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Trauma-Informed Women's Health (CTIPP CAN September 2023)

(Content advisory re: sexual assault and medical trauma)


Our September 2023 CTIPP CAN call focused on the realm of women’s health, acknowledging the unique challenges and experiences faced by those who identify as women. We embrace and respect the fluidity and diversities of personal identities and thus use the term “women” to encompass all who claim it.


The report and toolkit provide information to bring awareness to the nature and impacts of trauma related to women’s health issues as well as resources and considerations for change agents, advocates, and activists who wish to target this area for trauma-informed transformation to shift our society towards one that honors lived experience and supports recovery, healing, and well-being for all.

ROUGHT TRANSCRIPT:


00:00:05 Speaker 1: Perfect. Thank you, Jesse.

00:00:08 Speaker 2: Welcome, everybody. And we are delighted to be with you today. And as we're getting started with sharing this virtual space today, we would just like to begin by inviting you to join us in arriving in the here and now. First, just pausing to intentionally notice where you're really at, considering what you might like to let go of in terms of any thoughts or distractions of what happened right before you joined this meeting or perhaps shelving just for now, any concerns about the future or what you have to attend to after this meeting concludes? Knowing that all will be waiting for you later and just enjoying this brief moment of reflection and stillness as we shift our attention to the present moment that we are all fully here now, together. And we are so grateful for your presence and we're looking forward to diving into the topic for today's conversation, which is women's health. And so in terms of what you can expect during our time together, we'll be we'll begin by sharing some related items that we do want to just uplift. And after that, we'll be setting the table for our conversation on women's health, followed by really digging into a little bit of the context and the content of the resource that we've worked to create, led by Lori Hardie, who has graciously co-produced content around this topic with the tip. And before that, after that, rather, we will shift to optional activities like a brief, resilient practice followed by independence and group reflection around this topic. And just so you're aware, our director of communications that is Laura, will be monitoring the chat for us today. So please direct any wonderment that you have or any challenges you notice accessing anything or, you know, if you need a link to be reposted or something, you can reach out to Laura directly and she will be able to help you with that. And she will also be in the chat popping in links to resources as we speak to them in real time. So I would invite you to just be on the lookout for that as well. And thank you so much, Laura, always, for attending to the zoom side of things for the team. All right. So with that, I am passing this to back to our executive director, Jesse, and I'm going to go ahead and advance the slides for you, Jesse, and mute myself.

00:02:44 Speaker 3: Thanks, Whitney. And like you mentioned, I see that a few folks are still working to get onto Zoom. If folks ran into any sort of difficulties getting on. Apologies for that. We will continue to work on the back end there. But yes, so a few things that we just want to run through in terms of ktp tip. Very exciting one to share. Thank you, Laura. So first of all, there's a health care community of practice that a few folks wanted to start bringing together. And because of the participants on this call, if you go ahead and scan that QR code as well as Laura, put the link in the chat, you can sign up to join that community of practice that will be led by Deb Burke and colleagues and co-created with quarterly calls, um, to just, you know, coordinate on the ways that trauma informed approaches are being integrated into health care settings. And so again, if you scan the QR code, you'll get to the Google form. You can also get there through the link in the chat. On the next slide, you will see two different bills that there are opportunities to advocate around that continues to coordinate to promote the Rise from Trauma Act has a number of different programs. Section 101 creates a grant program for cross-sector community coalitions that we continue to support. There is also work around reducing hospital readmission rates, training for frontline service providers and other opportunities that that this legislation would help to address and further. And then the Community Mental Wellness and Resilience Act promotes cross-sector coalitions to take a systems and public health approach to promoting upstream prevention essentially through systems change, by coordinating a systemic response in advance of extreme weather events, other major disasters that can perpetuate trauma. Our society has a tendency to be reactionary. And as these events are becoming more predictable to communities, it's important to work in advance to build capacities, resource schools, networks and skills. And so there is an opportunity to reach out to your legislators by following the QR code C tip org slash action that you can take easy action to let your elected officials at the federal level know to support both of those. And then I believe that that bottom QR code is going to take you to a wonderful toolkit that can give you opportunities to advance this in terms of social media through other outreach as well. And so both of those are continuing to be important pieces of federal legislation that we will continue to mobilize around through our network within C tip, as well as other partners.

00:06:05 Speaker 1: Um.

00:06:07 Speaker 3: And then I want to turn it over to our wonderful new colleague. We are so excited to introduce Antron McCullough, our director of Empowerment and Engagement. And Antron, I won't say another word. It's all you. So happy to have you on to see on the CTIPP CAN call.

