Speaking of Women's Rights: 03/18

Wednesday, March 28, 2018

Practicing Doula Work at the Root

By Jordan Alam

The power of the doula profession is, in many ways, a far contrast to its origins. Traditionally, doulas are a part of the birthing person’s family, biological or chosen, and in many cultures they still are. The professional word “doula” is relatively new and not recognized across all communities. When people grow up in intergenerational and communal societies where they have seen their family members and friends give birth, they play the doula role regardless of whether they have formal training or not. Everyone in the community is involved in the child’s life through pregnancy and birth and beyond.

We now live in a society that is starved for this kind of connection. To me, the professionalization of doula care is an amazing resource that also reflects the fact that in the U.S. families and communities are routinely separated by circumstance or intent. It is worth investigating that contradiction. Often the people who need doulas most are unable to access them. This is especially true for black and brown communities, and particularly those with multiple barriers to receiving care.

An important aspect of my doula practice is working in partnership with EmPATH, an organization working to serve incarcerated pregnant people with doula and midwifery care. EmPATH envisions a world that honors the basic human right to support during the childbearing year, which means repairing the relationships that are taken away by the criminal legal system. Prisons and jails separate families through intent. It is intended for those spaces to sever connection as a form of punishment – a price that ultimately harms all community members and not just the individual. While best practices in baby friendly hospitals encourage bonding as critical for newborn development, varying practices in prisons and jails take away the power of the birthing person to keep contact with their child after birth. Families separated by incarceration often do not experience reunification with their children, and when they are reunited there is struggle to support the family because of the barriers to employment and housing faced upon re-entry. The trauma of separation impacts both parent and child at all of these stages.

Though connection with a doula is no substitute for the immense amount of care needed to support current and formerly incarcerated people and their healing, it is a small but impactful way to open the door. We see this work as having a ripple effect reaching far beyond its origin point, as backed up by research showing that maternal and infant health outcomes are vastly improved with access to a doula.

When I personally came across the word “doula,” I felt that it brought together all the skills I had been cultivating both professionally and personally for years – deep listening, advocacy, bringing comfort – all at a moment of deep transformation in someone’s life. I came to doula work through a training, having never seen or attended birth in my life prior to that. While this is not how all people come into birth work, I believe that many of us come to it seeking out this unique connection because we feel its absence from our daily lives. I consider my doula practice to be just as nourishing to me as it is for the people I serve, and sometimes even more so. I know that I have received so much important wisdom through my clients’ resiliency.

As we close World Doula Week, I invite all doulas to think critically about how we must push our profession further. We owe it to one another to return doula work to its roots. By serving those who have been most harmed and isolated by systems of oppression, we are building a richer community for them and ourselves. We are stepping into a pivotal life event that can affect the physical and emotional health outcomes for every family we touch. And our work does not stop in the birth room. Especially for communities of color, accessing care can begin to heal the connections we have lost through colonization and the criminalization of our bodies and lives.

As doulas, we have the honor of witnessing. And our responsibility is to communicate what we see and to leverage the power we have relative to our clients so that they receive the best care possible. Whether this is in direct client service or in generating resources for others to do the work, we all have the opportunity to meaningfully impact the lives of birthing people and their children. It is indeed a unique and radical position to be in.

Jordan Alam is a writer, performer, and birth worker based out of south Seattle. She coordinates the Birth Doula Services program at Open Arms Perinatal Services and runs her own doula practice. She is deeply passionate about empowering marginalized communities through promoting under-heard voices and serving those who have limited access to resources. Find more information about her work at www.jordanalam.com.

Photo by Janko Ferlič on Unsplash

Thursday, March 22, 2018

Washington Won't Go Back: State Passes Strong Laws to Expand & Protect Reproductive Health Care Access

In the face of federal hostility to reproductive health care services, Washington State leads the way in passing proactive legislation this session.

By Sarah MacDonald, Legal Voice;
Liz McCaman, National Health Law Program; and
Huma Zarif, Northwest Health Law Advocates

Washington State recently passed a suite of laws that expand and protect access to quality, affordable reproductive health care. These critical victories, many of which came after several years of community advocacy, are part of a larger trend of state legislation aiming to bolster protections for contraceptive coverage, abortion care, and other reproductive rights.

