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NHCOA Celebrates Mothers on National Women’s Health Week

Washington, DC- Dr. Yanira Cruz, President and CEO of the National Hispanic Council on Aging (NHCOA)– the leading national organization working to improve the lives of Hispanic older adults, their families, and caregivers– made the following statement in commemoration of National Women’s Week, celebrated May 11-17, 2014:

“Mothers are the backbone of Latino families and as such NHCOA happily joins in the celebration of National Women’s Health Week to commemorate the important contributions of the women in our lives.

With implementation of the Affordable Care Act (ACA), millions more women now have access to preventive health services such as vaccinations, mammograms, Pap smears, and lower cost birth control. By creating a health environment that encourages healthier lifestyles, the ACA has primed families everywhere to take greater control of their health, particularly given that mothers tend to serve as the health decision-makers for their families.

Now that millions more have access to preventive health services, however, it is imperative that we as health professionals do our part to bridge the knowledge gap between diverse communities and the U.S. health system with which they may not be familiar. In addition to knowing how to use their new health insurance, mothers must be able to prevent and identify health care fraud and what their rights are as a patient. By working together to increase access to and appropriate use of health services, we can create healthier mothers and families for generations to come.”

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What Mothers Need Series: Pregnancy Discrimination

 It takes a village to raise a child.

This age-old idiom rings true for cultures across the globe and its premise rings true even in pregnancy. Social support is an important contributor to the health and well-being of both pregnant women and their children and has been shown to mitigate risks to maternal and child health (such as low socioeconomic status), particularly among Latinos who often attribute strong familial and community ties to better birth outcomes (James, 1993). Conversely however, discrimination of mothers during pregnancy has been linked with infant mortality (Zuvekas, Wells, and Lefkowitz, 1999), sexually transmitted infections including HIV (Rosenthal et al., 2014), and maternal depression (Walker et al., 2012).

Discrimination during pregnancy can be inflicted on the mother as a result of her race/ethnicity, age, perceived socioeconomic status, or because of her pregnancy status. Diverse women are more likely than their white counterparts to experience discrimination during pregnancy, and young mothers are more likely to be discriminated against than their older counterparts.

Regardless of the justifications, discrimination at any phase is unacceptable.

During pregnancy, the discriminatory practices not only affect the health of the pregnant woman, but also set physiological set points for the growing infant that affect health throughout his life course. To further complicate the issue, overt signs of pregnancy discrimination in the workplace have been outlawed thanks to The Pregnancy Discrimination Act of 1978, but have instead been replaced by more subtle discriminatory acts. Subtle forms of discrimination, or microaggressions, arguably have the potential to cause significant harm within the healthcare system, where decreased rates of specialist referrals, increased wait times, decreased health education, and poor patient-provider communication all contribute to negative health outcomes that affect daily living and economic viability well beyond pregnancy.

In the era of the Affordable Care Act, where millions more now have access to health insurance, it is even more imperative to address other potential barriers to obtaining quality health care.

To address evolving but persistent issues of discrimination and bias in healthcare, researchers at the University of North Carolina – Chapel Hill will be collaborating with photojournalist Janet Jarman to generate discussions among pediatric residents about their own implicit biases against the burgeoning Latino communities in North Carolina through the Yo Veo Salud project. In particular, UNC researchers will be highlighting the lived experiences of young Latina mothers in the surrounding area using photovoice, where marginalized groups participate directly in research that affects them and use photography to shed light on the subtle discrimination that these young women continually face, particularly when trying to access healthcare services.

By addressing persistent instances of discrimination before, during, and after pregnancy, we can better meet the needs of Latino families throughout the life course and for generations to come.

 

This post is part of the Mother’s Day #WhatMothersNeed week of action during which NHCOA is joining several national organizations and advocates to raise awareness about quality maternity care, pregnancy discrimination, paid family and medical leave, paid sick days, fair pay, affordable health care, and more. Join the conversation May 5-9, 2014 at 3pm ET on Twitter and tell us #WhatMothersNeed. 

