Featured photo: Duke certified nurse-midwives Pennilee West, Estela Field, Carleen McKenna, Emily Joubert and Casey Hartell at the NC General Assembly to oppose Senate Bill 20, the state’s increased abortion restrictions. The three midwives in the center are part of NC Nurses for Reproductive Rights. (photo courtesy of Jill Sergison)
This story was originally published by North Carolina Health News, story by Rachel Crumpler
Jill Sergison, a certified nurse-midwife, stood amid a crowd of nearly a thousand people on May 13 wearing a rainbow-colored clinic escort vest and a white coat as Democratic Gov. Roy Cooper vetoed the state’s fast-tracked increased abortion restrictions.
Cooper wielded his veto stamp to much fanfare that Saturday morning during a rally on Bicentennial Mall, the public space between the old Capitol and the Legislative Building in downtown Raleigh. He was joined on stage by abortion rights supporters — many of whom were doctors in white coats — cheering and clapping as he used what power he had to protect abortion access.
Lawmakers overturned his veto just days later.
As Sergison watched the veto, the only medical professionals she saw represented on stage were physicians. Sergison was glad to see them there supporting access to abortion, but she was struck by the absence of any nurses — whose work would also be affected by the increased restrictions.
“I thought, ‘This is an oversimplification of the care team,’” Sergison said, noting that there were many nurses present in the crowd. “It’s a much bigger care team than this, and everyone needs to see it’s not just doctors supporting reproductive rights. It’s nurses too.”
Abortion restrictions affect more than women and their doctors, Sergison said, though it is often framed that way.
“I think that when we can start to think about things as a health care system issue and a community issue versus an individual with another individual, we start to see how we’re all affected,” she said.
Sergison left the rally motivated to pull together a group where like-minded nurses passionate about protecting reproductive rights can come together.
“Between the veto and the veto override, it just became obvious to me that what I was doing was texting a million different people in a million different conversations,” she said. “There was no central place for these conversations, so I put together a website and a listserv and just asked people to sign up.”
Since her group’s creation in May, Sergison said around 50 members have joined and word is still spreading. Joining the group is free and open to nurses of all designations, she said. It’s the only statewide group of nurses focused specifically on reproductive rights advocacy in North Carolina.
The resulting organization, NC Nurses for Reproductive Rights, will advocate for improved access to a range of reproductive health care, including contraception, gender-affirming care, abortion and infertility treatments.
“We have a sense of what nurses do clinically,” Sergison said. “I think we have much less of a sense of what nurses are capable of doing from an advocacy and policy space. I’m curious to see what we’re capable of doing.”
Elevating nurses’ voices
Sergison said nurses have largely been left out of health care policy-making and decision-making processes, despite being an integral part of providing care. She wants that to change.
NC Nurses for Reproductive Rights seeks to bring a new perspective to the table, not dismiss or replace any already present, Sergison said. Nurses have knowledge and insights from their interactions with patients seeking reproductive health care that differ from those of other medical professionals, she explained.
Maria Ellis, a nurse working in maternity care in Durham, agrees. She joined the group because she wants to elevate the voices of nurses in policy discussions.
“I think we have a unique perspective that works in collaboration with the physicians’ message but helps to emphasize how much this is going to impact people and how we know that from seeing it firsthand and doing this work,” Ellis said.
“Whether that work is early pregnancy counseling, abortion care, working in clinics that provide contraception and maternity care, it’s often a nurse you’re talking to first. They’re the ones that are triaging, getting a story and trying to help coordinate the care. I think there’s a lot that we can share to really express how important this type of health care is.”
Ellis and Sergison said they felt frustrated that existing North Carolina nursing groups didn’t loudly express opposition to the increased restrictions. In contrast, the NC Medical Society representing physicians released a statement opposing many of the changes.
To a degree, Ellis and Sergison said they understood that professional organizations cannot always take a position on controversial topics due to the scope of their membership and fears of alienating a segment. However, not taking a position just reinforced for them the need for a specialized nursing group focused on advocating for reproductive rights — one that can be vocal.
Sergison said she has gotten positive feedback about NC Nurses for Reproductive Rights from various reproductive rights organizations such as Sister Song, Carolina Abortion Fund and Planned Parenthood South Atlantic who agreed there’s been a gap in nurses contributing to reproductive rights advocacy.
“This was a huge body of clinicians that were largely eclipsed by the voices of physicians, not because the physicians were trying to do that but because there was just no organized group to show up,” Sergison said.
At the national level, Nurses for Sexual and Reproductive Health has similar objectives of advancing reproductive justice and access.
Channeling frustration into action
Lauren Fiel, a nurse working in outpatient OB-GYN care in Durham, said NC Nurses for Reproductive Rights formed at a politically and personally important time.
State lawmakers used the last months of the legislative session to pass laws restricting abortion access and gender-affirming care. Sometime this summer, state lawmakers are expected to return to Raleigh, and one of the actions likely to be on the schedule will be a vote to override Cooper’s veto of House Bill 808, legislation that will prohibit minors from accessing gender-affirming care, including puberty-blocking drugs or cross-sex hormones.
The changing legal landscape takes a toll on those working in reproductive health care who witness the daily fear and confusion patients experience.
“I just feel like I’ve been dragged through the mud for a while and was kind of losing steam,” Fiel said, adding that the work can sometimes be isolating with everyone working in their own silos.
But when she heard about and got involved with NC Nurses for Reproductive Rights, the prospect of channeling her frustration and that of other nurses into a collective voice and force in the policy space “lit a fire” in her again.
“Being around other people and working toward these goals that you all have — you all share — feels a lot more inspiring than just kind of like putting your head down,” Fiel said. “There’s tons of stuff that needs addressing in the reproductive health space, and you can’t do it all yourself. It can get a bit overwhelming when you’re just trying to do your job and do right by the people that you are trying to help.
“This group, from a personal standpoint, helps me to feel a bit more like what I am doing is making an impact.”
Rachel Kashy, a nurse practitioner working in family planning in Durham, moved from Louisiana to North Carolina last November. She fled the post-Roe abortion ban enacted in that state to relocate to North Carolina — a place she saw a better opportunity to provide needed reproductive health care. But almost immediately, she found herself working under new restrictions.
Kashy said she sees the effects of reproductive restrictions on her patients every day. Multiple patients have talked to her about their plans to move to the Northwest because they don’t feel safe in North Carolina due to threats to gender-affirming care.
“They’re fearful that they’re not going to have access to care that they depend on,” Kashy said. “They’re very good at articulating concerns.”
Like Fiel, Kashy said getting involved with the group makes her feel more empowered to have a collective impact on future policies, as she expects lawmakers will continue to introduce laws restricting reproductive health care in the months and years ahead.
“I don’t think our future is set in stone — that these things are absolutely going to happen if we continue to show up, inform, organize, mobilize,” Kashy said. “I think that there’s more reason to be hopeful when groups like this gather and share information.”
Sergison said NC Nurses for Reproductive Rights is focused on getting its membership numbers up and building relationships so it can be a force in reproductive rights advocacy.
“My hope is that we’ll find some momentum by making connections and partnering with other groups in order to create larger change throughout the state and push back against restrictive mandates that are harming people,” Fiel said. “When we band together, there’s a lot that can happen.”
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