces stronger, more capable workers later in life. Without a strong workforce, we have no economy.

Without support of maternal leave and family-friendly social policies, our country and its entire economic future is at risk.

To borrow the words of John Lennon,

Imagine if…

Read the whole post…

A New Work Ethic (that ends gender discrimination) for the 21st Century?

To borrow the words of John Lennon, Imagine if

…there was no more discrimination against women in the workplace, there was paid maternity leave for mothers and fathers, every workplace had flex-time, job sharing, compressed work schedules, the option of working from home when possible, and no child went without quality care from their parents during their first year of life…

…it’s easy if you try…

Actually, these progressive workplace policies, which I believe are basic human rights, already exist – in almost every developed country except the United States.  The time to change this – to support the American family – is now.

For example, in the Netherlands, one attorney states “working part time is now the rule rather than the exception among his friends.”  Fathers are taking a more active role in child rearing, which also allows mothers to continue working as well.  The difference – a flexible, progressive workplace that values the family.  In the Netherlands there are “part-time surgeons, part-time managers and part-time engineers. From Microsoft to the Dutch Economics Ministry, offices have moved into “flex-buildings,” where the number of work spaces are far fewer than the staff who come and go on schedules tailored around their needs.
“The Dutch culture of part-time work provides an advance peek at the challenges — and potential solutions — that other nations will face as well in an era of a rapidly changing work force.”  Read the full article here.

Staying informed with the information below – can help you advocate for a modern workplace in your own profession. Policies such as flex-time, job sharing, telecommuting, and the Dutch concept of “flex-buildings”should be considered. At present, only 22% of American workplaces even offer telecommuting.

It’s About Time

Mindy Fried, a sociologist, questions the lack of paid family leave in the US versus how common it (paid family leave) is around the world. Opponents of the recently squashed Paycheck Fairness Act argue that it is the fault of women for putting themselves in the position to have to take lower paying jobs – because they demand flexibility and more time with family.
However, Your Wo(man) in Washington’s Valerie Young disagrees, as do I.  She argues, “Women do most of the unpaid family carework in this country. Culturally and socially, it is more acceptable for women to do it than men. Is that fair? At the same time, women have to support themselves and their families. They work without the benefit of paid sick days, or family leave, or even the ability to ask for an alternative schedule. Is that fair? Is it even a good idea? Paid leave is a political issue, a gender issue, and as Dr. Fried shows below, a class issue as well.” Read Mindy’s full essay, It’s About Time, here

What Working Women Want

A Rutger’s University conference, “What Mothers Want,” sponsored by the National Association of Mothers’ Centers, gave this report from a recent blog post by Valerie Young.
Pamela Stone – Professional women were three times more likely than their male counterparts to interrupt their employment for “family responsibilities.”  When they return, they frequently turn away from their former fields and enter lower paid, lower prestige sectors of the economy motivated by the desire to “give back” or pursue caring professions or social service.  Becoming a mother has a profound impact on a woman’s values, priorities, and sense of identity.  After a career hiatus, a mother often changes both her behavior and career aspirations.  Motherhood exerts a powerful transformational effect. Read What Mothers Want here

The Glass Hammer: Shifting Gender Roles in the Workplace

From The Glass Hammer, an online community for women executives in business, law, and financial services…Director of External Affairs and the Women’s Institute at the Omega Institute for Holistic Studies, Carla Goldstein reports “Women have been doing double duty since WWII, but now we need to shift our focus and figure out how we can support men and women at work; how do we ensure that parents have the time to nurture happy, healthy families?” Read Shifting Gender Roles in the Workplace here

White House Report on Jobs and Economic Security for Women in America

Family support, especially for women, in the workplace, has gotten the attention of our current administration. Here is the official report and Executive Summary on how the US intends to respond to family discrimination in the workplace.  However with the recent squash of the Paycheck Fairness Act, it remains to be seen just how or even if this administration can begin the process of modernizing the American workplace. Read the Summary and Report here

Remote Working and Productivity
Opponents of modernizing the workplace, i.e. those who might argue that telecommuting is not productive, should read the latest report from The Glass Hammer on Remote Working and Productivity in the US.

