Category: Current Trainees

An Island in the Midwest: Illinois’ Abortion Policies

Author: Esther Bier, MPH candidate in Community Health Sciences and Maternal and Child Health

Illinois is an island in the Midwest for abortion access. Surrounding states such as Wisconsin, Indiana, Ohio, Iowa, Kansas, and Michigan all have more restrictive abortion legislation than Illinois. Wisconsin mandates state-sanction counseling and a 24-hour waiting period before someone can terminate their pregnancy1. Indiana recently outlawed the common and safe second-trimester abortion procedure called dilation and evacuation while permitting medical providers to refuse to participate in abortion care services2. Meanwhile, a recent bill in Ohio would ban almost all private insurance policies from covering abortion care3. And in Michigan, telemedicine is prohibited from managing medical abortions – an issue critical for rural and poorer pregnant people4. Indiana, Kentucky, Michigan, Ohio, Oklahoma, and Wisconsin all require that a parent or guardian give a minor permission to have an abortion. Kansas and Minnesota require parental consent from both parents5. Considering the sea of abortion restrictions in states surrounding Illinois, it is no wonder that more than 5,500 out-of-state pregnant people travelled to Illinois to receive abortion care in 20176.

In contrast, a person can receive an abortion in Illinois without completing state-mandated counseling, a 24-72 hour waiting period, or a government-required ultrasound. Crucially, while minors are not required to provide parental consent to access abortion, they are required to give notice to a parent, legal guardian, grandparent, or stepparent. On the surface, such a policy may seem reasonable, with the intention of improving communication and support between parents and children. If minors need parental support to attend a field trip or fill a cavity, surely they should be required to consult a parent about their choice to have an abortion. Many supporters of the law use their own children and their hypothetical pregnancies to bolster their support: “I would want my child to talk to me, wouldn’t you?” or “I should be involved in my child’s healthcare, as is every parent’s right”.

While such simplistic statements seem reasonable on the surface, one must consider the law’s dangerous implications. Minors who feel comfortable discussing their desire for an abortion with a parent do not need a law forcing them to do so. Conversely, minors who feel unsafe telling a parent they are pregnant and obtaining an abortion likely feel scared for legitimate reasons. Minors might fear violence or abandonment from a parent if they are discovered to be pregnant. They might be kicked out from home. They might fear retaliation in the form of economic abuse or neglect. Consider the fact that state-mandated dialogue between minors and their parents do not yield a supporting and communicative relationship. The state of Illinois is therefore placing these minors in highly unsafe terrain by forcing them to tell their parent or guardian that they are pregnant.

Enter the Judicial Bypass Coordination Project by the ACLU of Illinois. Minors who do not qualify for a legal (like if they are married) or medical emergency exception can have the parental notification requirement waived by a judge. The ACLU provides free legal services to minors who seek such waivers as well as a hotline service for callers to receive information about the program. I am a volunteer on this hotline every other week for two and a half hours. Volunteers are trained to understand the details of the parental notification law as well as how to discuss such intricacies for young people likely in the midst of a lonely and scary struggle. While receiving a legitimate phone call from a minor looking for legal services is uncommon during my shifts, it is important that the hotline exists and is ready to provide answers to pregnant people and their significant others in need.

I recently attending the ACLU of Illinois annual luncheon to celebrate their successes and the legal battles ahead. The hotel ballroom was packed with roughly two thousand people and a stage filled with headliner performances. Speech topics ranged from immigration to trans rights to voting access. In my own experience, abortion is not directly mentioned in large gathering such as this; lesser charged language such as “women’s rights” or “reproductive freedom” is used. I was therefore surprised when multiple speakers directly mentioned abortion access as a current and pressing issue for the ACLU. Representative Jan Schakowsky spoke passionately about repealing the Hyde Amendment (the federal law that bans federal money from paying for abortions) and making abortion care more accessible. She received a round of applause when she said that “Roe was not the beginning of abortion in the US, it was the end of women dying from abortion.” Similarly, Colleen Connell, the executive director of ACLU of Illinois, spoke of the nation-wide attempt to reverse Roe – the very law that allowed so many people access to jobs, income, and professional development. Roe underpins the right to access appropriate medical services, to raise or not raise a child, and to bodily autonomy and education. Reversing Roe would signal an end to personal freedom and devaluation for all people who can become pregnant.

