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Why Midwives Need to Reach the Community Sooner

American women are not as healthy as you might expect. A 2013 Institute of Medicine report called “Shorter Lives, Poorer Health” found that even as our life expectancy rises incrementally, we are “dying at younger ages than people in almost all other high income countries,” and the disadvantage is worse for women. A 2013 study of some 2,000 mother-daughter pairs in the U.S. found that the daughters “entered adulthood at greater risk for the development of chronic illness than their mothers.”

To some extent, health disparities are the result of racism and poverty and environmental pollution, and the U.S.'s lack of universal health coverage is a unique driver in the industrialized world. But why are women doing worse than men? In some cases we lack good treatment because of sexism and bias in medical research and treatment. But by some measures, our problem isn't too little access to medical care; it's too much care and the wrong care.

Overtreatment in maternity care has been well documented, as has the mitigating effect of midwifery care. This presentation will describe how typical gynecological care also exposes women to the harms of overtreatment and undertreatment before and after they are in the position to access midwives, and how the risks are greater for women of color. From unnecessary pelvic exams to the ubiquitous prescribing of hormones to the overuse of hysterectomy and other “minimally invasive” surgeries, Jennifer will present research and reporting from her forthcoming book about feminism's unfinished business in women's health and discuss how midwives can reach clients sooner.

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