In the UK, businesses are reporting huge savings by instituting telecommuting.  “Fifty-five per cent of businesses are seeing more home working now than before the recession,” said Mick Hegarty, Strategy and Communication Director at BT Business. Productivity is up by 20% in those who work flexibly compared with those who don’t, he went on. BT have generated a saving of between £6million and £7million as a result of improved productivity. Read more here 

Slowly but surely…To be learned, each day add something. to be enlightened, each day drop something.

…The US can be the example of family friendly work ethics, which stand to benefit every worker – not just those with children.

More Resources
How To Negotiate Better Every Day
Remote Employment
Your Wo(man) in Washington 
The Price of Motherhood

What I Don’t Understand About Women

I am on maternity leave through August and September, so please enjoy today’s guest post by NAMC’s Advocacy Coordinator, Valerie Young. Valerie writes the popular blog for mother’s rights, Your (Wo)Man in Washington.
BITL Founder, Ginger, in pursuit of “pushing back” in 2010,
fundraising for women and children in Haiti
through voice and song.
Photo taken at a North Carolina festival. 2010.
I know something about women.
  
I am one, and have been for my whole life. Much of my time is spent in the company of women, professionally and personally.  
As an advocate for women’s economic security, I think a lot about about our experiences. I spend more time than most looking at data and research on women’s finances, economic power, and how they are affected by cultural attitudes and government policy.  I talk for hours on end to female academics, politicians, economists, lawyers, and my personal women friends, some down the street and others scattered around the world.  Most are mothers, some are not.  I’ve birthed and am raising children, and I’ve experienced surgical menopause, the effects of which continue to reveal themselves with the passage of time.   The art and science of being female is pretty much constantly at the front of my mind.  And I have noticed something.
We rarely give ourselves the credit we deserve.  
There is a significant gap between the efforts we make, the responsibility we assume, our willingness to put others first, and the esteem in which we hold ourselves.  I don’t understand this.  Being on the front lines of our very own lives, we know better than anyone the demanding and essential roles we play.  Yet we often give ourselves short shrift.  Consider what our lives may include:

  • the physical demands of pregnancy and childbirth  
  • years of varied and unending tasks required to keep an infant, a toddler, a child, a teen, an adult child living, learning, and functioning in this unpredictable and complex world
  • the constantly changing compromise required by our unpaid care of family, from economic dependency, to paid work with too little time for home, to trading down our paid employment, and accepting less than we are worth, to be available to the people who need us
  • part time work  without health insurance or a retirement plan
  • excruciating choices, such as go to work and get paid, or stay with the sick child and don’t get paid, or worse
  • in later life, we have less money than men because we earned less, saved less, lived longer and spent more time taking care of other people.  

We do this year in, year out, knowing the consequences, and not caring because we have to go to work, or the baby is crying, or the school just called, or we are too tired to even think about it.

Certainly some women are satisfied with their own blend of family life and employment.  It is not impossible, but at least in my own admittedly unscientific survey of mothers, it is exceedingly rare.  The women I know want passionately to succeed as both mothers and earners.  They know instinctively it is not one or the other, or at least that it doesn’t have to be.  They tie themselves into knots trying to be all things to their children, partners, bosses, co-workers and clients.  They want to do good work, be valued for their efforts and ability, and be treated fairly.  They want to raise their children the best they can, and are willing to give their all to whatever they are doing, whether it’s a raising a well-adjusted human being, or producing a bump up in the bottom line.  The women I know set impossibly high standards for themselves, and work hard to achieve them.

