Tag: reproductive health

Categories
News News Blog News Feature

CHOICES Works To Improve Maternal Mortality By Addressing Racial Disparities

(Credit: CHOICES: Center for Reproductive Health via Facebook)

A report from the Centers for Disease Control and Prevention (CDC,) showed that the U.S. maternal mortality rate had increased 40% from 2020 to 2021. The World Health Organization defines maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes”

According to the CDC, 1,205 women died in the United States in 2021, compared to 861 in 2020. 

The report also stated that the rates for Black women “were significantly higher than rates for White and Hispanic women.”

The 2021 Tennessee Maternal Mortality Rate Annual Report showed that “non-Hispanic Black women” are 3.9 times as likely to die from pregnancy-related causes compared to” non-Hispanic white women”.  President and CEO, Jennifer Pepper of CHOICES: Center for Reproductive Health said that both the maternal and infant mortality rate crisis in Tennessee is “dire,particularly for Black women.”

The Tennessee Maternal Mortality Rate Annual Report also stated that more than 75% of deaths were deemed preventable, and discrimination contributed to at least 33% of deaths. 

“There’s something wrong with the system when African American women who are college-educated and have great jobs can still have poorer outcomes than white women who are uneducated,” says Dr. Nikia Grayson, chief clinical officer at CHOICES.

Accessibility is also an issue that contributes to increased maternal mortality rates in Memphis. Information released to CHOICES from the City Health Dashboard said that “60.3% of live birth are to African American and 35.4% of African American women who gave birth lacked adequate prenatal care.” In comparison, “15.3% of white women in Memphis lacked access to adequate prenatal care.”

“The U.S. model of providing reproductive health care is fundamentally broken,” said Pepper. “For people experiencing poverty, particularly people of color, the legacy of racist violence in controlling reproduction is still present. Pregnant women of color are often treated like social burdens instead of valued individuals with a right to bodily autonomy.”

CHOICES is committed to improving these outcomes, and is “increasing access for people at risk in Memphis’ urban core,” said Pepper. One of the ways that they have been able to improve birthing outcomes is through their midwifery services. According to CHOICES, 83% of their midwifery patients are Black women. They also said that Black patients are 6.6. times less likely to have a preterm birth at CHOICES than anywhere else in Tennessee.

There are many reasons why people may choose midwifery services however CHOICES said that it is strongly associated with “lower interventions during pregnancy and birth, cost-effectiveness, and improved outcomes for both the birthing patient and the baby.”

“The midwifery model of care supports pregnant people in trusting the normal processes of pregnancy and birth with the help of experienced midwives,” said Pepper. “Midwifery is people-centered and based on informed choice, which means taking the time to teach people about their bodies using evidence-based information and offering the options available so that a person can make an informed decision about what is best for them.”

Categories
News The Fly-By

Black Midwives: A Q&A with Dr. Nikia Grayson, CHOICES’ Director of Clinical Services

CHOICES is launching a fellowship to train Black midwives in Memphis. (Photo: Courtesy of CHOICES)

Dr. Nikia Grayson, CHOICES’ director of clinical services, said there are currently only four Black midwives in Memphis. Grayson discusses why increasing that number will mean more inclusive, culturally competent reproductive healthcare for Black women in Memphis. — Maya Smith

Memphis Flyer: What are the goals for the fellowship?

Nikia Grayson: We want to address the maternal and infant health crisis that we are seeing in the Black community. This fellowship will help to train Black midwives in a comprehensive, reproductive and social justice way that addresses the health inequities and systemic racism many are facing in the healthcare system. There aren’t that many midwives in the country and definitely not that many Black midwives. We would love to see more Black midwives in the South caring for their communities in a culturally congruent way.

Why does culturally congruent healthcare matter?

When patients see providers who look like them and understand their cultural beliefs and values, the way they communicate, and the things they may be experiencing, it leads to better patient outcomes. There’s a level of understanding and empathy. Studies have shown that patients with providers who are like them or come from their community have better health outcomes.

Why are there higher rates of pregnancy-related deaths among Black women than among white women?

One, there are providers who aren’t listening to their patients and who aren’t recognizing the importance of seeing patients as human and honoring their humanity. Because we have this disconnect between patients and providers, many people are seeking out care late. By the time they come in for prenatal care, many of their issues are exacerbated. Also, we know that patients who are underinsured or uninsured have very few providers they can go to. They also have to learn how to navigate the system. Just the stress of trying to navigate the healthcare system, as well as the stress of being a Black woman, really does take a toll on people’s bodies.

What does inclusive healthcare look like?

Inclusive healthcare looks like caring for the whole person. We have patients who might be experiencing housing, food, or job insecurity. So it’s being able to connect them to both the social and medical resources they need. There’s a fragmentation of care in our communities. We want to have an inclusive model where we build a care team so patients don’t experience that fragmentation.

