Tuesday, May 05, 2009

May 1 Celebration of Local Women Leaders

From left to right: Dee Johnson, Doris Pridgen, Caryn Hunt

Thanks to everyone who helped to make our May 1 Celebration of Local Women Leaders such an inspirational event!

We’ve posted the remarks of our honorees. (Doris Pridgen’s remarks will be posted very soon.)

From Dee Johnson:

I’m truly humbled by the honor Philadelphia NOW has bestowed on me and especially proud to be a part of the project to prohibit shackling of pregnant prisoners. I want to thank Karen Bojar for her commitment to changing this situation for women in prison, Naima Black for bringing the matter to the forefront, and Kathleen Creamer for her labor in developing the legislation. Without their efforts, I certainly wouldn’t be standing here.

We’ve certainly come a long way since we began this project last year. But we’ve still got a long way to go.

Today, women constitute the fastest growing segment of the prison population, and shackling pregnant prisoners is a policy that exists in most states throughout the country.

According to Amnesty International, 23 state departments of corrections have policies allowing restraints during labor and 47 states — including Pennsylvania —have no legislation protecting pregnant women in prison from being shackled. Only Illinois, California and Vermont forbid the practice, and New York has proposed legislation.

Can you believe a woman is shackled whether she has a history of violence or has ever attempted escape? Well, believe it!

Thank God that some changes have been made during the last year. In October 2008, the federal Bureau of Prisons banned the practice and last summer, the City of Philadelphia issued an Executive Order preventing the use of restraints on women who are in labor or delivery.

The Executive Order came at the urging of the Working Group to Enhance Services for Incarcerated Women. The Working Group is a consortium of about 30 organizations advocating on behalf of women in prison, including The Pennsylvania Prison Society, Philadelphia NOW, Community Legal Services, Maternity Care Coalition/MOMobile, Women’s Law Project, Pennsylvania Institutional Law Project and the American Civil Liberties Union of Pennsylvania.

And with their help, we have developed the Healthy Birth of Incarcerated Women Act — legislation that would ban the practice of shackling pregnant prisoners in Pennsylvania during transport to the hospital and while in labor, delivery and recovery.

Now, with a sponsor in the Pennsylvania House and a projected sponsor in the Senate, we’re hopeful this bill will eventually become law. However, in light of the recent defeat of a similar bill in Arkansas, we realize that we still have much to do.

Our toughest challenge will be garnering legislative support so that the bill not only comes out of Committee, but also goes to the floor of the Pennsylvania General Assembly for a vote and is ultimately approved. Here’s keeping hope alive!

From Caryn Hunt:

I am so proud to receive this award from Philadelphia NOW.

Thanks to my family and my friends who came out tonight to help me celebrate. It feels really good.

I learned about volunteering from my mother's example. She's been a lifelong volunteer. She volunteers even now at Hospice House. When I was little, she was the volunteer president for Third Century USA, the organization that planned Miami's Bicentennial celebration. An organization of 10,000 volunteers! And when I was 12 or 13, she took me to my first NOW convention. I was impressed then with the National Organization for Women and I remain impressed, especially by our Philadelphia chapter. Our NOW members are concerned, active and able- they get things done in the community. I am very proud to be receiving this award with Dee Johnson and Doris Pridgeon.

I learned about the maternity care crisis in early 2007. I was waiting to testify in Council on another issue and I heard Joanne Fisher present the findings of Maternity Care Coalition's report “Childbirth at the Crossroads”. I was shocked to hear that Philadelphia had lost 10 maternity units in ten years, since MCC had been tracking the issue, and I knew NOW would want to be involved. At that point, MCC described a city on the threshold of crisis. Since then, we've lost an additional 3 in Philadelphia. Now we're staring that crisis in the face.

Maternity Care Coalition has done a good job digging up the data and spreading the information. Philadelphia NOW is proud to be one of their sponsors for their “Insuring Healthy Births” initiative, which will kick off in Harrisburg Monday with a rally and press conference.

The trend is, a hospital closes a maternity unit, those births happen elsewhere, straining the resources of another unit until it in turn is closed. Thus the problem keeps growing without solution. Systems close their maternity departments, sometimes whole hospitals, because, they say, they're unprofitable. Childbirth is unprofitable.

That is just absurd in one sense, because profitable or not, we've got to have the babies, right? Now, in another sense it struck me, as it would probably strike any other parent, of course childbirth is not profitable. Profit is definitely not what happens when you have kids. If you're an uninsured or underinsured woman, you could be on the hook for tens of thousands of dollars after delivery, trying to pay that off while raising your baby. So this idea of unprofitability is kind of a no-brainer for women.

So women intuitively accept the notion that childbirth is not profitable, in the financial sense.