I say let’s recognize ourselves for the extraordinary creatures that we are.  We generate life, nurture, teach, grow.  We learn, strive, and work.  Our time is precious, our abilities unlimited.  We don’t realize our own strength.  When we became mothers, we committed ourselves to the service of human life.  That is no small thing.  Some portion of our own resources, energy, and purpose should be dedicated to our own interest.  So, stick up for yourself, sister!  We deserve better.  Push back against the status quo.  We have a stake in the future, for we will live there with and through our children.   How the future deals with us is up to us right now. 

Creation is what we do.  Every single day women remake the face of the world.  We have every right and every reason to make it a face that will smile back at us. 

Your (Wo)Man in Washington, Valerie Young
 
Valerie is Advocacy Coordinator for the National Association of Mothers’ Centers and its netroots initiative, Mothers Ought To Have Equal Rights.  She contributes analysis of policies affecting the economic security of mothers, educates members on the political process, and promotes a society that values the work of caring for children and other family members.  She brings the lens of motherhood to her coalition work on feminism, work/life issues, older women’s income security, and maternal health and well-being.
 
Valerie earned her law degree at Tulane University and practiced maritime insurance law in New Orleans for 11 years.  Before joining NAMC, Valerie worked for the National Association of Women Judges, and was a founder, along with Ann Crittenden and others, of the Mothers Ought To Have Equal Rights effort arising from publication of Ann’s book, “The Price of Motherhood”.  She also worked for the National Partnership of Women & Families fighting efforts to privatize Social Security, and promoting paid leave and other work/life issues.  She authored the National Partnership’s State Round Up of family friendly legislation in 2006.  She lives in suburban Washington DC with her family.

Mothering in America: An Uphill Climb

BITL Founder, expecting her third
child this month (June 2011).

This week’s guest post is penned by NAMC’s Advocacy Coordinator, Valerie Young. Valerie writes the popular blog for mother’s rights, Your (Wo)Man in Washington.

Being a mother in the United States is an uphill climb.  Alone among industrialized nations, we have no guaranteed paid leave policy for childbirth, adoption, illness, or even the occasional sick day.  Our federal pension system only accounts for paid work, leaving women with the short straw after time out bearing and raising children, tending to ill parents, spouses, or other family members.   We do most of the unpaid work in the home, and when we are employed outside the home, our income trails men’s by as much as 40%.  We lack anything near equitable political representation, we don’t occupy our fair share of board room seats, CEO suites, or participate proportionately in the distribution of financial assets around the world.  When you’ve studied gender inequality for awhile, you don’t shock easily.  But today I’m shocked.  In fact, all women in the US have a whole new reason to be outraged.  If we are to become the fit and fearless mothers Ginger encourages us to be, there is an issue screaming for our attention –  maternal mortality, in other words, women dying from childbirth or due to a pregnancy-related complication. 

Around the world, every minute of every day, a woman dies from childbirth.  This may not be surprising, as access to medical care, good hygiene, and clean water are not equally accessible.  What is astounding is that the US ranks a lowly 50th on the World Health Organization’s measure of global maternal mortality.  In other words, 49 other countries have figured out how to better care for women throughout pregnancy and birth so that more of them survive the process.  It’s true that the US spends more dollars on health care than any other country, but we don’t have the positive outcomes you’d expect in correlation.  Many pregnant women never get prenatal care, or only get it well into their pregnancies.  The latest data show that 17 out of 100,000 American women die from pregnancy-related conditions.  With 50 million uninsured, health care is beyond the reach of millions of expectant mothers.  In fact, the US rate of maternal mortality has been going up since 1987, when we hit a low of 6.6 deaths per 100,000 deliveries, and continues to climb. It has more than doubled in the past 24 years.  The good news is that maternal deaths are preventable in most cases.  Experts say that with appropriate care, the US rate could be reduced to 3 out of 100,000.