Categories
News News Blog

CHOICES Announces Training Fellowship for Black Midwives

(Photo courtesy of CHOICES).

CHOICES: Memphis Center for Reproductive Health is launching a fellowship to train Black midwives in an effort to create a stronger workforce of Black midwives here, the nonprofit announced Tuesday. 

The Center for Excellence Nurse Midwifery Fellowship will introduce recent midwife graduates to CHOICES’ full-spectrum reproductive and sexual health model. The year-long training program will also focus on reproductive and social justice principles. 

The goal is for fellows to be able to provide more inclusive, patient-centered healthcare, while taking action to dismantle systems of reproductive oppression and injustices. 

Dr. Nikia Grayson, CHOICES’ director of clinical services, said Black women are dying of pregnancy-related causes at much higher rates than white women.

“We must do our part to end racial disparities in maternal and infant health, and this fellowship is part of the solution,” Grayson said. “Black women deserve high quality, culturally competent providers, and we are truly honored at CHOICES to help train the next generation of midwives to care for their communities.” 

Black women were 1.5 times as likely as white women to die during or within the first year of pregnancy between 2017 and 2019, according to data from the Tennessee Department of Health. And Black women were 3.9 times as likely as white women to die from pregnancy-related causes. 

The fellows will have the opportunity to attend various types of births in different settings, working alongside CHOICES’ Black-led midwifery birthing team. 

Candidates must identify as Black or African American, have at least a master’s degree in nursing, have completed a certified nurse-midwife (CNM) program no more than a year ago, and have a current Tennessee CNM license or be eligible for one.  

CHOICES’ president Jennifer Pepper said the fellowship is the latest example of the nonprofit’s effort to be at the “forefront of innovation in the reproductive and sexual healthcare field.” 

“We are excited to share CHOICES’ values and to help create a workforce of Black midwives who are ready to care for people in a holistic and patient-centered way,” Pepper said. 

The fellowship is funded in part by the W.K. Kellogg Foundation, the UCSF Institute for Global Health Sciences Global Action in Nursing project, and Groundswell Fund’s Birth Justice Fund. 

Categories
News News Blog

CHOICES New Executive Director Brings a Vision to Reproductive Health

CREDIT: CHOICES

CHOICES

Jennifer Pepper takes over as CHOICES’ new executive director.


CHOICES, a nonprofit comprehensive care clinic, introduced new executive director Jennifer Pepper in a press release this week. Pepper, a Rhodes College graduate and longtime Memphian, said that her journey into reproductive health and began at a young age. Growing up, Pepper’s mom never shied away from discussing sex or reproductive health at length. And that got awkward.

“My mom was the cool mom, which was just completely embarrassing at the time,” she said. “I remember she rented a video from the public library about HIV and AIDS prevention and she made me and my group of friends watch this video. I just remember being absolutely mortified that I was being forced to do this with my middle school friends.”

But Pepper’s knowledge of reproductive rights and health led her to an internship at Planned Parenthood during her second year at Rhodes. The internship crystallized her appreciation of the educational side of reproductive health. While at Rhodes, she began helping other educators prepare for their sessions and going out into the community with the educators to observe. Pepper even began creating her own training documents while still a student.

“For my senior project at Rhodes,” she said, “I designed an HIV prevention curriculum. That curriculum helped me get my very first job out of Rhodes, at Le Bonheur doing HIV prevention education. That’s really where I spent the first part of my career — doing HIV prevention and testing.”

At Le Bonheur, Pepper spent time visiting drug rehab clinics, nursing homes, and prisons to teach about safe sex practices. After four years Pepper went to work full time for a then-smaller CHOICES as their patient educator, eventually leading to her writing the first grant that CHOICES applied for. It still makes her smile.

“I feel like I’ve really grown up with CHOICES, and in a lot of ways it’s my dream job. So, I’m really excited to be here.”

After leaving CHOICES in 2013 to lead the Memphis Ryan White Program with the Shelby County Government, Pepper went to back school to get her masters of business to further her career in the non-profit field before rejoining the group in 2018 as director of finance and operations.

“I had seen through my 10-plus years in the nonprofit field there were lots of people who wanted to help people and have really good intentions. And there was this lack of business acumen. So I figured that was something I could bring to the table.”

Pepper steps into CHOICES at a pivotal time. At the state level, the ACLU of Tennessee is fighting multiple cases that would shake up the reproductive health landscape in the state, affecting CHOICES and the way its comprehensive health clinic operates. Despite complications from the state level, Pepper says CHOICES will continue to put the individual first.

“We want to serve people throughout their lifespan. Because the person that needs birth control today might want to have a baby next year, and they might need an abortion in five years, or vice versa. You should be able to come to the same place where providers care about you and are empowering you to get those services.”

