Analysis Politics

Florida Governor Race Pits Candidates With Notorious Records on Choice

Nina Liss-Schultz

As Democrats struggle to take back the heavily Republican-dominated state legislature, reproductive rights and health-care access are sure to play out as central issues for both Republican Gov. Rick Scott and his likely opponent Charlie Crist.

In 2010, Republican Rick Scott won the governor’s seat in Florida after beating his opponent Alex Sink by a narrow margin of 62,000 votes. Since then, Scott and the Sunshine State have made the news for illegal voter purges, the killing of Trayvon Martin under the state’s “stand your ground” law, the refusal to expand Medicaid and implement the Affordable Care Act, several pieces of anti-choice legislation, and more executions than any other first-term governor in Florida’s modern history.

This November, Scott will likely face off against an unlikely candidate: former governor of Florida and Republican-turned-Independent-turned-Democratic contender Charlie Crist. Though the Florida primaries are in August, both sides agree that Nan Rich, a Democratic contender and former state senator, has little chance of beating Crist to the election in November. As Democrats struggle to take back the heavily Republican-dominated legislature, reproductive rights and health-care access are sure to play out as central issues for both candidates.

Reproductive Rights

Since taking office in 2011, a slew of anti-choice legislation has made its way to Scott’s desk. According to Lillian Tamayo, chair of the Florida Planned Parenthood PAC, 30 pieces of anti-choice legislation were introduced during Scott’s first term, four of which the governor signed into law.

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In June, Scott, a venture capitalist and former chief executive of the largest private for-profit health-care company in the United States, signed a bill that harshened the state’s existing later abortion ban, prompting some backlash from women within the state’s Republican Party. Along with narrowing the exceptions under which a woman can get an abortion after 24 weeks of pregnancy, the bill, HB 1047, also bans abortion at any point during the pregnancy if a doctor deems the fetus viable.

Pro-choice advocates say that Gov. Scott’s stance on abortion is more conservative than most Republicans’ in the state, and that he’ll pay for his far-right stance in the election. “Gov. Scott is so out of step, even with his own party,” said Tamayo, who pointed to the dissenting positions of state Republicans on several abortion bills Scott has signed into law.

In 2011, the Florida legislature passed a bill mandating that an ultrasound be given to a woman prior to her abortion. Several Republican senators spoke out against the legislation, including Sen. Nancy Detert (R-Venice), who said it insulted her. “I personally resent writing legislation that acts like I’m too stupid to confer with my own doctor on what I should do,” she said in a statement. Scott signed the bill into law, and it became effective in July of that year.

In 2013, Scott signed into law the so-called Infants Born Alive Act, which “provides that an infant born alive during or immediately after an attempted abortion is entitled to the same rights, powers, and privileges as any other child born alive.” As Rewire has reported, laws like the one signed by Scott rest on a myth: “[T]here is no evidence of a pattern of infants being ‘born alive’ after an abortion, much less of doctors killing infants in those circumstances.”

Tamayo says that the conservative legislature is out of touch with the views of Floridians, who in 2012 soundly defeated an anti-choice ballot initiative, Amendment 6, which would have prohibited the use of public funds for abortion. According to Tamayo, more Floridians voted against Amendment 6 than voted for president that year, evidence that Scott and the Republican legislature “pretending to be physicians” won’t gain them public support this election.

Crist, who was attorney general at the time of his eventually successful 2006 bid for the governor’s mansion, has a long and fraught history in Florida politics. Having first served in the state senate from 1993 to 1999, Crist lost his seat during the 1998 midterms. After regaining his position in Florida politics as attorney general from 2003 to 2007 and then governor, Crist made a run for U.S. Senate in 2010. After initially coming up short in the polls, Crist ran as an Independent, but eventually lost to young Tea Party Republican Marco Rubio. In December 2012, Crist announced via Twitter that he was joining the Democratic Party.

Crist’s action on abortion while governor was varied, changing, and convoluted. According to PolitiFact, throughout his career in Florida politics, “Crist has been all over the map on abortion.”

While running for governor in 2006 as the Republican candidate, Crist told reporters on the campaign trail that he would sign a ban on abortion except in cases of rape, incest, or medical emergencies. Later that year he clarified, “I’m pro-life. I don’t know how else to say it. I’m pro-life, pro-family, pro-business, pro-Republican.”