The first step in making this happen is requiring states to report data pertaining to maternal death.  Such information has not been gathered, nor is there any national record of what conditions or complications are the cause.  Legislation pending in the US House of Representatives would change that.  The Maternal Health and Accountability Act, if passed, would enable the states to count pregnancy-related deaths and create an advisory panel of medical experts to interpret the findings and make recommendations to prevent maternal death.  The theory behind the bill is expressed here by the Association of Reproductive Health Professionals:

The first step we need to take is to honor the lives of the women who have died by investing the necessary resources to identify why they died and learn from their deaths in order to prevent other women from dying. There are no acceptable excuses when we consider the fact that we lag behind most developed countries and when numerous developing countries, such as Vietnam and Albania, with much fewer resources than the United States, are making strides towards meeting their goals of reducing preventable maternal deaths, while the United States is backsliding.  http://www.arhp.org/publications-and-resources/contraception-journal/march-2011

Every Mother Counts and MomsRising, two organizations promoting mothers’ well-being, have a one click link that gets  you right to the inbox of your members of Congress, telling them you support the bill and urging them to pass it. They’ve drafted a brief message, and all you have to do is fill out your name and address to identify your US Representative.  It’s easy and effective.  http://www.everymothercounts.org/news/2011/05/christy-blogs-momsrising-may-14-2011

Motherhood is transformational, powerful, miraculous and sometimes terrifying. It doesn’t need to be deadly, especially in the wealthiest country the world has ever seen.  Passing this bill is a step in the right direction.  Please take action, click through, and encourage your legislator to step up.

If you would like to know more, here’s where to look:
http://mothersmonument.org/maternal-mortality/ 
http://www.everymothercounts.org/news/2011/05/christy-blogs-momsrising-may-14-2011
http://whqlibdoc.who.int/publications/2010/9789241500265_eng.pdf

Your (Wo)Man in Washington, Valerie Young
 
Valerie is Advocacy Coordinator for the National Association of Mothers’ Centers and its netroots initiative, Mothers Ought To Have Equal Rights.  She contributes analysis of policies affecting the economic security of mothers, educates members on the political process, and promotes a society that values the work of caring for children and other family members.  She brings the lens of motherhood to her coalition work on feminism, work/life issues, older women’s income security, and maternal health and well-being.
 
Valerie earned her law degree at Tulane University and practiced maritime insurance law in New Orleans for 11 years.  Before joining NAMC, Valerie worked for the National Association of Women Judges, and was a founder, along with Ann Crittenden and others, of the Mothers Ought To Have Equal Rights effort arising from publication of Ann’s book, “The Price of Motherhood”.  She also worked for the National Partnership of Women & Families fighting efforts to privatize Social Security, and promoting paid leave and other work/life issues.  She authored the National Partnership’s State Round Up of family friendly legislation in 2006.  She lives in suburban Washington DC with her family.

A Mother’s Bill of Rights?

As mothers, it is our nature to take care of others.  That is nothing new. What is shocking is that society has taken advantage of this fact for centuries. And while they continue to take, mothers continue to give.

How? For starters, the United States has one of the worst maternity leave policies among all industrialized nations.1  USA Today cites a Harvard study which firmly places America at the bottom of the barrel for mother support. The study found:

“Out of 168 nations in a Harvard University study last year, 163 had some form of paid maternity leave, leaving the United States in the company of Lesotho, Papua New Guinea and Swaziland.1”  

Mothers receive very little support, not only from our own government but also from society.  And the proof is in the proverbial pudding.

Society gives lip service to the value of parenting, motherhood, and child rearing – after all, the children are the future of our country – yet, childcare workers typically earn at or minimum wage. Further, if you are a mother working from home to raise up the future of our country – you get nothing. Not even a social security credit. You must depend entirely on your partner’s wages and retirement.


This poor show of support must change. Women have historically banded together to fight for their rights. Now mothers need to do the same.  Mothers need support urgently – or else the well being of our children and the future of the family unit in the US will be jeopardized. But wait – it already is.