00:06:27 Speaker 4: So good morning. Good afternoon or good evening to everyone, depending on where you're currently located. I'm very honored to be on this call with you today. And I just wanted to take a quick moment to thank Jesse and the team for giving me this opportunity to be a part of Ktp. So as Jesse said, my name is Antron McCullough and I am the director of Engagement and Empowerment, and I'm very excited to be a part of something that's so, so amazing. And just to kind of give you a brief background about myself, I've worked in child welfare and within academia for a number of years. However, I've also worked within this capacity for a while now. So although my face might look a little young for any of you guys who like sports, I'm actually a veteran within this work and I have a number of years of experience doing consulting work and working within policy and legislation for different organizations on trauma and what it means to be trauma informed. The main difference now and what I was doing and what I'm doing now is now I really get to work, do this work full time. And so I won't give it all away. But just to kind of give you guys a hint of what I'm going to be doing, part of the work is working on a youth advocacy series project, and so we're thinking about accessibility in mind. I'll be working really to support cross-sector community coalitions and youth education through advocacy, especially for individuals with learning disabilities while thinking of ways to build those healthy communities through advocacy. So I could continue to go on about that. But like I said, I'm just going to give you guys a quick hint of the work that I'll be doing in my current role, and I will be looking forward to these meetings and collaborating and really just getting to know all of you a lot more. And again, I want to thank Jesse and the team as well as all of you for allowing me to be a part of this call. And now I'll pass it back.

