SARAH VERBIEST

Looking Forward , Sarah Verbiest, founder of Every Woman Southeast, reflects on the new year and what it holds.
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OR: A brief history of why I hated doctors for so long, and why I finally stopped.

xo-jane-logo-660x400“Your blood pressure is a little higher than I’d like. It’s 120 over 90. If it isn’t lower by the time I next see you, I’ll have to take you off the pill.”

I am 20 years old, and sitting in the office of a woman I’ve been seeing as my primary care doctor for about three years. In my teens, when I finally aged out of the pediatrician’s office I’d been going to my whole life, my father’s then-girlfriend had recommended this doctor with the highest praise.

My pediatrician had had an obsessive fixation with my weight. It began when he instructed me to start my first diet when I was eight years old, showing me a colorful chart that explained what size I should be, and pointing out that I was near the top end of the average for my height and age. He wanted me to lose, I believe, one and a half pounds. Maybe as much as two. Every visit — even if I went in because I had a cold, or I had sprained my arm tree-climbing — began and ended with discussion of my weight, and I what I was doing about it.

My pediatrician was the first doctor I ever despised. So I was cool with it when I was told I couldn’t see him anymore. And given that I would soon need someone to give me my first pelvic exam, I was relieved to get such a strong reference from my father’s girlfriend, someone I knew and trusted.

It didn’t work out quite as planned.

My new doctor was never the kind, warm, supportive practitioner that was described to me. She was terse, and often cold; she did not have much patience for questions, and usually seemed in a hurry to finish our appointments. When I went in for that first pelvic exam, I was terrified, as this was before you could look up the details of the process on the Internet, and my dad’s girlfriend was as unforthcoming with her experiences (deeming such matters inappropriate topics of conversation) as my own mother was blasé (she would unflinchingly share every facet of the experience, but always with the hand-waving caveat, “It’s no big deal, you’ll be fine”). I had no objective narrative.

I was shivering on the table under a tiny paper robe, 18 years old, when my doctor came in, my chart in her hand. She frowned down into the folder full of papers and inquired, “If you’re not having sex, why are you getting a pap smear?”

“…Because I’m 18 and I thought I was supposed to?” I had read this, numerous places, that women were supposed to start getting pap smears at 18. I didn’t see anything that said it was only for women having penis-in-vagina sextimes.

She sighed lightly, like doing a pap smear was a waste of her time. I tried to chill out. But the tone for the visit was already set.

Back to the beginning of this story: it’s true that by 20, I was going in to these appointments already tense and braced for a bad experience. I was young, and though I no longer lived in South Florida, I was still on my father’s health insurance. It had genuinely never occurred to me that I could just find a different doctor whom I might see in Boston, instead of trying to fit in physicals on trips home. I suppose I thought changing doctors only happened in extreme circumstances.

When my doctor threatened my birth control, I panicked. My stomach sank and my heart began racing. If you’ve ever been a sexually-active 20-year-old with a pathological phobia of pregnancy, you can imagine my freakout. I mean, I was ALSO using condoms, but I didn’t altogether trust them, so the idea of losing the pill seemed like a terrifying risk.

I gulped and tried to keep it together. “Why?”

“The pill can elevate blood pressure in some people. You’re very young to have blood pressure near the borderline range. I’ll have to take you off the pill if you can’t get those numbers down.”

Notably, this was the end of our conversation. She never actually gave me any suggestions for lowering my blood pressure. Nor did she suggest alternative methods of birth control we could try. She instructed me to lower a number I didn’t understand, apparently through sheer force of will, or else she would take my birth control away entirely. I left the appointment believing those were the limits of my options.

After that experience, I did go back for one more appointment with her, but following that I peaced out of her office for good — although I carried away with me a newfound fear of having my blood pressure checked.

I kept my distance from doctors as much as possible for a few years after that. I went to a Planned Parenthood clinic in Boston for annual physical exams, but only so they would give me birth control pills. I paid for it all out of pocket, strolling past the bulletproof glass and the two sets of doors you had to get buzzed through, blissfully ignorant that just a couple years before, abortion opponent John Salvi had shot and killed two people, and wounded five others, at two family planning clinics in the Boston area. I thought it was just, you know, a cheap place to get the pill.

My experiences were slightly better at Planned Parenthood, but I never saw the same person twice, and thus never had much of an opportunity to build a relationship with anyone.

