Plus, takeaways from the Celebration of Black Kin Conference
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Good morning and happy Monday! As we near the end of April, we’re wrapping up our topic of discrimination and adversity. We understand that this topic is very broad and multifaceted. It certainly deserves more space and dedication than just one month. But we wanted to leave this topic on a positive note.

Here’s what’s in this week’s edition:

That’s all for now! See you at this week’s Fearless Friday.

— Emily Blobaum, Fearless editor

Program pairs nurses with first-time moms in need
Aaron, Amanda and Saylor on a family outing in Iowa. After Saylor's birth, Amanda and Aaron enrolled in Nurse-Family Partnership, a program designed to aid first-time, at-risk moms. Photo courtesy of Amanda Jones.
When Amanda Jones found out she was pregnant in 2018 at age 25, she was surprised. She and her fiance, Aaron, had been dating for 1½ years and were both working as servers in Longview, Texas — Amanda at Cheddar’s and Aaron at Buffalo Wild Wings.

"We weren’t in a position to have a baby," Amanda said. "We wanted her, but our financials were just not there."

Upon their daughter’s birth and enrollment into Medicaid, Amanda and Aaron were given a handful of pamphlets detailing programs and services that they qualified for. Nurse-Family Partnership was one of them.

Nurse-Family Partnership is a national home visiting program that pairs a first-time mom with a registered nurse. The nurse regularly visits with the mom during the prenatal period all the way up until the child’s second birthday. The program aims to improve pregnancy and child health outcomes by helping mothers engage in preventive health practices while also improving the economic self-sufficiency of the family.

The program is a national organization that works with network partners in 40 states. Nurse-Family Partnership has served more than 340,000 families since its replication began in 1996.

Originally on the fence about it — "I didn’t want someone coming into the house all the time" — Amanda decided to join the program shortly after their daughter, Saylor, was born.

Less than a year later, Amanda, Aaron and Saylor moved to Central Iowa at the end of March 2020 to be closer to family. They continued participating in the Nurse-Family Partnership program through EveryStep, a nonprofit health care and social services organization based in Des Moines.

Amanda was paired with Becky Borgman, who has worked in maternal care for 10 years and with Nurse-Family Partnership for six years. Due to COVID protocols, the two have mostly met virtually, either through FaceTime or phone calls.

Saylor hated taking baths, wasn’t the greatest eater and was a big biter, Amanda said. "Becky helped us immensely. We talked about different techniques for discipline and working through difficulties. We’ve had calls where I say, ‘I don’t know what to do,’ and she’ll remind me that everything is going to be fine and it’s just a phase. Becky is the best. Nurse-Family Partnership has honestly changed our lives."


Designed to serve the highest-need and highest-risk families, Nurse-Family Partnership hopes to help decrease the rate of health complications.

According to a fact sheet provided by Nurse-Family Partnership, 87% of babies in the program were born full-term, 86% of mothers initiated breastfeeding, 92% of babies received all immunizations by age 2, and 54% of clients above 18 were employed by the time their child was 2. Other successes include decreases in maternal alcohol use and smoking during pregnancies and a greater sense of confidence and empowerment in moms.

To be eligible, participants must be a first-time parent and be eligible for Medicaid. In Iowa, a maximum annual household pretax income of $29,000 for three people qualifies for Medicaid. At time of enrollment into the program, 84% of Nurse-Family Partnership clients in Iowa are unmarried and the median household income for participants is between $9,000 and $12,000.

Free to the participant, Nurse-Family Partnership is funded through a variety of streams in the form of federal, state and private dollars. Jordan Wildermuth, senior government affairs manager for Nurse-Family Partnership, said the largest source of funding is federal dollars. Private philanthropic dollars make up 33% of its revenue and the remaining 25% comes from the state.

Nurse-Family Partnership is currently only serving 13% of the eligible population in Iowa and is available in just six counties — Pottawattamie, Montgomery, Polk, Jackson, Clinton and Scott. That needs to change, Wildermuth said. "Iowa can do better in reaching some of these moms. We’re only serving a small number of families and there’s more that we could be doing."

‘Stopping at disparities helps no one’: How the Celebration of Black Kin Conference created space for discussions around Black maternal health
A Celebration of Black Kin Conference was held April 11-17 and focused on shedding light on solutions to the Black maternal mortality crisis. Design by Jamie Malone.
Last year, Olivia Samples had a dream of starting a conference around Black maternal health.

Samples, a nonbinary Des Moines-based doula who serves Black and queer families, decided the conference would uplift the positive things happening in the community. It would center Black birthing people, and the joy in Black parenthood. It would focus on solutions to the maternal mortality crisis. It would be broadcast through a holistic lens where people could show up as their full selves. It would create space for discussions around reproductive justice and bodily autonomy.