Almost ten years later, Crist’s current campaign for governor of the nation’s biggest swing state, this time as a Democrat, sends a different message about a woman’s right to choose. “Charlie believes that government should stay out of personal health decisions between a woman and her doctor,” according to Crist’s campaign website.

Political scientists and policy analysts say that Crist’s changing stance on issues like abortion might hurt him during the election. Sean Foreman, a political science professor at Barry University, told Rewire that “voters are sophisticated enough to know that candidates’ positions evolve, but when you seem to have a full-scale transformation over a short period of time, it will lead some to question Crist’s motives and if he stands for any principles.”

Medicaid and the Affordable Care Act

Florida is one of 24 states that have not expanded Medicaid under the Affordable Care Act, and one of 21 states where lawmakers aren’t planning to anytime soon. According to the White House, nearly 850,000 Floridians will remain uninsured because of the legislature’s failure to expand Medicaid. Families USA, a non-partisan research and advocacy organization, estimates that the number is likely to be even higher, noting that nearly 1.8 million Floridians will remain uninsured without Medicaid expansion.

By and large, poor Americans and people of color are most affected when states like Florida opt out of Medicaid expansion. According to the Kaiser Health Foundation, people of color are more likely to be uninsured than white Americans (the uninsured rate is 27 percent and 15 percent, respectively), with Hispanic Americans representing the most uninsured population in the United States (33 percent). The group estimates, however, that Black Americans will be most affected by lawmakers’ decisions not to expand Medicaid. “Four in ten uninsured Blacks with incomes low enough to quality for the Medicaid expansion fall into the gap, compared to 24 percent of uninsured Hispanics and 29 percent of uninsured Whites,” it found.

Before Rick Scott ran for governor, he was a leading Obamacare opponent. In 2009, the former hospital executive founded the group Conservatives for Patients’ Rights, an organization with $20 million behind it that’s designed specifically to oppose the Affordable Care Act. According to a Washington Post profile of the organization, Scott used $5 million of his own money to fund the group.

When the Supreme Court held in 2012 that Medicaid expansion, along with several other provisions of the health-care law, are optional for states, Scott announced that he would not implement them. Though Scott has still refused to set up a state-run online insurance marketplace since Obama’s re-election, the governor has walked back some of his opposition. Last February, Scott even went so far as to say he would expand Medicaid. In a statement on his website, Gov. Scott said his office would “support a three-year expansion of our Medicaid program under the new healthcare law, as long as the federal government meets their commitment to pay 100 percent of the cost during this time.”

Over a year later, however, Florida has failed to take any more steps toward Medicaid expansion, and whether or not Gov. Scott will be able to garner support for the expansion from within his own party remains an open question. As the Tampa Bay Times reported at the end of last year, Gov. Scott failed to press house Republicans to move forward with the plan. This year, the Florida legislature adjourned without accepting federal funds for expansion.

On Obamacare, Crist has gone from staunch opponent to fervent advocate. On the day President Obama signed the Affordable Care Act into law, Crist, who was then governor, tweeted: “Let’s keep up the fight and work to repeal this partisan, gov’t takeover of [healthcare].” He also tweeted, “Obama/Dems arrogantly trying to jam their gov’t run HC bill thru this week. Our country deserves a better, free market solution.” (A reporter at BuzzFeed took screen-shots of the tweets, which have since been deleted.)

But when Crist spoke to Ed Schultz on MSNBC in late 2013, Crist said he would help enact Obamacare, because it’s “the right thing to do.”

Sean Foreman told Rewire that Crist’s public allegiance to the health-care law is a politically calculated position, but could hurt him in the end. “Charlie Crist defending Obamacare is a risky position,” Foreman wrote in an email. “The Crist campaign has calculated that this is a major issue for him in proving his bona fides for Democratic voters,” but most other Democratic candidates, particularly for congressional seats, are distancing themselves with the law to seem more moderate.

Whether Crist will be able to distinguish himself from his former party through the issues of reproductive rights and the Affordable Care Act remains to be seen.

News Politics

Anti-Choice Democrats: ‘Open the Big Tent’ for Us

Christine Grimaldi & Ally Boguhn

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Read more of our coverage of the Democratic National Convention here.

Democrats for Life of America gathered Wednesday in Philadelphia during the party’s convention to honor Louisiana Gov. John Bel Edwards (D) for his anti-choice viewpoints, and to strategize ways to incorporate their policies into the party.