00:08:17 Speaker 2: In Antron And welcome. We're so delighted to have you on the team and thanks, Jesse, for anchoring our call today and just bringing some awareness to the chat that it sounds like there might be something that went awry with the meeting invites. So people might be filtering in and thank goodness this was recorded. I'm just going to go ahead and dive in since we've got a rich session planned for ourselves today. And so again, just moving on to setting the table for some of what we'll be talking about today with this being the most, I would say oxytocin and dopamine producing picture of a table that could possibly find here for this slide, because first and foremost, we really want to uplift that the content in the resource that we've created, as well as the content in the conversation that you will be witnessed to and may participate in today to hit on some sensitive topics. And so we acknowledge that each of you is the expert of yourself and we want to let you know this in advance so you are able to stand, empowered to continually check in with yourself, to stay connected to what's happening to your brain, what's going on in your body. And just please know that we trust you to do whatever is needed to help yourself stay regulated and feeling okay enough to remain present here today. Whether that is, you know, stepping away to grab water if things get activated, just switching your camera off for a moment and then coming back on later doing some deep breathing, whatever else you need at any moment in time, we trust you and encourage you to take that action should things feel a bit activating for you today. Next, we do want to upfront state that the resource we've created and the conversation we'll be having today is about acknowledging the unique challenges and interest sexual experiences related to accessing and engaging with health care faced by those who identify as women. And we do embrace and respect the fluidity of diversities and diversities, rather of personal identities, including those pertaining to gender. And we do want to be clear that we are using the term women to encompass and include all people who claim that term to describe themselves. And we also want to acknowledge that there are issues related to topics that are explored that do fall under that umbrella of women's health, so to speak, that absolutely can and really do impact individuals beyond the boundaries of gender identity and expression. And we've worked to capture these lived experiences as integrated within all of what we're speaking to, given the interconnectedness of health care and well-being among those living in marginalized bodies across the gender spectrum. So with that, we encourage everyone joining this call today to engage with an open minds and an open heart toward inclusion, with recognition for the ways that perspectives and needs for many groups of people intertwine when it comes to issues that we're exploring in relation to, again, that sort of overarching umbrella of women's health. And finally, we just want to let you know that this meeting is the first time in a while that we have shifted back to this 90 minute meeting format. We're always playing around listening to your feedback. Thank you for letting us know that you'd like more time for connection. And since this is a shift, we just want to take a moment to let you know that the final 30 minutes or so will consist of a totally optional time to be in breakout sessions, to connect, and then also to share in the larger group that we're in now after those breakout rooms. And that will come after this upfront content and the storytelling pieces that we're engaging with here. And we also want to link, share this link here for you. And this is a resource and toolkit that we've created that will be describing today, along with the link to our Transform Trauma podcast episode on this topic, which among other superstar women's health experts and professionals features Lori, who you're going to hear from today and am sure Jesse or Laura will be on top of sharing this in the chat as well, both now and also later when we're actually going to engage with the materials more directly. So you don't necessarily need to pull this up or take a look. Now you'll have the opportunity to do that later. I just wanted to anchor that. This is the piece that we'll be discussing today. And we also want to before we dive too much in, we want to take a moment to uplift what is actually in this document. And that start with a look at things that we know influence holistic health and well-being, like experiences of trafficking, sexual and gender based violence, intimate partner and family violence, significant life transitions along the life course as aging happens, experiences before, during and after childbearing, experiences of family separation, just the general sort of umbrella of mental health and substance use, poverty and also community based and other collective trauma experiences like historical, racial or cultural trauma. And so we really worked, you know, obviously we can't put every single thing that has ever happened underneath this umbrella in this report. And yet we've also think we've done a pretty good job of including the things that we found in the research that felt really relevant that we really want to uplift, that are connected to experiences of trauma and lived experience having challenges, maybe even being retraumatized, navigating the health care system. We also examine how trauma shows up in the healthcare system itself, right? So how interactions within our organizations and our systems and our institutions contribute to experiences of trauma and retraumatize nation as well as what gets in the way of change within those settings, which is examined through an ecological or systems lens. We also dig pretty specifically into what trauma informed change really takes and looks like. And while as we tend to like to disclaim here, you know, it's not a prescriptive set a recommendations since this is not about box checking and context matters so very much in terms of what this process unfolds and looks like along the way. What we do here is we provide information on how to think about and conceptualize and operationalize the values of a trauma informed approach in the context of women's health, which is really the how of aligning efforts with trauma, informed care, anchoring in those values. And we also do a pretty deep dive into uplifting issues related to and ways to think about integrating accessibility, belonging, diversity, equity, inclusion and justice, or the frame we strive to use. You'll find that in the document as well. There also are some concrete ideas and considerations related to framing and communication in a trauma informed way, right? So ways to think about moving from what's wrong with to what happened to and what's wrong with to support trauma, informed engagement at all levels of health care services and support. And that's from the inside out and the outside in, right? So we do take a look at workforce considerations and how do both expand a diverse and trauma informed and culturally responsive workforce that can effectively provide services and supports, explore throughout the document, and then also importantly, critically, how leaders and organizations and systems and institutions can provide the support through innovation and improvement that we know is needed to address the impact of the work. So again, really trying to provide thought at all levels here, the micro, the mezzo and the macro for health care transformation. And finally on that note, we do present potential avenues for advocacy and activism to shift local, state and federal policies, regulation laws and the administration thereof to create the context and conditions for resiliency and healing and justice to emerge in the health care space. And we provide some previous and current policies that have been under consideration in recent times to provide examples of where this is already gaining momentum, what's possible in terms of what's already happened as a model to uphold and aspire to in other arenas, and perhaps also legislation to use language for as template to build on in advocating in your own communities and states. If this is an area that you do want to jump in and take action around in a more direct way at the public policy level. And so that's what you'll find as you explore the toolkit. We recognize it's long. You're not expected to read everything. The thought, the thought and best hope is really, you know, that there is something for everyone, regardless of what your role is, regardless of how you are thinking about engaging with this type of content, whether you are someone working within the field, somebody who has access to health care, someone who is supporting others in your life, in caring, in accessing care. Just hopefully, you know, there is something for everybody there to be kind. Aware of and act on. And that's really the best hope. And so that's what you'll find again, as you explore the toolkit. And before we move on here, we do want to give you some context about what really catalyzed us to take this action. And we would say that it started with the team really talking about how to address some of the traumatizing and retraumatizing decisions being made in local, state and federal policy levels. You know, whether they are Supreme Court decisions or states limiting access to necessary health care for certain groups of people seeking specific types of care that we know are critical for holistic health and well-being and to disrupt intergenerational cycles of trauma and oppression, you know, policies that might even prevent or criminalize healthcare workers from making the professional decisions that they ethically and morally feel called to make. So this really also dovetailed these policy changes, really dovetailed and just the sociopolitical landscape in general, you know, dovetailed with our work in community based integrated health care systems over the last several years. And all of this prompted our team to think about our role in equipping people, organization, systems and policy makers with tools and resources to meet this moment by really just noticing the opportunities to revamp our systems of care through trauma informed and a healing centered lens, both to repair the harms that, you know, we were noticing as well as to prevent new ones from happening. And then what really drove us to take the actual step, to not just talk about and sort of strategize around these things was connecting with Lori Hardie, who will be passing the mic to in a moment just she reached out to connect around spearheading policy change in her home state of Indiana, which by the way, she's being incredibly effective at doing. And I'm sure this is not the last year we'll hear from her. And our conversation ultimately evolved in her lending her own personal and professional experience to our work in creating this toolkit and resource. So really? Yes, right. The bottom bullet, Kismet, the stars aligned in that conversation, and Lori and I noodled a little bit on what might make sense. And we landed on creating this resource to equip people with what they need to make the change that they want to see happen and to really highlight and bring awareness to the things that are transpiring in the world and opportunities to promote healing centered engagement and resiliency and trauma informed approaches. And so really, that's all I wanted to do to really anchor this conversation. Just as a reminder again, for those returning or who are entering in now and missed the beginning part, just inviting you to consider what you might need in order to help yourself stay presence and regulated, giving you all proactive permission to do whatever you need to do to take care of yourselves. As Lori shares her story or personal and professional lived experience. And Lori, I'm going to throw it to you to lead our discussion about shifting this paradigm. And please do share whatever feels important that is on your heart and mind here. And perhaps maybe starting with sharing a bit about yourself and what has called you to this work. I'm going to go ahead. I'm going to stop sharing so everyone can see you and I'm going to mute myself. And you have the stage. Thank you so much. Um, yeah. So my name is Lori Hardy.

