Mama's Got a Plan:

Maternity Care, Health Insurance, and Reproductive Justice

Monthly Archives: January 2018


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The HHS Office for Civil Rights

Personal beliefs and denial of care

Earlier this month, it emerged that tennis star Serena Williams came close to experiencing life-threatening blood clots after giving birth last fall, in part because medical staff delayed taking action after she requested treatment.

More recently, President Trump announced the establishment of a Conscience and Religious Freedom Division in the HHS Office for Civil Rights. Its purpose is to expand the ability of health care providers to exercise conscience clauses. ACOG, the chief U.S. professional organization for obstetricians and gynecologists, promptly issued a press release objecting to the move, stating, “Abortion, contraception and sterilization are a part of comprehensive reproductive health care and are essential to the health of patients. Professional medical organizations have clear guidance on the issue of refusal, noting that refusals of care must not compromise patient health.”

Well. All these announcements in such close proximity generated some questions in Ye Olde Cartoon Shoppe. Who is refusing care? To whom? What is their religious justification? Is it religion, or merely culture? What about having children, as opposed to not having them – are there any civil rights in play there?

Sometimes you look around, and no one is behaving the way you think they should. Except, of course, Ms. Williams, who acted intelligently and forcefully under challenging circumstances. And Baby Olympia, who does not need to do anything except be herself – which she so clearly does, perfectly and adorably. Congratulations on both counts, Serena Williams!  For all the other participants in these various dramas, there’s this:

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Click the image to open a larger version in a new window.

Images and permissions

  • The white-coated doctor is from Pixabay, shared under a Creative Commons license.
  • The plant is from pluspng.com. The site does not state any terms of use, but seems to make images freely available.
  • The photo of Serena Williams and Beautiful Baby Olympia is taken from an online video. Ms. Williams did not to our knowledge speak the exact words attributed to her in this cartoon, but we believe we have correctly represented her intentions.
  • The distinguished fellow with the stethoscope comes from Michelangelo’s The Creation of Adam, where he appeared with more background and without the stethoscope. The work is in the Public Domain.
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The Fellowship and US-MERA

A midquel is a “work that is set within the timeframe of a previous work, rather than before or after it.” The Fellowship of the Bill series featured an increasingly beleaguered and bedraggled band of legislative advocates journeying toward Michigan licensure for Certified Professional Midwives. In this midquel, the Fellowship encounters a Mysterious Elixir: newly emerging educational standards for midwives, as produced by a consortium of seven national midwifery groups, known collectively as US-MERA (U.S. Midwifery, Education, Regulation, Association). Three disclaimers are necessary before we proceed.

  • First: Whether certain educational standards should be included in CPM licensure legislation is inside baseball at its most extreme. We promise we will return to topics of more general interest in our next cartoon.
  • Second: Although Michigan’s experience with US-MERA was less than ideal, much of the chaos was a result of interweaving timelines. The education standards were being developed at exactly the same time that Michigan’s bill was proceeding through the legislature. Neither process was exactly predictable, nor did communication flow dependably between parties. Last-minute demands, confusions of meaning, and repeated shifts in focus made measured, documented decision-making quite a challenge.
  • Third: This cartoon arises solely from the fevered imagination of Mama’s Got a Plan. It is not to be taken as a statement of history or policy by anyone who matters.

As in our original Fellowship series, many liberties were taken with both Tolkien’s story and Michigan legislative history. No worries – just sit back and enjoy the ride.

Click each image to open a larger version in a new window.

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Book feeding frenzy

Happy new year! To start out 2018, check out this new feature: Mama’s Bookshelf. Want to find the latest in titles on Reproductive Justice, maternity care, midwifery, community birth, and other topics of interest to Mama’s Got a Plan readers? See the Goodreads feed on the upper right side of this page.

NOTE: To read the full review of a book, you must click the book title, not the Goodreads link. You do not need a Goodreads account to view.

Happy reading!