Women and mothers suffer from depression at nearly twice the rate as men.2,3 The CDC reports women suffer from postpartum depression (PPD) between 10-30% of the time, but that over 85% of mothers suffer from some type of depressive or mood instability in the postpartum period.  Further, studies support that PPD occurs, and may even be worse, during the toddler years, and is (PPD) now not only pulling fathers into its grip but also responsible for adversely affecting toddler and teenage academic performance and psycho-emotional well being.

Are you a mother who has felt depressed, alone, tired even exhausted, overwhelmed, and unable to cope with the mountain of responsibilities?  Mothers do have more responsibilities than ever – with more mothers working both outside and inside the home.  We live in a two income society now – where it has become almost impossible for a family to get by on one income.

In addition, 75% of household management and child rearing still falls to mothers who also work outside the home.5 Further, families members often no longer live in proximity to one another because of job availability, choices in education, personal, or professional decisions or requirements. This means mothers can’t drop their children off with a relative – to run important errands, go to work, go to a doctor’s appointment, or even to get a moment of silence to deal with existing problems or trauma. The FMLA may be in place in the US, but it is for a finite amount of unpaid leave and is reserved only for employees of large companies – where does that leave those who own or work for small businesses and corporations?

When will there be change in America – to support mothers, parents, and all childcare givers? Change usually starts at a grassroots level – with the persons who are being adversely affected by the situation. That would mean mothers organizing themselves to become active in policy by:

  1. Joining together and supporting one another, as I write in my Mommy Wars blog. 
  2. Entering the political arena to create change.  However, this is difficult to do if we cannot garner any support to re-enter (and remain) in the work force.  I often say that the best I can do, failing aspiration to a political office where mothers’ rights was high on my agenda, is raise sensitive, intelligent sons who will fight for their mother and the rights of all mothers. (I currently have two sons who are already learning the ropes.) The bottom line is, we must find (and fight for) a way to be agents of change.
  3. Getting involved with existing organizations who are already working for mothers’ rights.  See the Resource List below for more information on depression, postpartum depression, and the movement to create what could be called a “Mother’s Bill of Rights.”

What would be included in a so-called “Mothers’ Bill of Rights?”

There is not enough space in a blog forum to discuss discrimination against parents (both mothers and fathers) in our workplace and social forums today.  However, a mothers’ bill of rights might just as well be named the “Parental Bill of Rights” and would help to eliminate workplace and social discrimination by implementing a modern paternal leave policy, breastfeeding rights, inclusion of caregiving (for both the young and elderly) into the GDP (gross domestic product) as put forth by Ann Crittenden in her book, The Price of Motherhood, and setting up social security credits for those who have spent a life in caregiving.

As it stands now, women and their children are the poorest segment of society.They depend on the handouts of others (usually their spouse’s retirement). In fact, just being a woman means you are most likely to be poor in your old age, based on the number of “zero income” years that women have on their social security statement compared to men.6

It is time for change. Value must be given to parenting – objectively – instead of forcing us (parents) to be deafened by the continual din of empty lip service that rises from the streets of our hometowns and inside the political beltway of Washington D.C.

Resources
Gayle Peterson, LCSW, PhD
  – More information on depression and treatment

National Association of Mothers’ Centers
National Women’s Law Center
The Glass Hammer
America’s Parent Trap - Washington Post Column on the politics of parenting
Ann Crittenden  – Author and founder of NAMC, mother’s rights activist
Your (Wo)man in Washington - The NAMC Blog

*I took this photo in June when I was invited to Philadelphia to speak on my methods in medical therapeutic yoga at the 61st Annual NATA Convention.  The Liberty Bell has is not a sign of liberty attained – but rather represents the ongoing attainment of freedom for all.  The Liberty Bell is not just a symbol for Americans – but for citizens everywhere who are oppressed.  Many groups have sought refuge in the symbol of freedom that the Liberty Bell represents.


Sources
1.  USA Today, July 26, 2005.