00:21:30 Speaker 1: The first thing I want to say is thank you to the team for. For having me here, specifically to Whitney and to Laura for helping make this toolkit come to life. Um, so just to give you a little bit of background, so I am a nurse. I have been a nurse for almost 30 years. Um, my mother was a nurse. I'm a second generation nurse. My son is in EMS, so I am just, you know, immersed in health care, let's say. Um, I am also currently I got my bachelor's in 95. I got my master's degree in nursing in 18, and I'm currently at GW finishing my doctorate in health policy. So trauma informed care before that was even a term was sort of my superpower as a nurse and I didn't have a name for it then and didn't really understand what I was doing or what I was sensing. But what I want to do is there's so much good stuff in that toolkit. I know I'm sure there's some of you who are in, you know, professionally in the health care arena. But honestly, there are things in there, whether you are a family member or a patient yourself, You know, at some point we all interact with the health care system, whether you work there or not. Um, so just to sort of take it back to why this is so important to me. Um, so I'm old. I was born in 1969 and evidence based practice around loss and grieving was very, very different then. And my mom, when she had her second child, I was her oldest. She had her second child a year after me. That baby died at two weeks of age. When that happened. She did not receive trauma informed care. What she received was basically take this prescription, go home and go to bed. Um, and forget about it. And she her family members, her immediate family members were told, don't talk to her about it because it'll just make her sad, you know, go clear out all the baby stuff from the nursery and everybody just pretend like it didn't happen. So these are the absolute worst things, right, that they could have been instructed to do. We know that now at the time, those professionals thought that they were doing the right thing. So I do want to say, one, if anything, that I talk about is upsetting to you. You are not going to offend me if you go off camera or you leave completely. I get it. Number two is I'm not blaming anyone. I sit on both sides, Right. As a nurse and as a family patient, you know, someone who has been impacted negatively by the health care system and am an advocate for both. I strongly believe that healthcare professionals, by and large, want to do the right thing and lack the education to do that, lack the awareness of how to do that. But they want to do that. And I know this because I've worked in this area for so long and I've been teaching trauma informed care to other health care professionals, and I see them break down when they realize I have not been doing this correctly and I know that I have hurt people. So but back to that story. What that what came of that was. And at this time, my mom was 19 years old. What came of that is she became estranged from her entire family because she felt like if you don't care about me and my baby that I've lost, you won't even talk to me about it. Then you know I'm done. That led into drug addiction that lasted for 40 years. She died homeless and addicted to crack at the age of 53. Um, and I became a trafficking victim to help support her habit. When I teach health care professionals, I say. It might just be a Tuesday for you, but this is impacting patients and their families for generations. In ways that you may never know about or be able to even anticipate. But that one event in my mom's life changed. Not only my life. Her life. The rest of her family. The intergenerational trauma that I have passed to my children. Um, the way that my very own DNA is read and transcribed is different now than it was before that. And I see it. My children are grown and I see it. So the impact of trauma informed care. While it's a in my mind as a nurse, it's a small paradigm shift mean really right. It's not like we're. Doing something that is extraordinarily different than what we would typically do. What it does do, though, and I hope that you listen to the podcast because I have another nurse colleague there and a physician colleague who is a female physician of color who's an OB specialist. So a woman taking care of women and. The issues are this. It is the culture of health care and how we were all raised within health care. And I'll tell you what mean by that, which is. Saving people, right, is is what we are trained to do. That's the good. What? When I teach, what I tell people is you are not there to save anyone. People save themselves. They are experts in their own lives. They don't need you to tell them what to do. What they do need is safety. They need a safe place to receive health care. So that that whole culture of health care is part of the issue. The bigger part of the issue is their hearts are in the right place, but they don't receive education. So the entire reason that I went back to get my doctorate is because trauma informed care is not required in any state at any level of curricula for nursing education. Not required anywhere. Which. The majority of our patients. Are affected by. Um, when you look at statistics of, you know, trafficking survivors. 80% of them interact with the health care system at some point during their trafficking experience. More than 70% of just patients, Right? Just patients at large have experienced trauma. When you think about like women's health, which we focused on for this toolkit because there are some specific challenges, you know, challenges specific to women, but the principles in general apply to any gender, right? To any patient. Pediatric patients. Adult patients. Um, but when you look specifically at areas like OB where. A fetal loss is is traumatic. So when those women come back to have a subsequent baby, they're bringing all of that with them. And what I'm saying to you is we have never trained those nurses for how to appropriately care for her in a way that is going to support her through that next experience of having a baby. We've never trained the nurses who work in the E.R. to deal with, you know, the opioid, the trauma of that of poverty, of racism. We have never trained any of them. Now, some may have chosen to do that, right? It's not as if no one's doing that. But it is not mandated anywhere. Which I think is. I mean, something that, like I said, push me to go back to school because it's like, well, the intersection of health care and trauma is where I live and where I have always lived. It is my life's work. It's my passion. Like I said, I was doing that before the term was even coined, before anybody even knew what it was. As a young nurse, I can remember being in rooms with patients, let's say with the more, you know, a nurse who was training me or who was my resource, someone more, you know, senior veteran, and we would walk out of the room and would look at that nurse and say that Dad is about was