It would do these things because "stopping at disparities helps no one."

Born after months of planning, A Celebration of Black Kin Conference, held during Black Maternal Health Week (April 11-17), did just that. Here are four takeaways from a few of the sessions that I was able to attend.

‘Are we confident that we’ve made any progress on eliminating disparity? I’m not sure we have.’

Disparities within the field of health care are plentiful. Stephen Pedron, maternal fetal medicine specialist at UnityPoint in Cedar Rapids, wasted no time listing off concrete examples: Medicaid eligibility and reimbursement, electronic health record efficiency, language, transportation, child care, trust, lack of providers in general and specifically providers of color and differences in culture.

Addressing these disparities starts with communication, panelists said.

Having an initial meeting with patients and not just handing them a pamphlet in a rush and hoping they’ll read it on their own time is important, said Ayah Bilbeisi, dentist at Cedar Ridge Dentistry in Urbandale.

Sarah Bradbury, a certified nurse midwife at Broadlawns, emphasized the importance of providers being aware of barriers. "It’s easy for a provider to say, ‘Pick up this prescription and come back in or give me a call if you have issues,’ but we often don’t take transportation or reliable phones into account. We have to be mindful of people’s life situations."

By doing that, health care providers also have the responsibility to help educate patients so they can make informed decisions and advocate for themselves.

Sabbath Schrader, registered nurse at Broadlawns, argued that ultimately the burden falls on providers to recognize the needs and wants of the patient. "Yes, absolutely patients can and should do things to improve their ability to maneuver health care systems. But what are we [as providers] doing to improve our ability to help with that in the moment? It’s on us. It’s not just treat and street."

There’s no silver bullet to improve pregnancy outcomes of Black and Brown women, but there are known solutions.

One solution? Increasing midwife-led care. Iowa is one of only a handful of states that don’t provide licensing for certified professional midwives.

Certified nurse midwives — registered nurses who have graduated from a nurse-midwifery education program — are available. However, they mostly work in hospital settings because of the difficulty in establishing birthing centers.

"We have to work on the nurse midwifery situation in this state," Pedron said.

In the April meeting of the Iowa chapter of the International Cesarean Awareness Network, chapter leader Rachel Bruns cited statistics of VBACs (vaginal birth after cesarean) and cesarean births in the state.

The cesarean rate in Iowa is about 30%. Ideally, that rate should be somewhere between 10% and 15%, according to the World Health Organization.

A 2019 story in the New York Times stated that birth complications linked to surgical deliveries are among the biggest factors of maternal deaths.

"One in three American mothers delivers her baby via cesarean section, a rate that has increased more than 500 percent since the 1970s. While C-sections can often be lifesaving for both mother and baby, the surgery involved also carries serious risks," the article read. "'Caesarean sections are effective in saving maternal and infant lives, but only when they are required for medically indicated reasons,’ a 2015 report from the World Health Organization said. The report found that C-section rates higher than 10 percent were not associated with reductions in maternal and newborn deaths."

For birthing parents who have already delivered a baby via cesarean section, it can be difficult to find a provider that supports VBACs. While a successful VBAC is associated with fewer complications than a repeat cesarean section, although rare, a uterine rupture is a risk.

The rate of VBACs in 2018 was only 14%, which means that 86% of birthing people with a prior c-section birth had a repeat c-section. Of the roughly 34 labor and delivery units in the state, only one-third offer any kind of trial of labor after cesarean section or VBAC care policy.  

As part of the Iowa Maternal Quality Care Collaborative, Iowa hospitals have an opportunity to enroll in a free patient safety bundle through the Alliance for Innovation on Maternal Health, or AIM, that focuses on reducing primary cesarean sections. Hospitals need to enroll by May 1.

Another action step? Making sure doulas are covered by insurance, including Medicaid, Schrader said.

My experience as one of the first female Eagle Scouts in the state
My experience in Scouts BSA has been an incredibly irreplaceable opportunity. I
began getting involved with the program long before I even realized. As a younger sibling going along on family events and outings, I quickly picked up many skills and got very much involved. Once I heard girls could finally join, I was so excited to finally be able to achieve my goal of reaching the Eagle rank. I always wanted to join Scouting because everything I heard was happening in the program really interested me.

Troop 188 is made up of two separate units of boys and girls that function together for most everything, running the units in parallel. We have separate leadership, troop elections and patrol meetings, but besides that, all activities and most campouts are coed.