This is why I volunteer for the Judicial Bypass hotline and the ACLU: everyone deserves the right to live the life they chose. Access to healthcare and insurance should not be dependent on one’s zip code and immigration status. Everyone should enjoy bodily autonomy, regardless of age. If there is one concept I have learned during my first year as an master of public health student, it is that the health of an individual impacts the health of the larger society. When people are given the tools to succeed, their communities prosper and their health outcomes improve. This is what public health is fighting for and why I am in the fight for the long haul.

 

 

  1. Carafem. Abortion Access in Wisconsin. Carafem Web site. https://carafem.org/abortion-access-in-wisconsin/. Updated 2019. Accessed May 13, 2019.
  2. Gupta P. Indiana Strikes a Blow to the Heart of Abortion Access. The Slot Web site. https://theslot.jezebel.com/indiana-strikes-a-blow-to-the-heart-of-abortion-access-1834303489. Updated 2019. Accessed May 13, 2019.
  3. North A. The Controversial Abortion Bills Sweep the Country this Week, Explained. Vox Web site. https://www.vox.com/2019/5/10/18564436/ohio-abortion-bill-law-alabama-georgia-details. Updated 2019. Accessed May 13, 2019.
  4. Guttmacher Institute. State Facts about Abortion: Michigan. 2018. https://www.guttmacher.org/fact-sheet/state-facts-about-abortion-michigan.
  5. Planned Parenthood. Parental Consent and Notification Laws. 2019. https://www.plannedparenthood.org/learn/teens/preventing-pregnancy-stds/parental-consent-and-notification-laws.
  6. Leventis Lourgos A. More than 5,500 Women came to Illinois to have an Abortion Last Year Amid Growing Restrictions in the Midwest. The Chicago Tribune. November 20 2018. Available from: https://www.chicagotribune.com/news/ct-met-abortion-numbers-illinois-out-of-state-20181129-story.html.

MCH Students at the National Black Maternal Health Conference and Training Institute

Authors: Camille Bundy, MPH (c) in Community Health Sciences, Maternal and Child Health and Global Health

Aris Brown, MPH (c) in Community Health Sciences and Maternal and Child Health

On December 8th-December 9th, 2018 the Black Mamas Matter Alliance hosted the first National Black Maternal Health Conference and Training Institute. Two of UIC’s Maternal and Child Health trainees attended the conference, Camille Bundy and Aris Brown. Below are excerpts from their experience:

Camille: I can’t even put into words how liberating, inspiring and truly revolutionary the Black Maternal Health Conference and Training Institute was. This was my very first time attending a conference as a graduate student and it exceeded my expectations to say the least. For the first time in my academic career, I was in a space filled with women of color who are on the front lines of health disparities, especially those that pertain to Black women. That alone took off the pressure and allowed me to be completely free and submerged in the information that I was soaking in. If I could, I would have attended all of the break-out sessions because they were all really powerful topics. I chose to attend “Trauma-Informed Approaches to Interacting with Black Pregnant Mamas,” “Battling Over Birth: Black Women and the Maternal Health Care Crisis,” “Black Immigrant, African Immigrant, and Afro-Latina Women on Birth Justice and Maternity Care Work” and “Sharing Our Stories: Personal Loss, Healing, and Storytelling.” While each session taught me something new about the Black MCH world, they all reminded me of the historic and structural reasons why Black maternal health outcomes are less than satisfactory.

I met Black women from all sorts of professions: doulas, midwives, CDC employees, psychologists and sociologists. There is something so reassuring about networking with other black women-there’s an unspoken sense of comradery and sisterhood that comes along with it. By the end of the weekend, I gained not only the tools to tackle this work, but I also left with the confidence that I had been missing. The weekend affirmed that even in academic spaces that may not feel comfortable for me, it is equally important that my voice be heard and that my work for black mamas is valuable.  This was more than a conference. It was a breathing space. It was a weekend where Black women could get together, learn from each other, and encourage one another to continue fighting for our own health. It was a weekend that reminded us why Black Mamas truly matter. I am so incredibly thankful to have gotten the opportunity to attend this conference and I will be screaming to the mountaintops to encourage future MCH trainees to also attend!

Aris: I am relieved, proud of, and inspired by the 1st Annual Black Maternal and Child Health Conference and Training Institute. Coming to this conference was especially important for me because I do not see many women of color within the public health realm and with great representation here, I felt as though I got the support I was seeking, from women I felt comfortable with. It was refreshing to meet women from various disciplines who understood and shared my health concerns and struggles as a Black woman. I learned a considerable amount of information within each of the three sessions Camille and I attended. Each session addressed difficult/sensitive topics that Black women have endured, while arming us with practical techniques and tools such as: culturally competent questions to build rapport with clients/communities, the urban ACES metric, and community-based research approaches to conquer health disparities within communities of color.