2.  Regier DA, Narrow WE, Rae DS, et al. The de facto mental and addictive disorders service system. Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry, 1993; 50(2): 85-94.
3.  Narrow WE. One-year prevalence of mental disorders, excluding substance use disorders, in the U.S.: NIMH ECA prospective data. Population estimates based on U.S. Census estimated residential population age 18 and over on July 1, 1998. Unpublished.
4. Science Daily, 1999. 
5.  United Nations Conference on Trade and Development. TRADE AND DEVELOPMENT BOARD, Fifty-second session
Geneva, 3-14 October 2005. 

6. US Office of Social Security Administration: Office of Policy. 2000

The Mommy Wars

I recently had a question from a reader, a mother of 2 young girls. The problem she presented has been plaguing women since they left the home en masse and entered the workplace – from the 1970’s forward.  It is a problem we all struggle with – whether we are stay at home moms or working moms.

Here is my response to this busy, working mom – who like all mothers is just trying to do the best she can for her children.

Question:

Has anyone else had this problem? I work 2-3 days a week as a nurse in an extremely busy hospital Endoscopy department. I have 3 and 8 yr old daughters. I have a really busy life. I’m experiencing a sort of “backlash” from my friends. My work friends are giving me this “must be nice, only working 2 days a week.” My at home mom friends are giving me this “your too busy for us, your career and all.”

It is soo frustrating. It’s like I can’t win. Neither party has any idea what my home life is like and all I am responsible for. I’m really doing the best I can. Any suggestions??

Thanks,
XXX

My Reply:

Ask yourself this question first: Do you really like those friends who are giving you such a hard time?

In fact, are they really your friends at all? If it were me, I would not give them a second thought. Women have it hard enough in this world trying to balance being the (usual) primary caregiver, the (usual) primary household manager, and then oftentimes working outside the home on top of that. However, instead of helping each other – they frequently tear each over down over mothering choices.

This evolution is very sad, and it represents the demise of women’s relationships in this world. Women used to band together and help each other stand strong – through birth, child rearing, family life, work, and death. I believe we lost this womanly community of support when women started to believe they had to choose sides – either work inside the home OR work outside the home. They also bought into the belief that one was more important than the other. The truth is – both jobs are valuable and absolutely necessary.

Surround yourself with positive thinkers who support you.  You are doing your best as a woman and mother and you only have time in your life for those will help raise you up – not tear you down.

If you have not read any of Pulitzer Prize nominee and mother’s activist Ann Crittenden’s books, I highly suggest them. Crittenden’s books empower mothers- and leave no room for the petty backlash you are, and most ALL mothers experience, from their not so friendly “friends.”

You are doing a great job – and yes, you can have the best of both worlds as a mother and woman. I think you have made a great decision – it’s one I can relate to and strive for as a working mother with two young sons.

Congratulations to you, keep up the fantastic job of balancing your life well and having the awareness and wisdom to know when you may have to walk away from relationships which are damaging your well being.  Cut yourself loose from those false friends who do not support you. There are plenty of women out there who do support you, and I am one of them!

Blessings to your and your family,
Ginger

*photo taken of me speaking at a national health care convention in Philadelphia in June. What is not pictured is the internal struggle of me leaving my sons (again) to be “the working mom.”  I empathize with all moms – stay at home and working moms.  Women need to support women because no one else can truly understand the complexity of what life requires from us.

Women’s Health in the US: “Being A Woman Is Not A Pre-Existing Condition”

Insurance coverage is a top issue in women’s health care today, if not the top priority. Women hold the future of this planet in our bodies.

While I do not agree that “men make the rules”, at least not all of the time, still yet, I do agree with the National Women’s Law Center stance that “being a woman is not a pre-existing condition.”

If we, as women, do not have access to good health care for our body, mind, and spirit because we cannot afford exorbitant and inequitable insurance rates, then how can health care in America be “reformed”? Furthermore, how can the future of our country and planet be well secured?

Progress can’t and won’t be made in women’s health care reform unless we act today.

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