Eventually, in grad school, I got my own health insurance, and established myself with a regular primary care doctor. She was nice enough, but not long out of medical school, and her bedside manner was a little wobbly. She was fond of saying, “So, what are we doing about our weight?” like clockwork at the end of every appointment (who is “we,” exactly — could I be fat because YOU are eating too many donuts?). She liked handing me pamphlets about nutrition and calorie restriction, although she never once asked me what my daily diet was actually like. When I inquired about why I might be getting pain in my right shin when exercising, she was incapable of discussing possible causes or treatments beyond “lose weight” — and when I noted that, were I to take her advice, exercise would probably be a necessary component of doing so, she stared at me blankly.

xoJaneAuthorSome of her efforts were hilariously ham-fisted. Like the time she inquired as to whether I had ever considered gastric bypass surgery, literally at the same moment as she was scraping my cervix. (Even today, I wish I’d had the muscle control to have shot the speculum right into her face. HULKGINA SMASH. As it was, I only laughed maniacally.)

My health insurance changed again, and I chose a primary care doctor at random from a large book in my employer’s HR department, mostly because I had walked past the clinic where he worked many times, and it was conveniently located.

I had avoided male doctors ever since my pediatrician. I’d bought into the idea that male doctors are always terrible and patronizing to their lady patients. Given my prior experience, I didn’t take much convincing on this point. But there weren’t any women doctors accepting new patients at this particular clinic, and I thought, well, I’ll just go with this random guy for now, and change it later.

Dr. R was soft-spoken, warm, and had a kindness about him that put me right at ease. On my first visit, I explained that I would prefer not to be weighed as a matter of course every time I came in, unless it was necessary for some specific purpose — like to get the correct dose for a medication. I was willing to be weighed when needed, but my lengthy history of dieting and disordered eating meant the experience of getting on the scale caused such psychological upheaval that I would rather only do so when I really HAD to. I was literally trembling when I asked if he would be okay with this.

Dr. R, ever calm and measured, cocked his head to one side and asked, “How familiar are you with your body? Do you feel like you notice when things change?”

Familiar with my body? What does that even mean? At the time, I was sewing many of my own clothes, so that seemed pertinent. I explained that I knew my measurements intimately, and would notice if they changed, because it would affect my sewing. “If you wanted to MEASURE me every time I came in, I would be FINE with that!” I was selling this idea hard.

He laughed and told me that weighing individuals on every visit was mostly about tracking unexplained changes in weight, because that could indicate a problem that might otherwise go unnoticed. However, he said, “I think I can trust you to report any changes in your size.”

The shock and relief I felt took me days to process, and it wasn’t just about not having to be weighed all the time. The notion of being trusted with my body was utterly foreign to me. I was in my mid-20s, and still partly convinced that I had no right to govern my own body, that I could not understand my own health, that only doctors could unravel those mysteries and I had simply to accept whatever they told me about myself. This is a common experience for many women, especially women who are fat, but I hadn’t realized it had affected me so deeply until that moment.

I had never before met a doctor before who thought that my impressions of my health and wellness were as valuable as his own. This wasn’t a one-off thing, either. Over the decade that I saw him, Dr. R and I would routinely have discussions in which he would offer his own expertise, but then ask me how I felt and what I thought, and always in a manner that was sincere and interested. It wasn’t that he just went along with whatever I said, but he made me feel like I had the right to give input as the occupant of the body in question, rather than being dictated to, a passive and obedient patient.

In short, it felt like he and I were collaborating in my health, that I was an active participant in my own care. This was such a precious and magical gift, after all those years of thinking of my body as an aberrant monstrosity I was fighting, rather than an inexorable and valuable part of me.

I couldn’t have articulated any of this before I started seeing Dr. R. I didn’t know why I hated going to the doctor, why I sat in every waiting room feeling sick and powerless and grotesque. When white coat syndrome — a relic of my earlier experiences that I’ve not yet overcome — caused my blood pressure to surge when I first entered the exam room, Dr. R would recheck it at the end of my visit when I was calmer, to get a more accurate reading. He explained that using a too-small blood pressure cuff for your arm measurement can give a false high reading. He never made assumptions, but rather asked questions, posed hypotheses, ran tests, and worked to get the most accurate results possible. He preferred to operate within reality, and not vague generalizations. He believed me. He trusted me.

