News Politics

Congress Tried to Pass Anti-Women Bills on an Average of Once A Week

Robin Marty

How much was Congress focused on women's health and rights last session?  A lot.

Some might call it an obsession. However you want to look at it, the far right in Congress seemed to have an unhealthy fixation on women’s rights last session. According to the Committee on Energy and Commerce, the 112th Congress offered up an overwhelming 55 anti-women bills, averaging more than one a week.

From the report:

Since the beginning of the 112thCongress in January 2011, the Republican-controlled House has cast 55 votes for anti-women policies that undermine women’s health, roll back women’s rights, and defund programs and institutions that provide support for women.

“House Republicans have voted repeatedly for legislation that would be harmful to women’s health and women’s rights,” said Rep. Waxman.  “I have worked for decades to promote equality for women, but the bipartisan support for women’s programs that used to exist in Congress has been shattered by tea party extremism.  The Republican-controlled House has become the most anti-women House in modern history.”

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The report, prepared by the Democratic staff of the Energy and Commerce Committee, found that the House passed an average of one anti-women vote for every week that it has been in session for the 112th Congress.  These votes constitute almost 5% of all House legislative votes taken since January 2011.

But don’t forget, it’s just an “imaginary” war on women.

Culture & Conversation Maternity and Birthing

On ‘Commonsense Childbirth’: A Q&A With Midwife Jennie Joseph

Elizabeth Dawes Gay

Joseph founded a nonprofit, Commonsense Childbirth, in 1998 to inspire change in maternity care to better serve people of color. As a licensed midwife, Joseph seeks to transform how care is provided in a clinical setting.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

Jennie Joseph’s philosophy is simple: Treat patients like the people they are. The British native has found this goes a long way when it comes to her midwifery practice and the health of Black mothers and babies.

In the United States, Black women are disproportionately affected by poor maternal and infant health outcomes. Black women are more likely to experience maternal and infant death, pregnancy-related illness, premature birth, low birth weight, and stillbirth. Beyond the data, personal accounts of Black women’s birthing experiences detail discrimination, mistreatment, and violation of basic human rights. Media like the new film, The American Dream, share the maternity experiences of Black women in their own voices.

A new generation of activists, advocates, and concerned medical professionals have mobilized across the country to improve Black maternal and infant health, including through the birth justice and reproductive justice movements.

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Joseph founded a nonprofit, Commonsense Childbirth, in 1998 to inspire change in maternity care to better serve people of color. As a licensed midwife, Joseph seeks to transform how care is provided in a clinical setting.

At her clinics, which are located in central Florida, a welcoming smile and a conversation mark the start of each patient visit. Having a dialogue with patients about their unique needs, desires, and circumstances is a practice Joseph said has contributed to her patients having “chunky,” healthy, full-term babies. Dialogue and care that centers the patient costs nothing, Joseph told Rewire in an interview earlier this summer.

Joseph also offers training to midwives, doulas, community health workers, and other professionals in culturally competent, patient-centered care through her Commonsense Childbirth School of Midwifery, which launched in 2009. And in 2015, Joseph launched the National Perinatal Task Force, a network of perinatal health-care and service providers who are committed to working in underserved communities in order to transform maternal health outcomes in the United States.

Rewire spoke with Joseph about her tireless work to improve maternal and perinatal health in the Black community.

Rewire: What motivates and drives you each day?

Jennie Joseph: I moved to the United States in 1989 [from the United Kingdom], and each year it becomes more and more apparent that to address the issues I care deeply about, I have to put action behind all the talk.

I’m particularly concerned about maternal and infant morbidity and mortality that plague communities of color and specifically African Americans. Most people don’t know that three to four times as many Black women die during pregnancy and childbirth in the United States than their white counterparts.

When I arrived in the United States, I had to start a home birth practice to be able to practice at all, and it was during that time that I realized very few people of color were accessing care that way. I learned about the disparities in maternal health around the same time, and I felt compelled to do something about it.

My motivation is based on the fact that what we do [at my clinic] works so well it’s almost unconscionable not to continue doing it. I feel driven and personally responsible because I’ve figured out that there are some very simple things that anyone can do to make an impact. It’s such a win-win. Everybody wins: patients, staff, communities, health-care agencies.