The group attributed Democratic losses at the state and federal level to the party’s increasing embrace of pro-choice politics. The best way for Democrats to reclaim seats in state houses, governors’ offices, and the U.S. Congress, they charged, is to “open the big tent” to candidates who oppose legal abortion care.

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

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Democrats for Life of America members repeatedly attempted to distance themselves from Republicans, reiterating their support for policies such as Medicaid expansion and paid maternity leave, which they believe could convince people to carry their pregnancies to term.

Their strategy, however, could have been lifted directly from conservatives’ anti-choice playbook.

The group relies, in part, on data from Marist, a group associated with anti-choice polling, to suggest that many in the party side with them on abortion rights. Executive Director Kristen Day could not explain to Rewire why the group supports a 20-week abortion ban, while Janet Robert, president of the group’s board of directors, trotted out scientifically false claims about fetal pain

Day told Rewire that she is working with pro-choice Democrats, including Sen. Kirsten Gillibrand and Rep. Rosa DeLauro, both from New York, on paid maternity leave. Day said she met with DeLauro the day before the group’s event.

Day identifies with Democrats despite a platform that for the first time embraces the repeal of restrictions for federal funding of abortion care. 

“Those are my people,” she said.

Day claimed to have been “kicked out of the pro-life movement” for supporting the Affordable Care Act. She said Democrats for Life of America is “not opposed to contraception,” though the group filed an amicus brief in U.S. Supreme Court cases on contraception. 

Democrats for Life of America says it has important allies in the U.S. House of Representatives and the U.S. Senate. Sens. Joe Donnelly (IN), Joe Manchin (WV), and Rep. Dan Lipinski (IL), along with former Rep. Bart Stupak (MI), serve on the group’s board of advisors, according to literature distributed at the convention.

Another alleged ally, Sen. Bob Casey (D-PA), came up during Edwards’ speech. Edwards said he had discussed the award, named for Casey’s father, former Pennsylvania Gov. Robert P. Casey, the defendant in the landmark Supreme Court decision, Planned Parenthood v. Casey, which opened up a flood of state-level abortions restrictions as long as those anti-choice policies did not represent an “undue burden.”

“Last night I happened to have the opportunity to speak to Sen. Bob Casey, and I told him … I was in Philadelphia, receiving this award today named after his father,” Edwards said.

The Louisiana governor added that though it may not seem it, there are many more anti-choice Democrats like the two of them who aren’t comfortable coming forward about their views.

“I’m telling you there are many more people out there like us than you might imagine,” Edwards said. “But sometimes it’s easier for those folks who feel like we do on these issues to remain silent because they’re not going to  be questioned, and they’re not going to be receiving any criticism.”

During his speech, Edwards touted the way he has put his views as an anti-choice Democrat into practice in his home state. “I am a proud Democrat, and I am also very proudly pro-life,” Edwards told the small gathering.

Citing his support for Medicaid expansion in Louisiana—which went into effect July 1—Edwards claimed he had run on an otherwise “progressive” platform except for when it came to abortion rights, adding that his policies demonstrate that “there is a difference between being anti-abortion and being pro-life.”

Edwards later made clear that he was disappointed with news that Emily’s List President Stephanie Schriock, whose organization works to elect pro-choice women to office, was being considered to fill the position of party chair in light of Rep. Debbie Wasserman Schultz’s resignation.

“It wouldn’t” help elect anti-choice politicians to office, said Edwards when asked about it by a reporter. “I don’t want to be overly critical, I don’t know the person, I just know that the signal that would send to the country—and to Democrats such as myself—would just be another step in the opposite direction of being a big tent party [on abortion].” 

Edwards made no secret of his anti-choice viewpoints during his run for governor in 2015. While on the campaign trail, he released a 30-second ad highlighting his wife’s decision not to terminate her pregnancy after a doctor told the couple their daughter would have spina bifida.

He received a 100 percent rating from anti-choice organization Louisiana Right to Life while running for governor, based off a scorecard asking him questions such as, “Do you support the reversal of Roe v. Wade?”

Though the Democratic Party platform and nominee have voiced the party’s support for abortion rights, Edwards has forged ahead with signing numerous pieces of anti-choice legislation into law, including a ban on the commonly used dilation and evacuation (D and E) procedure, and an extension of the state’s abortion care waiting period from 24 hours to 72 hours.

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 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.