always an OB, that dad is something about to go off in there because I could feel it. It took several years before I realized they can't feel this. Right. They can't feel it. Um, because when you are prey in the jungle, right, as a child being trafficked, you get very, very good at anticipating. When it's about to go off, when someone is about to go off, when you might be in danger. I did not realize that. Not everyone had that. Um. Until I became a nurse. I also was in my 40s before I realized that. Every single decision that I have made that is substantial has been heavily influenced by that term. Who I married. My profession. And not only did I become a nurse just like my mom, because she was a nurse and she was a great nurse and most nurses who are addicted are. But I went into labor and delivery because if I couldn't save my mama and her baby, I was going to save every other mama and baby. It never occurred to me when I was making that decision that that was why I was doing right. Those were unconscious things for you, which then I learned, okay, as I'm now caring for these patients. I quickly recognized that I was seeing the tip of an iceberg right in the hour, day week that I spent with them. And that's part of my training too, with other because we get very again. We think we're doing it. And when I say we now, I'm talking about nurses. And when I say nurses, please, no mean everyone in health care. Just I'm a nurse and it's hard for me to not say that. Um. They think they're doing the right thing because they're being nice. They don't understand. Or even recognize that they may be hurting people when they think they are being nice and respectful. They just don't have that awareness because they don't have that knowledge. And that is why, um, Whitney mentioned my project. So my project in Indiana for my DMP is to have a policy in Indiana that mandates trauma informed care for nurses, both pre licensure and then continuing education for those that are already working in the field. Because when you do train people and they kind of get that light bulb, they go, Well, I can do that. I get it. That's not, you know, anything that different than what I'm already doing. I just did not know. And. But I also want to say, as a family member, for those of you who don't work in health care. My mom was a drug addict. I watched her her whole life be treated terribly by the health care system because she was a drug addict. Um. I also saw the same thing with my children who have had, again issues as a result of what they inherited from me. I myself have been treated that way as their parent. Mean, I had an experience where it was like, Well, why are you estranged from your family? You know, what's wrong with you? Um, all of those. I worked as an advocate with trafficking victims where I would go with them because they were afraid to go by themselves, saw how they were treated. So we can all advocate, right? If you're advocating for yourself or your friend or your family member, if you're advocating in terms of pushing for policies that address the need for this education, there's lots and lots of ways that we can all move this all forward, move this goal forward. Um. And I just want people to recognize that it's not a lack of compassion from health care folks. They truly do not know. And once they do, they want to do better and they strive to be better. Um. So I think, you know, when you look at things that are a bad interaction versus a good interaction within health care, and you think about those tenets of trauma, informed care. And I have had both as a you know, because, of course, I'm a patient at times, too. And it's just very simple. Um, the small change that can be made, but the impact is huge. Um, I had a situation where I was going to have to have. Um. A biopsy. A uterine biopsy. Any of that can be very triggering for me, right? For obvious reasons. When I called the office and said this might be difficult for me, I might have issues with this. I want to, you know, kind of plan for either extra time. Can I bring someone with me? Like, what are my options to kind of keep myself together? Because no need to do this. The office person. And again, this is why everyone matters and language matters at every level, right? It's not just the physician or the or whoever it is. The office person was like this mean. Her response was literally. Well, they've already put extra time on here. What else do you need? Just that one statement. Made me like I'm a problem, right? Like, I shouldn't say anything else. They already think that I'm a pain. When I actually got. But that would be enough for many people to be like, I'm not even going to go. I'm not even going to get care. I'm not even going to find out what's wrong with me and then follow through for my own well-being, because now I feel like I'm not safe there. I already had a relationship with this provider, so I was like, Whatever, I'll deal with it when I'm there, right? When I get there and we're in the midst of it. It was not the person I thought it was going to be. It was her. It was not the physician. It was her and Pete, which was fine. I didn't know her as well, but was like, It's okay, you know, self talking. In the midst of it, I just started to cry. And it was that trauma survivor silent. Just tears, right? Like, I'm just going to dissociate while this is happening. It's going to be over soon. And she literally stopped, looked me in the eye and said, Do you have a history? And I just did one of those, you know. And she said, Well, then we're just going to pause. And she covered me up. Said, We're just going to pause until you feel like you're ready to finish this. And if you don't want to finish it, that's okay, too. And she just sat down next to me on their little, you know, Dr. Stool. And pulled out her phone and she said, I'll just I'm just going to play Candy Crush and you let me know when you're ready. There are so many right things about that. One, that she's not probing for details, right? She's not asking me to tell my story. She's not putting me on that spot. She's recognizing that I'm having a reaction and she's not ignoring it, which is what a lot of us do because we don't know what to say, Right? So we just pretend like it's not happening because, God, if you say something, I don't know what to say back to you. Like, it's better if I just pretend like they're not upset. That's what a lot of us do. And then she normalized it, right? She literally said, Oh, this happens all the time. You are so fine. I'm not in any rush. And within a couple of minutes I'm like, okay, I'm good. Let's finish it, right? That when I tell people that and they were like, they think, you know, and they'll say, Well, don't know what to say. And I'm like, You don't have to. You don't have to have answers. All you have to do is recognize. I see you're having a hard time. How can I best support you? What can I do right now in this moment? I can sit here with you. Would you prefer to