What Mothers Need Series: Culturally and Linguistically Appropriate Maternal and Child Health Services

By Dr. Yanira Cruz, NHCOA President and CEO

Mother, grandmother and babyMotherhood is simultaneously one of the most beautiful and difficult experiences in a woman’s life, the effects of which can be seen in the health of subsequent generations. Health outcomes that span a person’s life are increasingly being linked to pregnancy and early childhood (Marmot, 2003). Hypertension, heart disease, and diabetes have all been linked to experiences in the womb and during infancy (HRSA, 2011). What is often excluded from discussion, however, is how parents, particularly new mothers, learn to care for their children. In diverse communities throughout the United States, learning to be a mother means balancing medical recommendations with traditional customs. This balancing act can, and often does, mean deciding between conflicting recommendations.

Recently, researchers at Emory University set out to answer the question: What do new mothers need? To answer this question, the team of investigators spoke with new mothers and medical providers across Georgia (Gazmararian et al., 2013). Mothers and their health care providers were nearly unanimous in declaring that the most urgent maternal and child health need is culturally and linguistically appropriate services and health education.

In some areas, such as infant bathing or umbilical aftercare, mothers from all linguistic and socioeconomic backgrounds indicated there was simply no information. In other arenas, such as Sudden Infant Death Syndrome (SIDS), the information was readily available in English and Spanish, but it did not resonate with the mother’s cultural and instinctual understanding of proper childcare (Merino et al., 2012). Moreover, almost all health care providers indicated that they found it frustrating that mothers either did not know infant care basics or knew and chose not to adhere to them. As a result, many providers provide little, if any, patient counseling around topics where they feel cultural influences will outweigh their medical recommendations. The result is new mothers that are either uninformed or misinformed about their own postpartum care or the care of their newborns and crave more information from their providers. Given the importance of early health throughout the life course, approaches to increasingly diverse populations of mothers must grow to meet the changing needs of maternal and child health in the United States.

Health education and patient-provider communication are of vital importance to the development of appropriate parenting skills and health of children throughout their lives. In order to improve communication between providers and mothers of diverse cultural and linguistic backgrounds, maternal and child health education must evolve. This is even more important in multigenerational households where grandmothers have a wealth of parenting advice to impart on new mothers. In the Hispanic community in particular, many of the practices new mothers adopt are customs and traditions passed down from generation to generation. Moreover, the evolution of recommendations and treatment standards over time can further complicate the recommendations new mothers must balance.

Approaches to increasingly diverse populations of mothers must grow to meet the changing needs of maternal and child health in the United States.

What we need is more, rather than less, discussion. Current approaches to parenting education leave knowledge gaps for new mothers, particularly when existing messages do not resonate across different cultures. Identifying and addressing those gaps is the first step to improving parenting knowledge and health outcomes throughout the life course. Moving forward means addressing some of the realities of motherhood in the United States:

  • Leverage the concept of good and attentive mothering that is fundamental to Latino and other diverse cultures as a way to connect health education with culture
  • Address infants’ reactions as an important deciding factor for mothers (e.g. sleeping longer on their stomachs, more frequent feeding when breastfed vs. bottle fed, etc.)
  • Understand that co-sleeping is a culturally ingrained practice for some populations, such as Latinos, and may be an immutable practice
  • Allow room in care recommendations for mothers that may on occasion co-sleep with their infants or otherwise take the path of least resistance from time to time
  • Acknowledge that recommendations evolve over time and that what we know today about maternal and child health may change in a few years when a mother has her next child
(Adapted from When Lack of Knowledge isn’t the Problem)

By advancing our approaches to maternal and child health education in tandem with changing U.S. demographics, we can better address the needs of diverse communities and work towards creating well-equipped mothers and healthier generations.

This post is part of the Mother’s Day #WhatMothersNeed week of action during which NHCOA is joining several national organizations and advocates to raise awareness about quality maternity care, pregnancy discrimination, paid family and medical leave, paid sick days, fair pay, affordable health care, and more. Join the conversation May 5-9, 2014 at 3pm ET on Twitter and tell us #WhatMothersNeed.