To put it simply, Dr. R treated me like a person worthy of dignity and respect, every time I saw him.

And that is what I said to his former PA last week, when she told me he had died a couple months ago.

I knew he had been sick. Dr. R had gone on medical leave a few years back, and then returned to work for a time, and then gone on leave again. Cancer.

His PA explained she didn’t have it in her to call every one of his patients to let them know, which I totally understood. I realized I was crying. Embarrassed, through sobs I told her that he was the first doctor I ever knew who made me feel like I had the right to be involved in my own health. I told her it really changed me, made me relate to healthcare in general and my body in particular not as things I tended to out of a begrudging sense of miserable duty, but because I was worth taking care of.

I wish I had told him that. He probably never planned it, or intended it — he clearly wasn’t trying to be an activist in the exam room, or to give me revelations, or build me up or anything like that. He was just doing his job. It was just how he worked. And just being himself was enough to help people.

Compassion is not a prerequisite for practicing medicine. Obviously. Medicine has its share of practitioners who relate to their patients as bodies on an assembly line. And I can even understand this, given the state of healthcare in the US, and the fact that virtually no one is getting the support they need, on either side of the desk. Primary care doctors and nurses often work impossibly hard to help more people than they can feasibly handle, and patients often suffer as a result. Doctors and other medical practitioners are not bad people, but they don’t always have the resources to be the kind of professionals they would like to be, and years of working in difficult circumstances will make anyone a little jaded.

Early on in confronting my doctor fears, one of the first revelations I experienced was when someone suggested that your doctor is technically your employee — if you don’t like the job she’s doing, you can fire her and find someone else. This idea helped me to learn to advocate for myself, but it also set me up to think of that relationship as adversarial; I was always waiting to be challenged, and in the panic of the slightest misstep, I would often have to decide whether to fight back (and come across as noncompliant) or lay down and let it go (and hate myself later).

And then I met a doctor who was truly, authentically compassionate and committed to asking questions, and testing and validating the facts, rather than moving forward with sweeping assumptions. And I realized that I didn’t have to hate doctors, or going to the doctor’s office, and I didn’t have to hate dealing with health stuff. I didn’t have to see it as a fight. I didn’t have to expect to feel dismissed or attacked. I didn’t have to feel guilty or broken or wrong or bad.

I could just, you know, try to be healthy. 

Lesley Kinzel is the Deputy Editor at xoJane.com. This blog was originally posted on xoJane.com on July 21, 2014. Click here for the original posting.

 

IndianWomenLogoInterpersonal communication aka face-to-face contact is quickly being replaced by all forms of social media contact, but the fact is that it is not the same. People are opting to text, Tweet, Facebook, instant message, email, blog or any other option rather than face-to-face interaction. Some say it’s simply because it’s convenient and so much quicker. The truth is; it’s a cop-out for when you really don’t want to hear ALL that the other person has to say. In our minds, we have no time for real communication. People of our society are choosing to become passersby or observers only of the many needs of our world with no real ties or commitment to anyone for anything. We mistakenly believe this lack of interaction will lessen our stress because we don’t have to deal with the problems of other people. Actually, even the historically sacred “family meal time” is now competing with smart phones, lap tops, notepads and other electronics; in addition to videos games and television from prior generations. Where will this all end?

IndianWomenblogpic3On Friday, September 19, 2014, a group of concerned American Indian Women held the 8th Annual Conference for American Indian Women of Proud Nations at the University of North Carolina at Pembroke. The theme of the conference was “Intergenerational Conversations: Sharing Our Stories to Encourage Healing”. The 2014 conference featured sessions on the Jim Crow South, Historical Trauma and The Waccamaw Siouan Women’s Talking Circle, which featured outcomes from recent community dialogue in the Waccamaw Siouan community. Dr. Mary Ann Jacobs and several UNC Pembroke students presented a session on the Jim Crow South. Committee members believed this year’s conference focused on building bridges between generations. Dr. Mary Ann Jacobs, who serves on the conference planning committee stated, “In years past, some of our younger participants said at the conference, they never had an opportunity to hear about the Jim Crow experience of their elders. That time frame had a dramatic effect on Native communities throughout the southeast. This year, we began a process to share with younger participants about those troubling years as well as the lessons learned by our elders.”