There are only a few of us attacking this aggressively, with few resources and without support. I’ve experienced so much frustration, anger, and resignation about the situation because I feel like this is not something that people in the field don’t know about. I know there have been some efforts, but with little results. There are simple and cost-effective things that can be done. Even small interventions can make such a tremendous a difference, and I don’t understand why we can’t have more support and more interest in moving the needle in a more effective way.

I give up sometimes. I get so frustrated. Emotions vie for time and energy, but those very same emotions force me to keep going. I feel a constant drive to be in action and to be practical in achieving and getting results.

Rewire: In your opinion, what are some barriers to progress on maternal health and how can they be overcome?

JJ: The solutions that have been generated are the same, year in and year out, but are not really solutions. [Health-care professionals and the industry] keep pushing money into a broken system, without recognizing where there are gaps and barriers, and we keep doing the same thing.

One solution that has not worked is the approach of hiring practitioners without a thought to whether the practitioner is really a match for the community that they are looking to serve. Additionally, there is the fact that the practitioner alone is not going to be able make much difference. There has to be a concerted effort to have the entire health-care team be willing to support the work. If the front desk and access points are not in tune with why we need to address this issue in a specific way, what happens typically is that people do not necessarily feel welcomed or supported or respected.

The world’s best practitioner could be sitting down the hall, but never actually see the patient because the patient leaves before they get assistance or before they even get to make an appointment. People get tired of being looked down upon, shamed, ignored, or perhaps not treated well. And people know which hospitals and practitioners provide competent care and which practices are culturally safe.

I would like to convince people to try something different, for real. One of those things is an open-door triage at all OB-GYN facilities, similar to an emergency room, so that all patients seeking maternity care are seen for a first visit no matter what.

Another thing would be for practitioners to provide patient-centered care for all patients regardless of their ability to pay.  You don’t have to have cultural competency training, you just have to listen and believe what the patients are telling you—period.

Practitioners also have a role in dismantling the institutionalized racism that is causing such harm. You don’t have to speak a specific language to be kind. You just have to think a little bit and put yourself in that person’s shoes. You have to understand she might be in fear for her baby’s health or her own health. You can smile. You can touch respectfully. You can make eye contact. You can find a real translator. You can do things if you choose to. Or you can stay in place in a system you know is broken, doing business as usual, and continue to feel bad doing the work you once loved.

Rewire: You emphasize patient-centered care. Why aren’t other providers doing the same, and how can they be convinced to provide this type of care?

JJ: I think that is the crux of the matter: the convincing part. One, it’s a shame that I have to go around convincing anyone about the benefits of patient-centered care. And two, the typical response from medical staff is “Yeah, but the cost. It’s expensive. The bureaucracy, the system …” There is no disagreement that this should be the gold standard of care but providers say their setup doesn’t allow for it or that it really wouldn’t work. Keep in mind that patient-centered care also means equitable care—the kind of care we all want for ourselves and our families.

One of the things we do at my practice (and that providers have the most resistance to) is that we see everyone for that initial visit. We’ve created a triage entry point to medical care but also to social support, financial triage, actual emotional support, and recognition and understanding for the patient that yes, you have a problem, but we are here to work with you to solve it.

All of those things get to happen because we offer the first visit, regardless of their ability to pay. In the absence of that opportunity, the barrier to quality care itself is so detrimental: It’s literally a matter of life and death.

Rewire: How do you cover the cost of the first visit if someone cannot pay?

JJ: If we have a grant, we use those funds to help us pay our overhead. If we don’t, we wait until we have the women on Medicaid and try to do back-billing on those visits. If the patient doesn’t have Medicaid, we use the funds we earn from delivering babies of mothers who do have insurance and can pay the full price.

Rewire: You’ve talked about ensuring that expecting mothers have accessible, patient-centered maternity care. How exactly are you working to achieve that?

JJ: I want to empower community-based perinatal health workers (such as nurse practitioners) who are interested in providing care to communities in need, and encourage them to become entrepreneurial. As long as people have the credentials or license to provide prenatal, post-partum, and women’s health care and are interested in independent practice, then my vision is that they build a private practice for themselves. Based on the concept that to get real change in maternal health outcomes in the United States, women need access to specific kinds of health care—not just any old health care, but the kind that is humane, patient-centered, woman-centered, family-centered, and culturally-safe, and where providers believe that the patients matter. That kind of care will transform outcomes instantly.