Having both genders on campouts may spark up some disagreements, but safety precautions are in place to keep in line with youth protection and separation of sleeping areas. The members of our troop get along very well with each other, and when the other first girls and I joined, the boys were very accepting. Many adult leaders in our troop have noticed that girls joining our program has definitely improved productivity and determination.

In order to start our unit, we had to get a group of at least five girls, and we have grown a lot since then. After February 2018 we had six girls for quite some time, and then slowly but surely we have grown to twice the size since then.

High-adventure trips and summer camp really appealed to me, and once I joined the
program, they lived up to everything I could’ve imagined. In 2018 I went on a 50-mile canoe and portage trip in the Boundary Waters with a small group from my unit and it was like nothing else I’ve ever experienced. I’ve attended two different summer camps since joining, Mitigwa and H. Roe Bartle Scout Reservations; both taught me a lot about the meaning of Scouting.

To me, being one of the first female Eagle scouts in my troop, city, state and country is an incredible honor I will carry through the rest of my life with pride. I feel incredibly blessed to have been able to have the opportunities and experiences I have over the past couple of years.

Left: Darnella Frazier. Center: Vanita Gupta. Right: Nicole Beaman.
In the headlines
  • After a jury found ex-police officer Derek Chauvin guilty of murdering George Floyd, praise flooded in for Darnella Frazier, the teenage girl who filmed the interaction with her phone last year. Some pointed out that Frazier's video may have been the only reason the police's original characterization of Floyd's killing, described as a "medical incident during police interaction," was challenged.
  • The U.S. Senate voted to confirm Vanita Gupta as associate attorney general for the Department of Justice. Gupta will be the first woman of color and civil rights attorney to serve in the job.
  • The Iowa Center for Children’s Justice announced Nicole Beaman as executive director. ICCJ, formerly part of Kids First Law Center in eastern Iowa, advocates for central Iowa children of parents engaged in high-conflict divorce or custody disputes.
  • New evidence from researchers at the Centers for Disease Control and Prevention have determined that the COVID-19 vaccine appears to be safe during pregnancy. The preliminary results are based on reports from over 35,000 U.S. women who received either the Moderna or the Pfizer shots while pregnant. Their rates of miscarriage, premature births and other complications were comparable to those observed in published reports on pregnant women before the pandemic.
  • Meet Bessie Madden and Emma Morgenstern. The 10-year-old Girl Scouts wanted to earn business badges. Bessie's been doing hybrid school and Emma has been fully remote. They both noticed their younger siblings had loads of free time in the remote school day. So they decided to offer online, 30-minute classes to students in kindergarten through third grade.
  • U.S. House lawmakers have approved legislation that would seek to narrow the gender wage gap. Passing 217-210, the Paycheck Fairness Act would increase penalties for violations of a federal law that already prohibits wage discrimination on the basis of sex, enhance prohibitions to prevent retaliation against workers who lodge a discrimination complaint, and ban contracts that block employees from sharing their salaries.
The Power of Visibility in Business Ownership
"I am a human being first. I am a Black woman second. Everything else follows that," Bridget Cravens-Neely says. "I have three grown sons, Black men that I have raised in this country, in this city, in this community. I could not not be involved. Seeing the struggles they’ve endured was my motivation for standing up and saying ‘This has to change, it’s time.’" READ THE FULL STORY>
Worth checking out
Is parenting during the workday here to stay? (Boston Globe). Paving the way: Women in male-dominated fields detail their journeys to success (Daily Iowan). They told her women couldn’t join the ambulance corps. So she started her own (New York Times). The Midwestern grandmas who became stock market celebrities (The Hustle). The girl in the Kent State photo (Washington Post). Embracing a new way of working (LinkedIn). Iowa sexual assault responders heard silence from survivors in early days of pandemic — but the cases didn't disappear (Ames Tribune). After a terrible year for women in the economy, these places are working toward a feminist recovery from COVID-19 (Time).

Join us this Friday at 8 a.m. when we'll feature stories of women who have overcome adversity and will detail discrimination that persists today.

Featuring speakers:
Maria Corona – executive director, Iowa Coalition Against Domestic Violence
Shaimaa Aly – business support manager 4, VP, Wells Fargo
LaSheila Yates – president and co-owner, West Sandy Bayou Candles and Novelties

The Power of Us
Did you miss the premiere of the Business Record’s first episode of The Power of Us? Re-watch the conversation with Urban Experience Editor-in-Chief Dwana Bradley and Business Record Editor Emily Barske along with guests Joshua Barr, the director of civil and human rights for the city of Des Moines, and Scott Raecker, the executive director of the Robert D. and Billie Ray Center at Drake University, as they discuss what civility really means and the concept of calling people out versus calling people in.
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