States like Washington are acting now as a defense against the federal government’s repeated attempts to restrict access to health care. Despite the importance of comprehensive family planning services for women’s health outcomes and economic security, the Trump administration has chipped away at the accessibility and quality of reproductive health care services in the following ways:
Because of these federal actions, many states are working to ensure and expand access to reproductive health care. This latest wave of contraceptive coverage protections began in California in 2014, with legislation sponsored by the National Health Law Program (NHeLP) and Essential Access Health. In the wake of that bill, NHeLP created a Model Contraceptive Equity Act that has since been used to introduce similar legislation nationwide. These bills fill in gaps left by federal guidance and prevent insurers from using medical management techniques, like prior authorization or cost-sharing, to erect access barriers.

Washington State became the tenth state to adopt a version of the Model Act when its legislature passed the Reproductive Parity Act (Senate Bill 6219) earlier this month. The bill requires health plans to cover all FDA-approved contraceptive methods free of cost-sharing requirements and over-the-counter contraceptives without a prescription. The bill goes further and requires health plans that cover maternity care services to also cover abortion services, making Washington State a bulwark against the tide of states that have prohibited both private and public insurers from including abortion coverage in their health plans.

Further, the Evergreen State seized the opportunity to go beyond contraceptive coverage to enact laws protecting other necessary reproductive health services. House Bill 1523 creates a strong defense against federal attacks by requiring health insurance plans to cover, without cost-sharing, all preventive services covered by the ACA as of December 2016. In addition to contraception, covered services include HIV and STI testing, screening for breast and cervical cancer, breastfeeding supplies and supports, and domestic violence screening. Advances were also made through House Bill 2016 to ensure incarcerated people who are pregnant or who have recently given birth can access midwifery or doula services.

However, more work remains to be done. DACA recipients, undocumented women, and other immigrants under the federally mandated five-year bar face gaps in coverage that create unique barriers to accessing care. Similarly, transgender people need specific provisions to ensure they have coverage for gender-affirming services. The groundwork for addressing these issues was set this legislative session with the introduction of Senate Bill 6105.

Washington State advocates like Legal Voice and Northwest Health Law Advocates, with support from NHeLP, are committed to pushing for broader, more inclusive laws and policies that meet the needs of all of Washington’s communities.

Sarah MacDonald is Marketing & Communications Manager for Legal Voice, a progressive feminist organization using the power of the law to make positive change for women and girls in the Northwest. More at legalvoice.org.

Liz McCaman is a Staff Attorney at the National Health Law Program, focused on state reproductive health policy.

Huma Zarif is a Staff Attorney at Northwest Health Law Advocates (NoHLA), an organization working to achieve a health care system in which all Washington residents receive quality, affordable health care. More at nohla.org.

Photo by Simone van der Koelen on Unsplash

Wednesday, March 7, 2018

New protections for LGBTQ parents in Washington!

By David Ward

For decades, Legal Voice has worked to ensure that our law recognizes families in all forms—including families formed by LGBTQ couples. We’re happy to report that yesterday, Washington Governor Jay Inslee signed into law Senate Bill 6037, which greatly improves the Washington law about how people are legally recognized as parents!  The new law takes effect on January 1, 2019.

Here are some of the key provisions of this update to the Uniform Parentage Act:
  • It allows people who are presumed to be a child’s parent under Washington law (including married same-sex couples who have children) or who are intended parents through the use of assisted reproduction to sign what is called a “voluntary acknowledgement of parentage.” Under federal law, we believe every state in the country should be required to recognize a voluntary acknowledgement of parentage as proof that a person is a child’s legal parent. This provides a way for LGBTQ parents to help protect their rights in every state in the country, without having to go to court. However, parents are still advised to consult with family law lawyers experienced in LGBTQ rights in order to decide what steps to take to ensure that their parental rights are protected.
  • It establishes clearer and simpler rules for courts to issue judgments that recognize a person as a legal parent of a child. Some LGBTQ parents in Washington have sought such “parentage judgments” in order to obtain a court order that recognizes them as a legal parent of a child.  This bill should make that process clearer for parents who may wish to pursue this option.
  • It creates a regulated system that allows compensated surrogacy in Washington State, while protecting the health, well-being, and autonomy of women acting as surrogates. Legal Voice worked with the bill’s sponsor, Sen. Jamie Pedersen, to ensure that the bill provides strong protections for women acting as surrogates—protections that will help balance the power between intended parents and surrogates, ensuring that such arrangements are entered into knowingly, with care, and subject to legal oversight.
  • It preserves the protections we gained last year that provide a way for people who become pregnant as a result of rape to prevent the rapist from being recognized as a parent of the child.

In the coming months, Legal Voice’s Self Help Committee will work to develop materials that explain the changes made by this law and what they mean for you.

David Ward is Senior Attorney at Legal Voice, where his work focuses on gender violence, family law, and LGBT rights.