But it is predictable. You may not know when a specific pregnancy is going to happen, right? but you know as sure as the sun sets in the West, there will be babies. Like death and taxes. And you would think someone could figure out how to make that pay? Without incentivizing excessive medical intervention, I mean. Even though 25% of all hospitalizations are maternity-related, there's no money to be made in childbirth? That seems absurd too. Who created this system where childbirth is unprofitable? Clearly not feminists.

Temple's Northeastern Hospital is set to close at the end of this month. It's an illustration of so much that's wrong with our healthcare system and how it effects maternity. They went from around 700 births in 2003, and because of other closures in the area- and despite Temple's confidence that those births would transfer to Temple Hospital, they went to Northeastern- last year, Northeastern delivered nearly 1800 babies. In most business models, this would be a success. For Northeastern, it was the kiss of death, because of their “payer mix”. 50% of their patients rely on Medicaid, and they don't get reimbursed at a sustainable rate for their costs, so the more births they handle, the greater that deficit grows. And fixing Medicaid reimbursements in this state is a key recommendation from Maternity Care Coalition.

Now, we've heard a lot from Temple about their profits, but not much about how they'll continue to fill that need. 1800 births, 55,000 ER visits. Northeastern is a busy hospital. And the doctors there say Temple's plans for transitioning those patients are not just flawed, they're nonsense. Temple is dumping their problem on the city to deal with.

And no one can compel Temple to answer for their care responsibility. Legally, they only had to give a two month notice, and legally, there's no oversight to evaluate need in this kind of decision. Our state elected officials did not hesitate to get into this- State Senators Mike Stack and Larry Farnese, State Representatives John Taylor and Mike O'Brien have worked hard to bring Temple to the table and to turn this around. Councilmembers Maria Quinones-Sanchez and Marion Tasco questioned the city's health department at budget hearings about the impact of Northeastern's closure on the city, because they know that this will become the city's problem. They know this city can't afford the loss of that care. Neither can it afford the loss of those 850 good-paying jobs. If those were new jobs, what wouldn't the city do to attract them? But without legislation that requires an assessment of need, our elected officials can't really do anything.

In 1979, the state abandoned its Certificate of Need program, wherein need was evaluated, and there was a community oversight component to that. It was rescinded in this state, as in other states, to “liberate market forces” in healthcare, and this was supposed to benefit patients. Back in 1979, we had more than 40 maternity units serving the greater Philadelphia region. Now we have 24. In Philadelphia, we have six. Six hospitals where babies can be born. Representative Phyllis Mundy has introduced HB247 to revive a Certificate of Need program in the state. Maybe that will gain some traction and give lawmakers the tool they need to protect people. So these decisions are not made based just on profits, but also on care.

When I went to that NOW convention, I was just a kid. But as I grew and had my own daughter, I've become aware, as adults do, that the world is full of unconscious prejudices, ingrained, and sometimes accepted as unquestioned fact. Sometimes logic seems so pat, and assumptions are buried so deep, that we forget to question them. But questioning the dominant paradigm is a fundamental lesson of the feminist movement.

Either we must accept that birth will not be profitable, or we need to change our model and understanding of its nature and adapt to design something that is profitable. And do what we can in the meantime to help pregnant women.

Birth is a case where “less is more”, and in the end, restructuring the way maternity care is delivered will offer a more permanent solution, and may be the best answer to our local crisis. The US has one of the highest maternal mortality rates and the second worst newborn fatality rate in the industrialized world. Women do not need medical intervention in most cases, and yet it's those interventions that drive up billings and that ward off the threat of malpractice suits.

Childbirth is an incredibly personal, intimate event, yet we've created a system where a hospital needs to have 2800 births a year at least in order to break even. It's a natural event, yet 99% of women give birth in hospitals, an unnatural and alarming percentage by medically unnecessary c-section, and with an increasing array of monitors and gadgets that remove all ability of women to take an active part in their labor. Surely, we can invent something better than this.

This city has a large un- and underinsured population which, of course because of the economy, will grow. We've got to start where we are, with what we're given and question everything to find better ways to deliver care to people. And I commend Council for confirming Councilman Bill Greenlee's Resolution to support HR676, the single payer bill before Congress. We have all got to take responsibility for fixing healthcare absurdities, and at every battlefront we come across. While it can seem like we don't hold a lot of power at the city level, we hold more than I think we exercise. We should advocate directly, as a city, in the halls of power, both in Harrisburg and DC, for our healthcare needs. I challenge all of us to do that one more thing that can make a difference.

I see lots of people here I know from my community, from my daughter's school, from various issues and campaigns, and I'm inspired by you all. We know it matters what you do, and that one person can make a difference. Knowing that empowers us all to go forth and get the changes we need to live healthier, fuller lives for ourselves and each other. So, celebrate tonight, and then tomorrow, go back out and keep fighting the good fight.


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