What I liked most from the conference was how the participants worked in unison with each other. Everyone was extremely helpful and brought various perspectives to discussions, theories and frameworks. Additionally, I was intrigued and delightfully surprised by the amount of cultural shifting solutions to research, policy, and patient care for Black mamas and their children. It was such an uplifting experience to witness seasoned women utilizing their platforms and resources to further propel younger women like myself into positions of meaning, power, and responsibility. This weekend showed me that it is vital to continually fight for the injustices pertaining to Black mamas and their babies. I was taught that my voice mattered, even as a student. There were no hierarchical practices and all ideas were welcomed. The Black Maternal Health Conference was a chance to “reclaim my time” and the time for all Black women. I am humbled and beyond appreciative for my opportunity to attend this conference. The information embedded in me was invaluable and I am determined to direct my work within the MCH world to advancing the Black Mamas Matter agenda. I encourage all MCH trainees (no matter their race or ethnicity) to attend this conference in order to observe the unique and united connection of health professionals, progressing evidence-based advocacy for Black mamas.


Young Feminist Conference

Authors: Esther Bier, MPH(c) Community Health Sciences, Maternal and Child Health & Nadezh Mulholland, MPH(c) Community Health Sciences, Maternal and Child Health

On a rainy Saturday morning at the beginning of October, four hundred (mostly) young people gathered at the Chicago Teachers Union headquarters in Fulton Market for the Young Feminist Conference, hosted by the organization Cause the Effect. By 9AM, the hall was filled with youth, eager to discuss the day’s topics. This particular Saturday also happened to be the same day Brett Kavanaugh was confirmed to the Supreme Court. Emotions were raw as participants discussed the inescapable swirl of news surrounding sexual violence from recent weeks. To be gathered in a room with so many hopeful young people felt particularly poignant on such a grim day.

This sentiment was shared by Bridget Gainer, Cause the Effect founder and Cook County Commissioner of the 10th district, who gave opening remarks and a review of her organization’s mission. Cause the Effect seeks to increase political engagement among women, with a focus on empowering high school and college-aged youth. Cause the Effect hosts an annual Young Feminist Conference, a free space for feminists of all ages to learn about and discuss current issues relevant to women’s and LGBTQ+ liberation. To further strengthen feminist political involvement, the organization founded a political action committee to support and endorse local women candidates.

The first panel, moderated by Sarah Karp (a WBEZ contributor), discussed sexual violence and harassment and the recent Chicago Tribune exposé about sexual abuse in Chicago Public Schools (CPS). The panel was composed of survivor advocates, an anti-violence social worker, an educator, and CPS parent. They did not parse words when demanding CPS transparency and accountability, and offered the audience support and suggestions for how to manage sexual violence. The second panel, ironically dubbed “Everyday Feminism from Four Bad Feminists,” featured some of the most creative, successful, well-spoken, and driven people imaginable. All women of color, panelists included a previously homeless engineering company CEO, a WNBA champion, a Harvard-enrolled tech CEO, and an eighteen-year-old running for DuPage County Board. The women spoke about their successes in male-dominated fields, motivation during trying times, and support systems.

The last panel addressed Chicago gun violence with a southside attorney, a youth-home worker, an assistant state’s attorney, and an anti-gun violence advocate. This panel gave way to a heated discussion about the source of violence in poor, primarily black neighborhoods on Chicago’s southside. While one member believed violence is partially the result of families failing to teach children how to peacefully resolve conflict, another member pushed back stating violence is primarily caused by systemic racism, over-policing, and disinvestment. In spite of this rift, panelists were united by the belief that the name “Chiraq,”used to highlight southside violence reminiscent of the Iraq war, creates an inaccurate representation of daily life in southside neighborhoods, demonizes black people, and erases vibrant community life.

Tonika Johnson, a photographer from Chicago’s Englewood neighborhood, served as a meaningful example of southside pride. Members of Resident Association of Greater Englewood (RAGE), of which Johnson was a founder, felt frustrated by the monolithic representation of their Englewood as a violent and despondent community. RAGE collaborated with Englewood Rising to display billboards around Englewood of fathers kissing their children, people playing, worshiping and working – an Englewood story many Chicagoans had not heard. RAGE also hosts So Fresh Saturdays featuring food, music and celebration, reminding community members that parks and green spaces are theirs to use. In doing so residents proved that Englewood is not merely a site of violence and poverty but one of hope and pride.