have some? You know the time to yourself? Like what's going to help you right now? And like, you don't have to give them the answers. I've had other nurses ask me like, Well, do I have to have their consent called the police? I'm like, Well, you don't have to, but you better or you're going to get somebody killed. Because if they don't have their safety plan figured out yet, you're not helping them. So just those kinds of conversations are what we need to be having in health care. Because again, the one who's saying like, I just want to call the police because I want to help her, she's in this bad situation. She's clearly with this man who's abusive. He's answering all the questions for her. He's, you know, controlling what we can do and not I can't get her away from him to even talk to her. There's clearly a power struggle here, you know. And I would say, yeah, but. Is he paying her mom's rent? Does he have access to her children? Like what you do right here in this moment is not going to account for all the other variables that are going on in her life. And you don't know what those are. Um. Because I was an OB in Pedes. I worked in ICU. There's a lot of trauma in a neonatal ICU. Neonatal abuse. I don't know if you guys know this are filled, filled with babies who are born to women with drug addiction. It is very hard for those nurses to not be angry with those parents. Because they see these babies struggle and they love these babies and want to protect these babies. But I would say things to them like. When they would, you know, judge the mother. How could she do this? We should criminalize this. They should go to jail for doing this to this baby. And I would say, okay. I hear you. I understand. I know that's coming from a place of I want to protect this baby, right? However, what if I told you that that mother spent the last two years in a dog cage being injected with heroin? Does that change how you see her situation? Does that change how you see her? Because for all you know, that's what has happened. Right. We have no idea what brought them here. In their life to this point. But I can guarantee you that whatever choices that they are making. Are what they thought were going to be the best for them or theirs in that moment. And we don't have all of that context. What you do have is the opportunity to provide a place where they feel safe and they feel respected and they feel that you are a soft place and a safe place to be so that maybe they'll come back. Or maybe like me growing up. I thought everyone knew. When I was being trafficked, my worldview was that you were either part of it or you knew about it and look the other way, because in my mind it was so prevalent and obvious what was happening to me. That there were not There was no. World. Where people truly did not know because it was right under their nose. And. That is where I get very. Protective of patients because think. We have no idea. None. I can remember many times being at my mom's bedside when she was sick and nurses would overhear my level of conversation with her, which, as you can imagine, we had our issues. And they would pull me aside and say, You're not being very nice to your mother. And shame me. And I would say you have no idea. What I have been through with this woman. Right. You don't know her. You don't know Our relationship. And what she's doing right now in front of you is manipulation. Right. But you don't know that because this is the only time you've interacted with her. Those types of things happen all the time. So what I tell healthcare providers, nurses, whoever is assume the best, assume that there is a good reason for whatever the family dynamics are for whatever their, you know, life currently is. They have reasons. And it's not your business. Honestly. They don't have to tell you. They don't have to disclose. You don't need to dig. Because if I, as a child or even an, you know, young adult, if I had had that type of care. While it would not have saved me from my situation because no one could do that but me. What it would have done is open up my worldview to say there are people out there who might be safe. To plant that seed. Because. I did not believe that that was the case. So I tell people I wouldn't. You could have. Pulled my fingernails out and would not have disclosed what was happening to me. That's not how that works. But what we could do as health as folks in health care, is to provide a place of safety, because it might be the first time they've ever experienced it, and they may not believe that it's possible up until then. And planning that seed and having that grow. If they have another experience that shows them the same thing, then they may, you know, continue to come back and it may change how they feel about everyone else in the world that they think is, you know, going to hurt them. Or as part of the system or can't be trusted or whatever it is. And people have good reason not to trust health care. Good reason. Black folks have a whole history of reasons not to trust health care. People who do not, you know, who are nonbinary have good reason not to trust health care. Women have good reason not to like. These are facts. And just because you as a nurse are not there trying to harm anyone, you may actually be doing that because you don't know any better. Even if you think you're being nice. Even if you think that you're helping. Your help may be harmful. Um. So just to summarize all of that, I just want to say that thank you guys all for being here. I hope that there is something within the toolkit, within the podcast or anything that I may have said that resonates with you. I hope that. You advocate or your if you as patient, advocate for yourselves for that. Um. That is your right. Right. So if you have someone that you feel like is being disrespectful, is rushing you, is judging you or your family member. Please feel empowered. I know many people feel, Oh, it's a doctor, it's this. Please advocate for yourselves When you're in a health care situation, if you feel like you need to and say what you need because sometimes they just don't know. And think that there's this fallacy amongst the general population that they think that, you know, we've all been trained to manage that we haven't. Right. So they're probably doing their best. And some guidance from you around. You know, what would really make this easier for me is if. Whatever. I want to have my back to the corner. I want to be able to see the door and see who's coming in and out. I'm sorry you didn't introduce yourself. I need to know who's in my room. It helps me to feel safer. You can say those things. Right. If you don't already. So. I think that's all I have. I know I'm coming. I don't want to go overtime, so. Thank you all for listening. And as you get the opportunity, if you see policies, things coming up around training for health care, please advocate for those and support those as well because we really need that. So thank you so much.

