Equity and Inclusion Commitment Statement

Acknowledgment:

We acknowledge and take accountability for the history of healthcare, including modern western midwifery and birthing practices, which are deeply rooted in cis-hetero-patriarchy, white supremacy, and colonialism. Our practices in the United States have created deep inequities for Black, Indigenous, People of Color; LGBTQIA+ Folx, Immigrants and refugees; People with disabilities; People experiencing homelessness; Plus-sized people; and Working class people, among others. The harm from historical practices continues today, as these communities face on-going discrimination and countless barriers to accessing health care, health coverage, inclusive and equitable care, and culturally matched care. We take accountability for our complicity in these practices and we commit to on-going actions to ensure equity and inclusion are at the heart of everything we do at Our Community Birth Center.

Our Community Birth Center exists and provides services on the unceded land stolen from the Kalapuya, Siuslaw, Cow Creek Umpqua and Yoncalla peoples. We acknowledge these communities, their elders both past and present, as well as future generations. We also acknowledge that the United States was founded upon exclusions and erasures of many Indigenous peoples, including those on whose land our Birth Center is located. This acknowledgment is to demonstrate commitment to taking accountability for harm committed both past and present, to participating in ongoing learning as individuals and as an organization, and to beginning the process of dismantling the ongoing legacies of settler colonialism.

The origins of midwifery in our community reside with Indigenous Midwives on Turtle Island and with Granny Midwives in the Southern United States. The midwife role, the model of care, and the traditional healing practices of Indigenous Midwives and Granny Midwives are the foundations from which midwifery has grown. We recognize that modern health care institutions and professionals, and specifically white settler doctors, nurses, and midwives, attempted to discredit, ban, and eliminate Indigenous Midwives and Granny Midwives. The mistreatment continued on when modern midwives culturally appropriated practices of Indigenous Midwives and Granny Midwives without acknowledgment and without taking any accountability for the harms done.

In summary, health care providers, including modern midwives, nurses, and birth centers, have contributed and continue to cause significant harm. We are taking accountability by acknowledging and seeking to understand the harm done, by finding opportunities to make reparations, and by growing an organization and model of care that maintains equity and inclusion as priority in our work.

Our Commitment:

Our Community Birth Center is committed to providing an inclusive and welcoming environment and supporting dignity, belonging, and a sense of community for all of our clients, staff, volunteers, board members, subcontractors, and vendors as well as equal opportunity and fair practices for prospective employees and prospective clients. Our Community Birth Center does not discriminate on the basis of ability/disability, race, color, national origin, housing situation, age, gender, religion, language, ethnicity, indigeneity, socio-economic status, sexual orientation, marital status, veteran’s status, pregnancy, childbirth, pregnancy-related conditions, or any other protected identity. This applies to all our programs and operations, including but not limited to, organizational management, hiring and firing of staff, selection of volunteers and vendors, and provision of services.

Our focus is equitable access to midwifery birth center care, wrap-around support that helps parents and babies thrive, and improved outcomes through safe and thoughtful health care services. At Our Community Birth Center, clients participate actively in their care and in decision-making, which helps build trust between clients and staff. We provide wrap-around care that includes pregnancy, birth, and postpartum care, in one safe and home-like environment. Care is provided in the community, which empowers our clients. Our model is time-intensive and highly supportive, which improves health outcomes and reduces overall health system costs. Our Community Birth Center seeks to proactively prevent health complications and traumatic health care experiences through practicing cultural humility, providing health education, and holistically supporting our clients.

Our Community Birth Center was made by and for the community. Our birth center offers an alternative to the systemic inequities and disempowerment of people using reproductive health care and the overuse of medical intervention that can increase risks for parents and babies. Over the past several years, right here in Lane County, 34% of people giving birth experienced a cesarean birth according to birth certificate data published by the Oregon Health Authority. This rate is more than double the World Health Organization recommendation for a healthy cesarean birth rate. We recognize that overly high cesarean surgery use causes more harm to pregnant people without improving outcomes for babies and that Black, Indigenous, and People of Color disproportionately undergo cesarean birth. The Strong Start for Mothers and Newborns Initiative shows birth center care decreases cesarean birth, preterm birth, low birth weight, and the costs of health care while also increasing client satisfaction.

As a community-focused organization, it is our responsibility to serve all members of our community, particularly those who face systemic barriers, mistreatment, and disadvantages. It is also our responsibility to carry out our commitments to social justice and anti-racism with humility and transparency. As a newly emerging organization, we have an opportunity to weave equity into the fabric of everything we do. We take this opportunity and responsibility seriously.

Our Community Birth Center’s Goals:

Social Justice Focus:

Problem: Lack of fair access to health care. Poor health outcomes with current models of care that privilege wealthier families and communities. Major disparities in quality of care provided and in health outcomes.
Goals: Increase awareness of access to birth center services to ensure that everyone who would like these services knows they exist. Ensure all individuals can access services regardless of economic status.
Outcomes: Increased quality of care across demographics in Lane County. Improved birth and child health outcomes. Fair access to each person’s preferred care.