Reclaiming your own narrative was a salient theme throughout the panelists and speakers. Participants were encouraged to speak their minds even when their opinions might be unpopular. Whether about sexual violence, neighborhood violence, or policing, everyone has the right to truthfully define their own lives and communities and reject the narrative of outsiders. This message seamlessly blends with concepts discussed in our public health courses about intentionally creating space for communities to set their own priorities and dictate their needs. Considering the history of health officials using communities of color and erasing their voices, this conference served as a helpful reminder about how to examine our own biases and operate as an ethical public health practitioner.


MCH STUDENT FIELD EXPERIENCES 2018

Author: Gabrielle Lodge, MPH(c) Community Health Sciences, Maternal and Child Health

This summer, MCH Trainees participated in field experiences both locally in Chicago and across the US. We were able to connect with four Center of Excellence (CoE) in Maternal and Child Health (MCH) Masters students and asked them to share their experiences and advice they would give to prospective and incoming MPH students.  Read their stories below.

Isabella (Izzy) Litwack

Izzy’s field experience was with an organization based in Chicago, EverThrive Illinois, what she considers one of the “policy experts around town”. Izzy worked on two projects simultaneously. The first project was on contraceptive justice, a new initiative that kicked off April 2018. EverThrive IL started a statewide coalition that included stakeholders, policy makers, lawyers, and medical providers. This coalition aimed to increase contraceptive access to people in Illinois. Izzy helped lay the basic foundation of this project. She researched current policies, regulations, and bills to understand what exists in Illinois to promote or restrict contraceptive access. She also engaged in a policy cross-walk where she compared contraceptive access in Illinois with 11 other states.

Izzy’s second project was related to Medicaid Buy-In. This November, the gubernatorial election is taking place in Illinois, and the democratic nominee is J.B. Pritzker. Pritzker has announced his healthcare platform to include a Medicaid Buy-In component. Pritzker has proposed a plan to allow any Illinoisan to buy into Medicaid, which traditionally has only provided medical coverage to low-income populations. This policy could be of particular importance to EverThrive IL because it could potentially provide insurance coverage to children who have not qualified in the past. To help EverThrive IL strategize, Izzy dedicated time to researching all relevant information on Medicaid Buy-In. This included looking at proposed legislation across different states and within Illinois related to Medicaid Buy-In.

Izzy has always had an interest in policy work and was grateful for the opportunity to get an inside look of a policy and advocacy organization. It allowed her to dig into healthcare and understand how policymakers have a huge role in impacting access to care. Moreover, her field experience with EverThrive IL allowed her master the language of policy and insurance coverage. Izzy says that often there are terms thrown around that we do not fully understand. This experience allowed her to have a better understanding of the terms often use in healthcare policy, Medicaid, health insurance, and the overall healthcare market.

Izzy’s advice to prospective, and incoming MPH students:

“The field experience isn’t just about getting the job done. Take advantage of the opportunities that are presented to you. Use your field experience to network. Use this opportunity to preform informational interviews with the people you are working with. Asking people what they do for their jobs is valuable. Treat the field experience as more than a requirement for school.”

Channon M. L. Campbell, B.S., MSN

Channon was an intern for the Center for Community Health at Northwestern’s Institute of Public Health and Medicine. She interned specifically for the Mothers and Babies program, a postpartum depression (PPD) prevention intervention program. This program promotes healthy mood management by teaching participants how to effectively respond to their stress. It is delivered as a group or as a one-on-one intervention.

Channon worked primarily with low-income women of color. She conducted a series of surveys, gathering depression scores of mothers which are tracked at 12, 18, and 24 months. She also conducted surveys on bonding, and how mothers interact with their child. Some survey tools focused on child development such as the Ages and Stages Questionnaire (ASQ), while others related to mental health, such as the Beck’s Depression Inventory (BDI). Surveys were conducted at home-visits, but if unable to, Channon would provide outreach through phone calls. Channon would manage the data from home visits and client interactions to track changes and progress of both child development and mother’s mental health.

For her Capstone, Channon will be work with Mothers and Babies to look at the long-term effects of client’s participation this program. She will look to understand if the program was impactful for the mothers to access preventative care to their infants (well-child checks, and immunizations). This is also allowing her to gain experience with research protocols and methods, such as designing a research question, data compiling, data management and working with the Institutional Review Board (IRB).