00:48:01 Speaker 2: Oh, sorry. Maps to you. And wow is all I have to say. Thank you so very much for sharing so much of yourself with us today. Humbled to have been witness to that and hope that, no, you have to skedaddle, but hope you have the opportunity to check out the chat. There's a lot of love for you there, a lot of acknowledgment.

00:48:23 Speaker 1: Very powerful. Yeah. Don't have to sort of not look at that when I'm talking, you know, got to totally, you know.

00:48:29 Speaker 2: I know I wasn't really keeping it together. I'm a little emotional. You got me. I really appreciate we really appreciate everyone. Really appreciate you sharing so much of yourself today. Thank you so much for your leadership in this work. Thanks for all you do and who you are. And we just adore you. Wish you the best and know that this is not the end of our relationship.

00:48:51 Speaker 1: Absolutely not. No.

00:48:54 Speaker 2: All right. And so with that, folks, of course, again, just taking this moment to notice what's coming up for you. Everything from here on out is totally optional. And your choice to engage with I'm going to pull my slides back up here. The first thing we're going to begin with as we ease back into the session and then the discussion is just beginning with an invitation to find a comfortable position and engage in this optional brief resilience practice to check in with ourselves, get a quick moment of centering and grounding in after all, we just heard as we transition to individual reflection and group connection time. FYI, if you prefer to take a moment to step away, grab water, stretch, take a bio break, something else. You're certainly invited to do that. Now, for those of us who are going to be joining for the resilience practice before we go into breakout rooms and to have individual reflection, time and group time, just going to begin again, finding a comfortable position or maybe needing to wiggle a little to find that sweet spot. And now either closing your eyes or softening your gaze by looking down toward the tip of your nose or finding a point around you to look at or focus on. Just noticing that everything here is in invitation and that you have choices on whether and how you engage with this practice. Taking your right hand if you feel called to and raising it to your nose. Gently placing your left hand either on your knee or your belly or your heart. Whatever feels right for you. But taking your right hand, raising it to your nose and first emptying your lung completely with a good exhale. And now gently pressing your right nostril with that thumb to close it up a bit. And then inhaling slowly yet fully through that open left nostril. And gently holding that breath while you use your ring finger now on your right hand to rest your left nostril to close it while releasing your right nostril. So now your left nostril is closed and exhaling through that open right nostril. Now keeping that right nostril open and inhaling deeply through it. And holding your breath briefly as you use your thumb to close that right nostril and exhale fully through that left open nostril as you release your ring finger. And so that is one cycle of our alternate nostril breathing. I'm inviting you to join me in doing three full cycles. I'll guide and sort of taper off how much I say along the way. Again, keeping that right nostril closed with your thumb, inhaling through that left nostril. And holding while you switched to having your left nostril closed and your right open and exhaling. Inhaling through the right nostril. Holding and switching, opening the left and exhaling out. In our cycle of breathing in. Which are your nostrils breathing out with your right open nostrils. Weaving in. Twitching and exhaling out of your lap. Do more cycles breathing in. Working and breathing out. Holding and switching and and breathing in. Twitching and exhaling out of the left. Last one in. Hold and switch and exhale. Now breathing in. Holding, switching and really giving a good last exhale out of that left nostril. And now bringing some awareness to this space. Opening your eyes if they're closed, refocusing forward if you were looking somewhere else.

