Tasha Welch balances on a ball chair in her living room, gently rocking herself back and forth. The 30-year-old is pregnant with her second child, a pregnancy that, unlike her first, has given her a litany of problems. For a while, the baby pressed on her sciatic nerve, leaving her unable to walk. Such complications have kept her unable to work her regular job as a hairstylist at JCPenney for the past few months.
What’s made things even more difficult is that she feels her doctors haven’t been taking her concerns seriously. “It’s hard to get people to listen,” she said. “To understand that nobody knows your body better than you.”
Louisiana’s record on women’s health has consistently been among the worst in the nation. A report by the nonprofit March of Dimes issued this summer found that one third of parishes in the state lack access to maternal health care. Louisiana regularly receives an “F” on the organization’s score card, which measures the state of maternal and infant health in each state.
In addition to a lack of resources, many women — like Welch — say their concerns being ignored, not being listened to and not being properly informed about procedures or medications have eroded their trust in the health care system.
A new office under the state’s department of health aims to help fix that. But after its first year in existence, a lack of action, funds and exclusionary language in the bill that created the office has some of its early supporters doubting its potential.
The Office of Women’s Health and Community Health was established under a bill passed by the Legislature and signed by Gov. John Bel Edwards in June of last year. According to its mission statement, the office is “dedicated to focusing on women’s health outcomes” and will serve as a “clearinghouse, coordinating agency and resource center for women’s health data and strategies.”
The office is led by Assistant Secretary Torrie T. Harris, a former health equity officer for the city of New Orleans and adjunct professor of public health at Xavier University.
As its first steps, the office aims to “gather input from community members to understand what their health needs are,” said Harris, an effort currently pursued in town halls scheduled across the state in the upcoming months.
The next step, she noted, will be to attract more long-term funding. Despite its expansive mission, the office is currently funded at only $925,000 annually. For comparison, the state’s public safety department spent more than twice as much on body cameras and tasers alone this past fiscal year.
Harris acknowledges this challenge. “We need more money to do community level work,” she said. “We want to ensure we have a long-lasting, long-term impact in this state.”
To attract more grant funding for the office’s work and continued operations, Harris said data and stories that demonstrate need will be collected. “Louisiana could stand to do a better job of documenting the data of our communities, to leverage our stories,” she said. “The onus is on me to really demonstrate the need.”
Currently available data already sketches a troubling picture. Louisiana has the third highest teen birth rate in the nation. The state’s maternal and infant mortality rates are among the highest in the nation. The situation is even more dire for Black women, who are more likely to die at childbirth and have a higher prevalence of many health conditions, according to research conducted by the National Institutes of Health, the Centers for Disease Control and Prevention and the Kaiser Family Foundation.
Welch is aware of those statistics and says she has seen the root causes play out first hand. When she gave birth to her first child, she hemorrhaged. She said no one told her what might have caused the complications or that she should mention them to a doctor in preparation for the delivery of her second child.
With the statistics on maternal mortality among Black women in mind, the experience left Welch, who is Black, especially concerned. “I don’t want to be one of them,” she said. “I have kids I need to take care of, a family.”
Despite existing data on women’s health outcomes, getting an office established in the first place was not an easy task, said Rosalind Cook, president of the New Orleans League of Women Voters, one of the effort’s earliest supporters.
“We would meet with legislators who didn’t even think there were any disparities in health care,” Cook said. But after years of lobbying legislators — and quite a few concessions — they finally saw success.
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Some of the compromises made along the way were harder to swallow than others. The bill includes provisions explicitly prohibiting staff from recommending or promoting abortion. It also includes language that restricts the office’s services to women born a “biological female.”
It’s this language that caused at least one of the organizations originally involved in the effort to turn its back on it. “An office that is not going to fight for all the folks that it should be looking out for is going to be useless or it’s going to be weaponized,” said Pearl Ricks, executive director of the Reproductive Justice Action Collective.
Ricks was born intersex, a term referring to those with reproductive or sexual anatomy that doesn’t fit the boxes of “female” or “male,” and said the language establishing the office doesn’t account for people in that position. It’s exclusionary to the point of being detrimental, noted Ricks. “It’s problematic from the start and incomplete from the start.”
Cook’s group also had issues with the language, but continued to support the effort to create the office. “We figured that once we got it, then perhaps there could be some movement,” she said, explaining the league’s stance. The past year, however, left her dismayed about the process for establishing the office and, by extension, its future potential. “The groups had no input,” she added.
Cook also pointed out that there hasn’t been much visible action from the office since its creation a year ago. There have been no annual reports, for example, which are scheduled to be released in April of each year, according to the bill that created it. The office currently has only two staff members, including Harris, but is planning to add three more in the upcoming weeks, according to Harris.
Building something from the ground up takes time, Harris said. “We’re doing the work.”
As for concerns over some of the language in the bill, Harris said her office was simply aligned with state policy on abortion and that limitations on the demographics it would be serving were less black-and-white in practice.
“We’re not measuring or asking people about their gender,” Harris said. But, she noted, “We’re going to follow the legislation,” leaving open the practical implications of limiting the office’s services to those born “biological females.”
When asked what she would want out of an office focused on women’s health, Welch, the soon-to-be mother of two, had a straightforward request. “It’s simple: just listen,” Welch said. “We will tell you what’s going on with us. Care.”
Having learned about the impacts of the medication she received during the birth of her first child from a caseworker at a local nonprofit that has helped her navigate prenatal care, Welch has decided to try for a natural birth this time around. If all goes according to plan, she’ll be giving birth next week.
Correction: An earlier version of this story incorrectly identified the president of the New Orleans League of Women Voters. Her name is Rosalind Cook. We regret the error.
Alena Maschke reports on health for The Current and the Acadiana Advocate. Her work is supported by the William C. Schumacher Foundation, Pugh Family Foundation, Pinhook Foundation and Blue Cross Blue Shield of Louisiana.