I coined the phrase “Easy Access Clinics” to describe retail women’s health clinics like a CVS MinuteClinic that serve as a first entry point to care in a community, rather than in a big health-care system. At the Orlando Easy Access Clinic, women receive their first appointment regardless of their ability to pay. People find out about us via word of mouth; they know what we do before they get here.

We are at the point where even the local government agencies send patients to us. They know that even while someone’s Medicaid application is in pending status, we will still see them and start their care, as well as help them access their Medicaid benefits as part of our commitment to their overall well-being.

Others are already replicating this model across the country and we are doing research as we go along. We have created a system that becomes sustainable because of the trust and loyalty of the patients and their willingness to support us in supporting them.

Photo Credit: Filmmaker Paolo Patruno

Joseph speaking with a family at her central Florida clinic. (Credit: Filmmaker Paolo Patruno)

RewireWhat are your thoughts on the decision in Florida not to expand Medicaid at this time?

JJ: I consider health care a human right. That’s what I know. That’s how I was trained. That’s what I lived all the years I was in Europe. And to be here and see this wanton disregard for health and humanity breaks my heart.

Not expanding Medicaid has such deep repercussions on patients and providers. We hold on by a very thin thread. We can’t get our claims paid. We have all kinds of hoops and confusion. There is a lack of interest and accountability from insurance payers, and we are struggling so badly. I also have a Change.org petition right now to ask for Medicaid coverage for pregnant women.

Health care is a human right: It can’t be anything else.

Rewire: You launched the National Perinatal Task Force in 2015. What do you hope to accomplish through that effort?

JJ: The main goal of the National Perinatal Task Force is to connect perinatal service providers, lift each other up, and establish community recognition of sites committed to a certain standard of care.

The facilities of task force members are identified as Perinatal Safe Spots. A Perinatal Safe Spot could be an educational or social site, a moms’ group, a breastfeeding circle, a local doula practice, or a community center. It could be anywhere, but it has got to be in a community with what I call a “materno-toxic” area—an area where you know without any doubt that mothers are in jeopardy. It is an area where social determinants of health are affecting mom’s and baby’s chances of being strong and whole and hearty. Therein, we need to put a safe spot right in the heart of that materno-toxic area so she has a better chance for survival.

The task force is a group of maternity service providers and concerned community members willing to be a safe spot for that area. Members also recognize each other across the nation; we support each other and learn from each others’ best practices.

People who are working in their communities to improve maternal and infant health come forward all the time as they are feeling alone, quietly doing the best they can for their community, with little or nothing. Don’t be discouraged. You can get a lot done with pure willpower and determination.

RewireDo you have funding to run the National Perinatal Task Force?

JJ: Not yet. We have got the task force up and running as best we can under my nonprofit Commonsense Childbirth. I have not asked for funding or donations because I wanted to see if I could get the task force off the ground first.

There are 30 Perinatal Safe Spots across the United States that are listed on the website currently. The current goal is to house and support the supporters, recognize those people working on the ground, and share information with the public. The next step will be to strengthen the task force and bring funding for stability and growth.

RewireYou’re featured in the new film The American Dream. How did that happen and what are you planning to do next?

JJ: The Italian filmmaker Paolo Patruno got on a plane on his own dime and brought his cameras to Florida. We were planning to talk about Black midwifery. Once we started filming, women were sharing so authentically that we said this is about women’s voices being heard. I would love to tease that dialogue forward and I am planning to go to four or five cities where I can show the film and host a town hall, gathering to capture what the community has to say about maternal health. I want to hear their voices. So far, the film has been screened publicly in Oakland and Kansas City, and the full documentary is already available on YouTube.

RewireThe Black Mamas Matter Toolkit was published this past June by the Center for Reproductive Rights to support human-rights based policy advocacy on maternal health. What about the toolkit or other resources do you find helpful for thinking about solutions to poor maternal health in the Black community?

JJ: The toolkit is the most succinct and comprehensive thing I’ve seen since I’ve been doing this work. It felt like, “At last!”

One of the most exciting things for me is that the toolkit seems to have covered every angle of this problem. It tells the truth about what’s happening for Black women and actually all women everywhere as far as maternity care is concerned.