Channon’s advice to prospective, and incoming MPH students:

“For the field experience, consider breaking up the credit hours over two semesters. I found it overwhelming to have the 5-hour credit commitment in one summer and in the end, found it more beneficial and feasible to spread out the field experience over two semesters. I had competing priorities with other classes and work, so reducing my credit hours for the field experience was the best move for me. Map out your internship and follow it to a ‘T’ so you can get it all done. Don’t pick an internship because it is paid. Find an experience that aligns with what you want to do and find something that you will enjoy going to each day.”

Lauren Schwerzler, RDN, LDN

Lauren was selected as the Title V MCH intern for the Minnesota Department of Health in St. Paul. This is a national internship program out of the National MCH Workforce Development Center. Lauren was paired with an undergraduate student who is also an MCH Trainee from the MCH Pipeline Program, at the University of Maryland. Every state has a Title V agency that is charged with “improving the health and well-being of women (particularly mothers) and children” (Maternal and Child Health Bureau). Lauren helped the Minnesota Title V agency prepare for their need’s assessment that will be conducted in 2020. She curated materials and data briefs to facilitate the process to engage with stakeholders. She produced four data briefs for Minnesota’s Title V current priorities: breastfeeding, pregnancy intention, transition, and medical homes. Lauren also learned about health inequities that impact breastfeeding uptake, specifically racial disparities and regional differences in Minnesota.

Lauren pulled main themes out of a statewide survey that asked Minnesota stakeholders the most critical needs for women, children, and families. This survey can be filled out by anyone, and was distributed to community health workers, public health professionals, firefighters, police officers, and people who speak Spanish and Hmong. They received over 3,000 responses. Lauren conducted an analysis and found that the main themes included: housing, childcare, and education.  

Lauren additionally worked on a project related to the Title V Needs Assessment process. She developed a key informant interview guide for the Title V agency to utilize as they prepare for the needs assessment.  She also analyzed the Minnesota student survey on parental incarceration. Lauren says that the most exciting part was conducting key informant interviews with folks from Volunteers of America to understand the needs of currently or previously incarcerated women and their children.

Lauren’s advice to prospective, and incoming MPH students:

“Once you have a field experience, don’t be afraid to ask questions. Preceptors tend to be more willing to go outside the schedule of projects you laid out. My preceptor showed me to link data, which wasn’t listed in the projects we originally talked about. Speaking up within the organization is important, at times people within the organization would respond “I didn’t think about that”. Don’t think of yourself as “just the intern”, think of yourself as a “new employee”. This is a fundamental period. It allows you to see what you like and don’t like, and you should take it seriously. It is great for networking and I recommend doing it in a geographical place you are interested in working when you graduate.”

Rachel Mason

Rachel’s field experience was with the Illinois Department of Public Health. Her preceptor was Amanda Bennett, PhD, a UIC alum and the current CDC MCH Epidemiologist assignee for the state of Illinois. Her project was focused on School Based Health Centers (SBHC).  There are 67 SBHC in Illinois, and half of them are in Chicago.  Rachel’s project built off of the Harvard-CDC Evaluation project and she employed program evaluation principles to assess barriers to and facilitators of high-quality SBHC adolescent health services. She also created a quantitative annual assessment to increase the knowledge about service capacity and standards of care within SBHCs across Illinois. This survey will be sent early fall to assess the SBHC on an aggregate level. Since there are no current data, these data will be used understand differences between SBHCs and identify areas of improvement.

This project also led Rachel to reaching out to SBHCs directly. Rachel conducted qualitative interviews at the SBHC with staff, and used the frameworks developed by the Harvard students to get specific themes of the staff’s needs. Rachel was excited to be able to be onsite at the SBHCs to conduct her interviews and found that seeing the physicality of the centers was very helpful. She was able to speak to others outside of the interviews and asked them about their experiences with SBHCs. She synthesized her findings in a final report and presented them to IDPH leadership. Rachel was really happy to have exposure to both quantitative and qualitative work.

Rachel’s advice to prospective, and incoming MPH students:

“Critically think about what you want out of the field experience. Make a list of important things that you want to get out of the internship. Think about the subject matter of your project and how long you anticipate doing this type of project. Make sure you “mesh” with your preceptor. You’ll want to feel comfortable to ask your preceptor questions.”