IndianWomenblogpic1Two types of Native communication exercises were successfully demonstrated; a fishbowl and a talking circle. Each is useful in different ways. Fishbowling information is useful to share information and perspectives of members of one group with those of another. The instructions below will assist in your construction of a fishbowling exercise.

  • Step1: When all groups have concluded their research or read a selected article they are ready to share their findings. This can be done by using a fishbowl exercise, with one group forming an ‘inner circle’ where they discuss their findings with each other, while another forms an ‘outer circle’, with their backs towards the inner circle, and listens and records the discussions of the first group. The rule is that those in the outer circle can only listen, and cannot contribute to the discussion in the inner circle.
  • Step 2: When the inner circle discussions have ended, the groups swap, so that the inner circle becomes the outer, and vice versa. Repeat steps 1 and 2 until all groups have heard from one another.

IndianWomenblogpic2Talking, sharing and healing circles are useful when the topic under consideration has no right or wrong answer, or when people need to share feelings. Moral or ethical issues can often be dealt with in this way without offending anyone. The purpose of talking circles is to create a safe environment for people to share their point of view and experiences with others. This process helps people gain a sense of trust in each other. They come to believe that what they say will be listened to and accepted without criticism. They also gain an appreciation for points of view other than their own. During the circle time, people are free to respond however they want as long as they follow these guidelines. All comments should be addressed directly to the question or issue, not to comments that another participant has made. Both negative and positive comments about what anyone else in the circle says should be avoided. Just say what you want to say in a positive manner. Speak from the heart. Click here for more information on the Guidelines for Talking, Healing, and Sharing Circles and Principles of Consultation.

Overall this was an inspiring and affirming conference that facilitated intergenerational transfer of Native ways from Lumbee elders and knowledge to younger generations in a very real and unique way. I guess, what is glaringly apparent is that healing tends to happen when there is true and meaningful dialogue that is delivered via face-to-face or interpersonal communication. Let’s not give up on any real genuine chances of healing that still remain for humanity! We need all the healing we can muster!

KayFreeman
 
Veronica Kay Freeman (Coharie and Waccamaw Siouan) is the Co-Chair of the Conference for American Indian Women of Proud Nations Planning Committee, the Community Intervention Supervisor for the Eckerd Youth Alternatives, Inc., and a member of the Every Woman Southeast Coalition Leadership Team

“You girls are worthless… a waste of my time.”

army dogtagsIn 1978, I was a visionary 18-year-old girl from Johnstown, Ohio – a town encompassing a grand total of 2.9 square miles and whose idea of big news involved an increased corn yield for one farm family or the next. With nothing to do but go to school and clean the house, I had plenty of time to think about what I wanted to do with my life, and please believe, I knew. I wanted to be a world-renowned artist, to draw for Disney, to have an excuse to express my “artistic” flare in everything I do and wear. In high school I drew all the time, I painted murals on school walls; I even doodled as I daydreamed. When I got my acceptance letter from the Columbus School of Art & Design I knew that I’d finally be able to do something I loved. And then my first dose of reality set in.

My parents told me just one month before I was set to graduate from high school that they wouldn’t be sending me to art school. My world immediately stopped spinning; gravity had lost its force and I was suddenly floating in an abyss of uncertainty. And all too quickly I started free falling back to earth, suddenly terrified about the prospect of my life. My options according to my mother: marry a man or get a job. So, I decided on the latter. Just a month after graduation, I joined the United States Army with the rest of the guys I thought had no future. And let me tell you, doing so changed my life forever.

Over the course of my 20-year career as a woman in the United States Army, I have many memories, both good and bad.  But the experience that continues to stain my mind is what I endured in basic training. Basic training was a very structured and rigid environment with daily threats, intimidation, and high expectations.  If political correctness existed then, I surely wasn’t aware of it. Drill instructors were openly sexist against their female platoons to a degree that most would find unbelievable today. These weeks of training involved not only torturous physical exercise, but a constant condemnation of each female private. We were told by our male drill instructors that we were worthless and a waste of their time. And what’s worse, they told us that the entire platoon would pay if we “cried for our mommies and daddies.” So I didn’t cry.