There is a need for us to recognize how the system has taken agency and power away from women and placed it in the hands of large health systems where institutionalized racism is causing much harm. The toolkit, for the first time in my opinion, really addresses all of these ills and posits some very clear thoughts and solutions around them. I think it is going to go a long way to begin the change we need to see in maternal and child health in the United States.

RewireWhat do you count as one of your success stories?

JJ: One of my earlier patients was a single mom who had a lot going on and became pregnant by accident. She was very connected to us when she came to clinic. She became so empowered and wanted a home birth. But she was anemic at the end of her pregnancy and we recommended a hospital birth. She was empowered through the birth, breastfed her baby, and started a journey toward nursing. She is now about to get her master’s degree in nursing, and she wants to come back to work with me. She’s determined to come back and serve and give back. She’s not the only one. It happens over and over again.

This interview has been edited for length and clarity.

Commentary Politics

Is Clinton a Progressive? Not If She Chooses Tim Kaine

Jodi Jacobson

The selection of Tim Kaine as vice president would be the first signal that Hillary Clinton intends to seek progressive votes but ignore progressive values and goals, likely at her peril, and ours.

During the 2016 presidential campaign, former secretary of state and presumptive Democratic presidential nominee Hillary Rodham Clinton has frequently claimed to be a progressive, though she often adds the unnecessary and bewildering caveat that she’s a “progressive who likes to get things done.” I’ve never been sure what that is supposed to mean, except as a possible prelude to or excuse for giving up progressive values to seal some unknown deal in the future; as a way of excusing herself from fighting for major changes after she is elected; or as a way of saying progressives are only important to her campaign until after they leave the voting booth.

One of the first signals of whether Clinton actually believes in a progressive agenda will be her choice of running mate. Reports are that Sen. Tim Kaine, former Virginia governor, is the top choice. The selection of Kaine would be the first signal that Clinton intends to seek progressive votes but ignore progressive values and goals, likely at her peril, and ours.

We’ve seen this happen before. In 2008, then-presidential candidate Barack Obama claimed to be a progressive. By virtue of having a vision for and promise of real change in government and society, and by espousing transparency and responsibility, he won by a landslide. In fact, Obama even called on his supporters, including the millions activated by the campaign’s Organizing for Action (OFA), to keep him accountable throughout his term. Immediately after the election, however, “progressives” were out and the right wing of the Democratic party was “in.”

Obama’s cabinet members in both foreign policy and the economy, for example, were drawn from the center and center-right of the party, leaving many progressives, as Mother Jones’ David Corn wrote in the Washington Post in 2009, “disappointed, irritated or fit to be tied.” Obama chose Rahm Emanuel as Chief of Staff, a man with a reputation from the days of Bill Clinton’s White House for a reluctance to move bold policies—lest they upset Wall Street or conservative Democrats—and a deep disdain for progressives. With Emanuel as gatekeeper of policies and Valerie Jarrett consumed with the “Obama Brand” (whatever that is), the White House suddenly saw “progressives” as the problem.

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It became clear that instead of “the change we were hoping for,” Obama had started on an impossible quest to “cooperate” and “compromise” on bad policies with the very party that set out to destroy him before he was even sworn in. Obama and Emanuel preempted efforts to push for a public option for health-care reform, despite very high public support at the time. Likewise, the White House failed to push for other progressive policies that would have been a slam dunk, such as the Employee Free Choice Act, a major goal of the labor movement that would have made it easier to enroll workers in unions. With a 60-vote Democratic Senate majority, this progressive legislation could easily have passed. Instead, the White House worked to support conservative Democrat then-Sen. Blanche Lincoln’s efforts to kill it, and even sent Vice President Joe Biden to Arkansas to campaign for her in her run for re-election. She lost anyway.

They also allowed conservatives to shelve plans for an aggressive stimulus package in favor of a much weaker one, for the sole sake of “bipartisanship,” a move that many economists have since criticized for not doing enough.  As I wrote years ago, these decisions were not only deeply disappointing on a fundamental level to those of us who’d put heart and soul into the Obama campaign, but also, I personally believe, one of the main reasons Obama later lost the midterms and had a hard time governing.  He was not elected to implement GOP lite, and there was no “there, there” for the change that was promised. Many people deeply devoted to making this country better for working people became fed up.

