A shorter version of this piece can be found in the Diversification and Inclusion (D/I) column in the Fall issue of Quickening. If you are interested in reading future pieces related to diversification and inclusion, please look for the D/I column in
Catchers in Training: Lions and Tigers and Diversity
What went wrong, and right, with the 59th Annual Meeting’s Opening General Session
By Liz Donnelly, Anna Tran, and Jyesha Wren
Student Nurse Midwives at the University of California, San Francisco
At the recent ACNM 59th Annual Meeting & Exhibition in Denver, the Opening General Session was entitled "The Diversity Advantage: The Oz Perspective" prepared by diversity strategist Lenora Billings-Harris
. Her talk was followed by a music video created by Hip Hop Saves Lives
, a nonprofit with a stated mission to teach humanity through hip hop. Many members in attendance found the content of the opening plenary troubling, including a group of students from the University of California San Francisco who brought their concerns to the D/I Task Force and to the ACNM leadership. In response, ACNM President Ginger Breedlove publicly apologized for the content of this year’s Opening General Session. As the group of students who requested the apology, we want to take this opportunity to explain in depth why we felt an apology was warranted, as well as our experience working with ACNM leadership.
We were fortunate to have had a course on health disparities as part of our midwifery education curriculum where we learned troubling statistics, such as black infants being twice as likely to die before their first birthdays than white infants, black women being 4 times more likely to die from a pregnancy related complication than white women, and even with the same complications, black women are 2-3 times more times likely to die than white women. We also learned about midwifery’s tradition of service to underserved populations and ACNM’s current commitment to reducing healthcare disparities. We were thrilled to learn of the work of the D/I Task Force
towards workforce diversification, a critical component to the elimination of disparities as identified by the Health Resources and Services Administration’s summit “Nursing in 3D: Workforce Diversity, Health Disparities, and Social Determinants of Health.” Midwifery has much work to do on this given that only about 9% of ACNM members identify as a race other than white.
Thus, when we saw that the keynote speaker at the Annual Meeting was Lenora Billings-Harris, a diversity educator, we expected the speech would facilitate greater understanding of the lack of racial diversity in midwifery, as well as why this diversity is important to the health outcomes of the people we serve and to the future of our profession. We were immediately discouraged when the speaker opened by saying she intended to give a talk about diversity without making anyone feel uncomfortable. Deep conversations about sexism, racism, transphobia, homophobia and other instances of reflection on systemic disparities are often uncomfortable. In order to have productive discussions on these issues we each must find a way to sit with discomfort. The speaker continued with metaphors from the Wizard of Oz which danced around the subject of diversity, resulting in overly simplified messages about human decency: be nice to people who are different than you, don’t look down on others, and don’t talk about someone behind their back. The avoidance of directly talking about racism and its implications for our profession and the communities we serve made many people feel disappeared and disrespected. When we avoid or gloss over inequalities it paralyzes our efforts to reduce them.
As the keynote address finished and people were filing out, a hip hop music video appeared on the big screen. It first appeared that the video, “A New Dawn” by Hip Hop Saves Lives, was an attempt to diversify the session with token images of African-Americans. We then anticipated that it would be in honor of a midwife of color. We were disappointed when it concluded with images of a white midwife, Ruth Lubic, in a beam of light surrounded by black children. While there is nothing inherently wrong with the video, it is a problem that black people are overrepresented in entertainment and underrepresented in professional and academic environments. Including the video in the absence of any representation by midwives of color furthered the common perception that the roles black people play are that of artist, musician, or impoverished person in need of saving by someone outside their community. To demonstrate racial diversity through this video was unprofessional and disrespectful. This closing left many deeply disturbed with the treatment of race in this opening session.
After the session, we spoke to a diverse group of midwives and found we were not alone in feeling hurt and disrespected. In these conversations we learned that neither D&I nor the Midwives of Color Committee (MOCC)
was consulted in the development of the session. MOCC has been working for years to address the uncomfortable reality of racial and ethnic disparities within midwifery. The failure to include their insight was deeply unsettling to us as students who recognize them as the trailblazers who have paved the way for our sense of inclusion within ACNM. The affirmation that our experience was widely shared coupled with learning that the institutional resources on diversification and inclusion had not been utilized prompted us to call for an apology from the board.
On Thursday morning, while circulating our petition requesting an apology, 2 of us ran into Ginger Breedlove, ACNM President. Ginger’s immediate response was to listen open-heartedly. She promptly offered to publicly apologize on behalf of the institution and to dedicate time during the conference for us to share our concerns with ACNM leadership. The following morning we met with representatives from the board, MOCC, and D/I. We were able to express our concerns about the opening session as well as our concerns about the structural barriers that prevent racial and ethnic diversification within ACNM. This meeting was followed by Ginger’s apology at the closing business meeting. A few of us participated by standing with Ginger to thank ACNM leadership, including MOCC and other ACNM members, who have been working on diversification within ACNM for many years.
The board modeled the humility, deep listening, and responsiveness that is appropriate in these kinds of situations. We share it both as a model of how to respond and because it gives us hope that ACNM is ready to engage in the urgent work of increasing racial/ethnic diversity within midwifery and addressing disparities in birth outcomes. These missteps were made possible by the lack of racial and ethnic diversity within ACNM membership and leadership. If ACNM is going to be relevant and impactful in national efforts towards improving birth outcomes and reproductive health care for all people, the organization must address the structural and personally mediated barriers to increasing the racial and ethnic diversity within our profession. Such a task is not undertaken by leadership alone. We hope that by sharing our experience, you feel inspired to listen open-heartedly to colleagues of different backgrounds, to sit with discomfort as you explore how systems privilege some at the expense of others, and to feel empowered to get involved with midwives working towards diversification within ACNM.
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