For many of us, it was our first time away from home, so you can probably imagine the fear and loneliness we felt at the end of each day – days that started when most sane people were still sleeping, days filled with yelling, threats, hustling from one place to the next, rapid eating (with little breathing or tasting), and listening to drill instructors as they berate you, your family, and even your pets.  After a day like that you can probably image how the only source of relief from all of that stress would be a good solid cry… but crying was considered a “cardinal sin.” Just one tear rolling down your cheek would mark you as weak.  So, I learned not to cry. Nothing broke my exterior – not the birth of my children, the pain of a broken ankle, the disappointment when I didn’t get selected for promotion, or the death of fellow soldiers.  By the time I was promoted to Sergeant First Class, I had completely forgotten that whimsical girl from Johnstown.

blog authorNeedless to say, the Army completely altered me, my personality, and my ability to feel emotions. But on the day of my retirement it was as if a dam broke. After 20 years I was finally able to release a lifetime of pent up joy, pain, hurt, happiness, and disappointment that I’d endured for so long. And since my retirement I’ve realized that that young starry-eyed girl is still alive and well in the mind and bodyof a woman who’s lived it all. In spite of my experiences in basic training, I look back on my time in the military with a sense of fondness, and I’m not ashamed to admit that I will now cry at the drop of a dime.  Until next time, Hooah!!

 

Frederica Zabala, US Army retired Sergeant First Class, mother of two and grandma!

By Kathy Hodges – Co-Executive Director, Family Violence & Rape Crisis Services

Violence in relationships is a reality for far too many women in our community, especially young women. The CDC estimates that at least one in every 3 women will be the victim of violence in a relationship at some point, and our history at our agency suggests that for many women violent relationships often start in their teens and twenties. This violence often impacts all aspects of a woman’s life and makes it difficult for her to seek health care, find support from her family and friends, or to support herself and her children financially.  Her partner may not only control where she goes and who she talks to, but may limit her access to contraception and coerce her into unwanted sexual activities.

Women who are being abused by their partners often carry around shame and guilt for their violence. They are isolated from community supports, and feel they have nowhere to turn.  Our communities must be prepared to recognize violence and provide support for victims in order to turn around this epidemic of violence.  We all must know the signs:

  • Injuries that don’t match the explanation or recurrent injuries 
  • Fear or anxiety about a partner’s response to a situation
  • Reluctance to participate in activities without a partner’s permission 
  • Withdrawal from family, friends and social situations 

Each of us can be the bridge a woman needs to safety in her life. We can help her to change her situation. The first step is to listen to her and believe her.  She may never have been able to share this before, so she may need to talk for a while.  It is important to let her know that you believe her.  If anything, she is likely minimizing the violence she has experienced.  It is every bit as difficult as she is telling you.  The next step is to connect her with supportive services.  Your local domestic violence agency is a powerful resource and ally for her.  Help her get in touch with the agency by sitting with her and helping her with the contact.  Finally, she needs you to keep the door open and help break the isolation she is experiencing.  She may not be ready to leave.  She may not be ready to do anything.  Just by talking to her and listening to her, your support can help her start to see her way to safety – the first step on her path.

By Mallory Perez – Health Policy & Management Graduate Student

Femme 6 is a student group of Health Policy & Management majors at the UNC Gillings School of Global Public Health. For the Spring 2014 semester, this team of six young women is assisting Every Women Southeast as the coalition grows and expands its network of resources. Mallory Perez from Tampa, FL is a member of Femme 6.
Nowadays, the word “collaboration” gets thrown around a great deal, whether it is a new music record or a team at work focusing on an upcoming project. I recently read an article that made me think critically about why some collaborations work and why others fall flat. “Collective Impact” by Kania and Kramer in the Stanford Social Innovation Review mentions comprehensiveness and risk-taking as part of what makes collective impact successful. The evidence of the effectiveness of cross-sector partnerships is building…slowly. So, what makes engagement in collective impact so difficult? Don’t we all want positive social change?
The five conditions of collective success described in the article are as follows: common agenda, shared measurement systems, mutually reinforcing activities, continuous communication, and backbone support organizations. Establishing all of these elements across various organizations in multiple social sectors can magnify the impact of an initiative and generate large-scale change. Beyond the difficulties of obtaining funding, this type of work requires a change in mindset, one that fully promotes equity. I have learned that collective impact works best when each member has “skin in the game”. No one person pushes to be the sole champion of change. Rather, collective impact is more of a process, and less of who can claim the outcome. The opportunity to learn from the expertise and perspectives of others is invaluable. That opportunity is where we grow, where we bring about change.