Standing up for progressive principles is not so hard, if you actually believe in them. Sen. Elizabeth Warren (D- MA) is a progressive who actually puts her principles into action, like the creation against all odds in 2011 of the Consumer Finance Protection Bureau, perhaps the single most important progressive achievement of the past 20 years. Among other things, the CFPB  shields consumers from the excesses of mortgage lenders, student loan servicers, and credit card companies that have caused so much economic chaos in the past decade. So unless you are more interested in protecting the status quo than addressing the root causes of the many problems we now face, a progressive politician would want a strong progressive running mate.

By choosing Tim Kaine as her vice president, Clinton will signal that she values progressives in name and vote only.

As Zach Carter wrote in the Huffington Post, Kaine is “setting himself up as a figure willing to do battle with the progressive wing of the party.” Kaine is in favor of the Trans-Pacific Partnership (TPP), a trade agreement largely negotiated in secret and by corporate lobbyists. Both Sen. Bernie Sanders, whose voters Clinton needs to win over, and Sen. Elizabeth Warren oppose the TPP because, in Warren’s words, it “would tilt the playing field even more in favor of … big multinational corporations and against working families.”

The progressive agenda includes strong emphasis on effective systems of governance and oversight of banks and financial institutions—the actors responsible, as a result of deregulation, for the major financial crises of the past 16 years, costing the United States trillions of dollars and gutting the financial security of many middle-class and low-income people.

As Warren has stated:

Washington turned a blind eye as risks were packaged and re-packaged, magnified, and then sold to unsuspecting pension funds, municipal governments, and many others who believed the markets were honest. Not long after the cops were blindfolded and the big banks were turned loose, the worst crash since the 1930s hit the American economy—a crash that the Dallas Fed estimates has cost a collective $14 trillion. The moral of this story is simple: Without basic government regulation, financial markets don’t work. That’s worth repeating: Without some basic rules and accountability, financial markets don’t work. People get ripped off, risk-taking explodes, and the markets blow up. That’s just an empirical fact—clearly observable in 1929 and again in 2008. The point is worth repeating because, for too long, the opponents of financial reform have cast this debate as an argument between the pro-regulation camp and the pro-market camp, generally putting Democrats in the first camp and Republicans in the second. But that so-called choice gets it wrong. Rules are not the enemy of markets. Rules are a necessary ingredient for healthy markets, for markets that create competition and innovation. And rolling back the rules or firing the cops can be profoundly anti-market.

If Hillary Clinton were actually a progressive, this would be key to her agenda. If so, Tim Kaine would be a curious choice as VP, and a middle finger of sorts to those who support financial regulations. In the past several weeks, Kaine has been publicly advocating for greater deregulation of banks. As Carter reported yesterday, “Kaine signed two letters on Monday urging federal regulators to go easy on banks―one to help big banks dodge risk management rules, and another to help small banks avoid consumer protection standards.”

Kaine is also trying to portray himself as “anti-choice lite.” For example, he recently signed onto the Women’s Health Protection Act. But as we’ve reported, as governor of Virginia, Kaine supported restrictions on abortion, such as Virginia’s parental consent law and a so-called informed consent law, which, he claimed in 2008, gave “women information about a whole series of things, the health consequences, et cetera, and information about adoption.” In truth, the information such laws mandate giving out is often “irrelevant or misleading,” according to the the Guttmacher Institute. In other words, like many others who let ideology rather than public health guide their policy decisions, Kaine put in place policies that are not supported by the evidence and that make it more difficult for women to gain access to abortion, steps he has not denounced. This is unacceptable. The very last thing we need is another person in the White House who further stigmatizes abortion, though it must be said Clinton herself seems chronically unable to speak about abortion without euphemism.

While there are many other reasons a Kaine pick would signal a less-than-secure and values-driven Clinton presidency, the fact also stands that he is a white male insider at a time when the rising electorate is decidedly not white and quite clearly looking for strong leadership and meaningful change. Kaine is not the change we seek.

The conventional wisdom these days is that platforms are merely for show and vice presidential picks don’t much matter. I call foul; that’s an absolutely cynical lens through which to view policies. What you say and with whom you affiliate yourself do indeed matter. And if Clinton chooses Kaine, we know from the outset that progressives have a fight on their hands, not only to avoid the election of an unapologetic fascist, but to ensure that the only person claiming the progressive mantle actually means what she says.