Categories
News News Blog

Local Abortion Provider: ‘Phone Ringing off Hook,’ Staff Short, But Services Continue

CREDIT: Facebook/CHOICES

Facebook/CHOICES

CHOICES’ main clinic on Poplar

With a smaller staff and a slightly different set operating procedures, CHOICES, one of two clinics in the city that performs abortions, is still open and providing services.


Katy Leopard, assistant director of CHOICES, said the clinic’s call volume has been up, some staff members are working from home, and the clinic has had to decrease the number of patients it sees, but services will continue. CHOICES’ main focus, she said, has been to provide the essential services patients need, while ensuring that staff and patients remain safe and healthy.

“What we do healthcare-wise is definitely under the umbrella of essential healthcare,” Leopard said. “So, we are definitely open and providing services. Our phones are ringing off the hook and people may have a little trouble getting in touch with us, but we are working very hard to get those calls answered and schedule appointments because we know how important what we provide is to our patients.”

Leopard said in addition to the increased call volume, there has been an increase in the number of patients who actually show for their appointments. Ordinarily, she said the show rate for appointments is between 50 and 60 percent, but now, it is up to about 80 percent.

“People are just feeling very anxious and wanting to take care of these things very quickly.

They are thinking ‘oh my god, if I’m going to do it I better do it now before CHOICES has to close,’” she said. “And while I don’t think that’s in our future and I think we will be able to stay open, we are certainly doing our very best.”

Over the past couple of weeks, Leopard said CHOICES also saw an influx of patients from Texas and other states, where abortions were banned and considered a nonessential medical service.

“It was this horrible moment where — for while the clinics in Texas were all closed, and Louisiana, and Ohio — we were seeing people from everywhere,” Leopard said.

Monday, federal judges temporarily overturned the ban in Texas, Ohio, and Alabama, and Leopard said that will “greatly alleviate some pressure.”

At the onset of the COVID-19 pandemic, Leopard said CHOICES immediately opted to allow all non-essential staff members to work from home, as well as those with underlying health conditions that might be more susceptible to contracting the virus.

CHOICES also implemented unlimited paid sick leave for all employees because “the last thing we wanted was for our employees to come in if they aren’t feeling well so they could get paid.”

Down a few staff members, Leopard said initially CHOICES decided to only see abortion patients for the time being, while pushing other wellness appointments until April.

“But after it began to look like this is going to go on for a month or so, we realized that birth control and things like that are essential for the community,” Leopard said. “People need their IUDs removed or they need their prescriptions filled and all the other things that we do.”

Leopard said CHOICES has begun to look for ways to provide the services it can, like renewing prescriptions, via telemedicine.

[pullquote-1]

Typically, abortion patients are required to come in for a patient education session before scheduling an abortion, but Leopard said this process now takes place over the phone.

Out of caution, patients are also screened over the phone and asked about contact with anyone who has been diagnosed with COVID-19 or has had symptoms prior to their appointment. Patients are again screened the day of their appointment before they come into the clinic. Leopard said this week CHOICES will begin checking the temperature of everyone who comes into the building.

Other precautionary steps CHOICES has taken include reorganizing its waiting rooms so that patients sit six feet apart and frequently sanitizing surfaces and equipment in the clinic. Additionally, to limit the number of people in the clinic’s waiting room and potential exposure, CHOICES has temporarily stopped allowing patients to bring a guest with them, unless they are a minor.

“What we provide is critical and essential healthcare to people in this community and we will do everything we can to stay open,” Leopard said. “So, we’re open, seeing patients, and scheduling appointments. But at the same time we are being very, very cognizant and careful to limit exposure to our patients and staff. The thing that could be a real problem for us is if one of our clinicians gets sick. So, we are doing what we can to prevent that.”

[pullquote-2]

Leopard said CHOICES is doing all that they can to “help the community access the tools they need to control their reproductive lives and healthy sexual lives.”

To that end CHOICES sponsored a drive-thru emergency contraception give-away last weekend in its parking lot.

“We are very aware that sex is something people do and quarantine isn’t going to stop that,” she said. “It’s part of our experience as humans. We also give them away at our front desk. So people can come in very quickly and get some if they have an oops moment.”

[pullquote-3]

Leopard said without a doubt, CHOICES needs to remain open, as its services are essential for its patients.

“When I talk to patients about how they would be impacted without the services we provide, it’s very clear that what we do is essential,” Leopard said. “I mean my dry-cleaners and auto mechanic are still open. So, to argue that not being able to control whether or not you continue with a pregnancy that can ripple through your entire life in so many ways is not essential is not even an argument. All you have to do is talk to our patients to understand why what we do is essential in their lives.”