Every Woman Southeast is working to apply the collective impact model to women’s health and preconception health. The health sector is rapidly evolving, and it is becoming increasingly clearer that “good health” extends far beyond medical care. Public health, entertainment, advertising, education, and politics are just some of the players that influence our choices, and subsequently our health. At present, Every Woman Southeast seeks to engage partners that will help impact policy decisions and the housing/transportation available to women. Both of these factors contribute to how much autonomy and control women have over their own health. As Every Woman Southeast continues to build more cross-sector relationships, more individuals will discover the ways in which they can participate in collective impact.

By Sarah Leff, MPH, Program Associate at the UNC Center for Maternal and Infant Health

In May of last year, I graduated from the UNC Gillings School of Global Public Health with my MPH in Maternal and Child Health (MCH). I have been working at the UNC Center for Maternal and Infant Health, first as an intern and now as a program associate, for a little under two years now. It makes my head spin (in a good way) to think about how much I’ve learned in that short time. Being exposed to so many different aspects of MCH helped me refine what I was really interested in. One of my main interests now is preconception health – even though I had never heard of it before I started graduate school. To me, preconception health is women’s health – making sure that we are healthy and happy throughout our lives. As we say in MCH, ‘from womb to tomb.’ And, since many of us will have children one day, preconception health helps protect their health in the future as well.

Preconception health is an exciting and challenging field to work in, because it is more directly relevant to me as an individual than some of our other projects. Unlike tobacco cessation or postpartum care, preconception health is personal for me – I am a consumer, part of the target audience. I can understand some of the barriers to preconception health, because I’ve experienced them. Beyond tangible barriers like lack of health insurance, there is the mental struggle to value health and prioritize it in my life. Even as someone working in public health, this can be a challenge! It sometimes feels like between leaving our teens and when we become mothers, women drop off the map in terms of health care. We are often busy building our careers, finding time to nurture our personal relationships, figuring out how to make it as independent adults, and laying the foundation for the lives we want to have in the future. Among all of these concrete responsibilities, health can feel somewhat abstract, and healthy behaviors can feel like a luxury. It’s hard to find time to take care of yourself, visit the doctor, cook, and exercise. Unless you don’t have a choice – I’ve found that having a puppy is a great way to make exercise not optional!

So how do we get the message out – to the women we serve AND to ourselves – that our health is important? I’ve been very excited to learn about the new Show Your Love social marketing campaign. This campaign is a partnership between the CDC and the Preconception Health and Health Care Initiative, and the name pretty much says it all – Show Your Love! To yourself, and if you are planning a pregnancy, to your baby. This message resonates because it frames health not as an obligation or another stressful item on your “To Do” list, but as a way to love and care for yourself. This positive message helps remind me that ultimately, health is a prerequisite for everything else I want to enjoy in life, so I need to take care of my health and myself. Show Your Love isn’t a vague concept either – the supporting resources and materials help women with specific steps they can take to protect and promote their health. I’d like to add that preconception health shouldn’t be ‘ladies only’ – it is vitally important to include and engage men in this effort, and encourage them to Show Your Love as well – to themselves, and to the women in their lives.

Love is a word we use a lot in MCH. Maybe because even on the hardest days, we still know we’re lucky to be doing what we love. I hope Show Your Love spreads and catches on across the country – it’s a message we could all use a little more of.

By Kendall Gurske, Graduate Intern, UNC Center for Maternal and Infant Health
As a graduate student in both Social Work and Public Health, I’ve spent a lot of my academic career negotiating ways to bridge these two fields and become a leader in the broader arena of women’s health. Currently, an increasing emphasis on preventive care and integrated health and wellness services is shaping the national public health context, and should provide new and exciting opportunities for collaboration between these two historically partnered fields. As this new context continues to evolve, Social Work expertise on community health, safety, and welfare will become an increasingly valuable knowledge base within the field of public health.
As a result of my unique experience as a student in both of these realms, I have come to truly value the contributions that can be made to women’s health through collective action and impact. Every Woman Southeast embodies this ideal of working together not only across disciplines, but also across state lines. There is a wealth of diversity among the participants in terms of background, field of expertise, and home state. Members work for nonprofits, for government agencies; they are epidemiologists, physicians, and agency leaders.
The unfortunate reality for the southeast is that while there is a national push towards improving and increasing the availability of preventive health services for women, there is a dearth of resources and political will in our states. While our states face similar challenges, through Every Woman Southeast I’ve come to learn that they also have developed vastly different and innovative approaches to confronting them. By working together, across state lines and across disciplines, Every Woman Southeast is sharing successes in South Carolina that could be implemented to address a problem in Alabama.
My time as a graduate intern with the UNC Center for Maternal and Infant Health and Every Woman Southeast is coming to a close, and my graduation date is fast approaching. However, I know that no matter what vantage point I end up working from as a new professional, continued involvement in Every Woman Southeast will ensure that I am aware of state and regional efforts to promote preconception health, and that I have a forum to share my professional successes and challenges in the state of North Carolina. 