Racial Justice Focus:

Problem: Indigenous and Black people have higher perinatal mortality and morbidity rates than white communities because of racial bias and systemic and institutional racism. Limited access to culturally matched care. Limited access to Spanish-language health care services, in particular from native Spanish-speaking healthcare providers despite having a large local Latinx population.
Goals: Increased access to culturally matched care through the birth center. Increased access to Spanish-language healthcare services. Improved health outcomes.
Outcomes: Improved health outcomes for parents and babies who are Black and/or Indigenous demonstrated by our birth center data compared to Oregon birth certificate data. Lower preterm and low birth rates, lower cesarean birth rates, and higher rates of breast/chestfeeding. Increased access to Spanish-language healthcare services.

Gender Inclusivity Focus:

Problem: Discrimination against LGBTQIA+ folx in health care settings and by health care providers. Pervasive use of language and care that is not gender affirming. Limited options for gender affirming health care.
Goals: Create and maintain a welcoming environment. On-going training for birth center staff on cultural humility and inclusive care. Client feedback is taken seriously and adjustments are made promptly as needed.
Outcome: Client survey responses reflect inclusive and respectful care. Staff are contributing to the work, actively making an inclusive environment, and supporting each other’s learning.

Reproductive Health Focus:

Problem: Lack of autonomy and informed consent. Legislation and policy that limits reproductive health options. Limited investment in improved health care safety.
Goals: Increase independence, access to information, and thereby offering authentic informed consent around reproductive health options. Present information in the preferred format and preferred language of each client. Maintain a setting that allows for questions and autonomy free from judgment.
Outcome: Informed consent and refusal are practiced with unconditional support. People are able to receive health information clearly and fairly. Clients feel empowered, involved in and satisfied with their care.

Mental Health Focus:

Problem: Health care services tend to focus on physical health and overlook mental health. Limited access to mental health care and limited access to holistic health care.
Goals: Provide holistic health care through Our Community Birth Center that sees mental, emotional, and social health as equal in importance to physical health. Staff proactively discuss mental, emotional, and social health and support birth center clients in accessing community resources. Ensure all health care staff are trained in and practice Trauma-Informed Care.
Outcome: Every health care visit at Our Community Birth Center includes a mental health component; clients access mental health services at higher rates due to the breaking down of stigma and the support of the health care staff at the birth center. Trauma-Informed Care is incorporated into every client visit. Overall health of birth center clients improves as a result of the holistic care provided.

Environmental Focus:

Problem: Single use items and medical intervention produce large amounts of waste in perinatal health care. Plastic production and excessive waste negatively impact the health of people in our communities and the health of our natural environment. The people most impacted often do not have a say in environmental practices and policies of healthcare organizations.
Goals: Avoid unnecessary medical interventions, use reusable products and supplies such as cloth hand drying towels and washable utensils and dishes, recycle when possible, and use an energy efficient hot water heater and energy efficient laundry. Consider the people and communities impacted by our daily activities and product use at the birth center, seek input from our community on environmental justice steps to take.
Outcome: Birth center care treds gently on our natural environment and inspires others to choose reusable and energy efficient options. Reduced plastic and pharmaceutical use improves the health of communities and people across the globe that are harmed by plastic production, excessive waste, and unfair distribution of environmental resources and damages.

This Commitment Statement highlights several of our acknowledgements and goals but it does not cover the full depth of our commitment to equity and inclusion nor the breadth of the community-focused services we provide. It also does not cover the whole history of reproductive health injustices that have occured and continue to occur. We recognize there are limitations to Equity and Inclusion Statements and that the truth of our commitment can only be demonstrated by the actions we take and the work we do.

Contact:

Our Community Birth Center commits to maintaining an inclusive and welcoming environment for all of our board, staff, clients, volunteers, subcontractors, and vendors. We also commit to making changes and improvements regularly and as needed to fulfill this commitment. Anyone who has questions or would like to get involved can reach out to: AlexAnn Westlake, Executive Director and Certified Nurse Midwife: alexannwestlake@ourcommunitybirthcenter.org, or Amanda Bedortha, Social Justice Committee Chair: amandabedortha@ourcommunitybirthcenter.org

Any board members, staff, volunteers, clients, or community members with feedback to share with Our Community Birth Center are encouraged to contact the Social Justice Committee, the Executive Director, or the Board of Directors. Per our Whistleblower Policy, the organization will not allow any form of retaliation against individuals who raise issues of social or racial justice.

One way to connect with Our Community Birth Center and share feedback is through our electronic Feedback Form. This form allows for anonymous or non-anonymous feedback. Feedback entered into this form is reviewed by a committee that includes representation from the Board of Directors, Birth Center Staff, and Social Justice Committee. Alternatively, written feedback can be mailed or delivered to Our Community Birth Center, 188 West B Street, Building O, Springfield OR 97477 or feedback can be given over the phone by calling the birth center at 458-234-6800.