By Erin McClain, MA, MPH, Research Associate at the UNC Center for Maternal & Infant Health

My favorite parenting advice blogger, Magda Pecsenye, who writes the blog Ask Moxie, recently posted a response to Jessica Valenti’s book Why Have Kids?: A New Mom Explores the Truth About Parenting and Happiness and Valenti’s piece for Babble, both of which pointed out that while there is a lot of rhetoric about the importance of mothers, the job itself is not valued.
In her post “Free But Not Cheap”, Moxie reframes the argument, saying that motherhood is not a job, it’s a relationship. As the parent of two young children – one in early elementary school, one in infancy – this statement struck me like lightning! As Moxie writes: “If we think it’s a job, then nothing makes sense about it. How is it possible that it’s so important but also so undervalued?… But motherhood makes sense when you realize that it’s a relationship. Loving and nurturing your child is the relationship you have with your child. That’s why when you have a bad day as an adult, you still want your mom (if you have a good relationship with your mom) even though she isn’t making your meals, changing your clothes for you, driving you to work, or doing any of the stuff moms of kids do.”
From a public policy standpoint, Moxie goes on to say, “But we do need to make sure that the jobs associated with raising children are valued, financially and socially. We need protections for SAH [stay-at-home] parents. Protections and better wages for paid caregivers. And respect for everyone who does the jobs of raising children.” I hope you will read Moxie’s post (especially the comments!) – I would love to know if her approach resonates with you.

By Carol Brady, Executive Director of the Northeast Florida Healthy Start Coalition, Inc.

What a great kick-off for the Kellogg grant and Every Woman Southeast! There are so many opportunities and synergies with other initiatives focusing on poor outcomes among women and children in our region — ASTHO, AMCHP HRSA, CDC Consumer Work Group. Our leadership group will be an important vehicle for implementing strategies within and across our states. The concepts of “adaptive leadership” (loved Sterling Freeman, the meeting facilitator!) and “leading from the middle” really resonated with participants. We have momentum!

Check out some pictures from the meeting below!

Some EWSE coalition members take a tour of  UNC-Chapel Hill after the meeting on May 22.
One of the facilitated activities from Sterling Freeman.
Megan Lewis from RTI presenting an update from the National Initiative on Preconception Health and Health Care Consumer Work Group.
Lori Reeves (Florida) and Sarah Verbiest (North Carolina) lead a group brainstorming session.

By Monica Murphy, MPH, Public Health Prevention Specialist, Metro Public Health Department

Attending the EWSE Regional Meeting May 22-23, 2012, was a great experience. It was truly “a meeting of the minds!” Representatives from each of the 9 member states were in attendance and full of energy and enthusiasm. The two day meeting was jammed packed with discussions about the vision, identity and direction of EWSE and the much anticipated launching of the W.K. Kellogg grant. Everyone at the table shared their expertise, practical wisdom, and hopes for the grant project and the overall work of EWSE.

As a new EWSE team member from Nashville, TN, this meeting was an opportunity to get an in-depth understanding of the mission and goals of EWSE and to be a part of the strategic planning process as the collaborative prepares to move into a new phase. As an emerging public health leader, I have learned that improving the health of our communities is not a one man or woman job. The work that we do in our communities and states will not reach its full potential nor have maximum impact without the vision for new approaches that include collaboration, systems thinking, and adaptive leadership strategies. The EWSE collaborative is one example of a multi-state effort to improve the health of all women in the Southeast regardless of race, place, or circumstance.

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