00:53:30 Speaker 1: I invite you.

00:53:32 Speaker 2: To place your right hand on your heart now and just notice what has shifted for you. A moment of stillness. What feels more balanced in your nervous system? What feels lighter on or fuller or energized for you. And feeling free to type a word or two into the chat to describe how you're feeling as you arrive in this space. If you'd like. Again, we had an emotional time and just accepting and nonjudgmental, noticing where you're at right now as you release this practice. There's always something so special about being together in harmony and community, regulating our nervous systems together. Relaxed and comfortable. Centered and relaxed. Motivated. Calm. Beautiful and hard. I'm just so grateful that all of you are here to join us in these optional moments of connection. With self, with other with the world around us. And to that point, we're going to move into some independent reflection time at this point. And Laura will drop the link to where you can download this document in the chat. I think a third or fourth down, it will say sort of reflection and community connection or connectivity. Laura if you can just put the language in the chat of what that says for folks to download this document. Um. That you can download this. And really this reflection point is just to guide you in beginning to explore and think about at a very high level transformation in women's health. And of course, this document is long, right? The not the reflection document, but the toolkit and resource itself. It's a biggie. And so really there's no expectation that you leave with huge insights or anything like that and just really skimming, reflecting, noticing on what your first look is like, what strikes you, what calls to you to come back to. And these prompts are intended to help you connect with that resource document and just to anchor the conversation in the breakout rooms where you'll have the opportunity to talk about whatever is calling to you on this topic and exchange thoughts again if you so choose. This is completely optional. And by the way, during your independent reflection time, if you are not interested in participating in breakout rooms or you just aren't in a place where you can do so at this moment, or it's not safe for you to do so, you're driving or something like that. Please feel free to just shoot. Shoot me a message in the chat during this time and we'll place you in a breakout room. Sort of an ancillary one for folks who are choosing not to engage, but do want to stick around for the remainder of the meeting for the last few minutes where we reconvene as a group and sort of debrief and process and share. And so there are no expectations or supposed to with this document. We invite you to take around ten minutes to engage with this resource and jot down whatever comes to you while we play some background music here to give you some focused time for your preliminary exploration. And so let's go to about eight. That's very specific, eight after the hour and we will go ahead and play some music. Feel free to turn your cameras off or whatever else you need to do in this moment to feel comfy as you take the time to navigate through this document. You. You. You. Me and just inviting you to finish up the thought that you are on. If you're jotting things down, finish the sentence you're on. If you are reading and I am going to go ahead and just advance this slide to what is our community agreement. And before we move you into a breakout room, we do just want to take a quick moment to anchor in or re anchor in really our community agreements that we've co constructed with you since the beginning and think January or February of this year. So these have been added to over time and each of us is committing to hold ourselves accountable to these agreements in and that is an expectation of participation in these discussions that we really try to create co-create with you, because we have found that in our group, this is what we've determined is needed to preserve a brave and accountable space for our conversation. And again, this has been constructed with folks over time. And so based on the fact that you might not have been here for one of our conversations before, we do want to pause, give you an opportunity to scan this slide there. Also on the second page of the document, the reflection documents and inviting you to share if you need anything else to participate fully today, it's going to give a bit of a pause. Excellent. All right. So you are in breakout rooms of either 3 or 4. And if you are in breakout room six, it is because you have shared with me that you want to be here for the full group discussion and are looking to do something other than be in the breakout rooms. And during this time that we're going to be together, which is just bringing awareness to the fact that you'll be in a room if it's room sticks, know that everybody there is prepared to sort of just be in that space and in that room. And so the time we're going to bring you back about 25 minutes into the hour. So that means that you'll have about 15 minutes to discuss, which we know is a limited time. But we will be able to then spend the last five minutes in community together just bringing awareness to any of the process that you want to share. We're not going to ask you to point anything out. You can discuss whatever feels alive for you after seeing this presentation today and after moving through this document. And with that, I'm wondering, is there any see some chats? I just want to double check. Um, so okay, so I do apologies and people didn't let me know for and they're letting me know now. I want to make sure I honor all this choice. And now I'm going to make sure that the breakout rooms, everybody's where they want to be. All right, cool. So I think these should be good to go. Going to open the room. See you back at 25 after and we'll check in then. Be well. Have a great conversation.

01:10:36 Speaker 5: Well, it was just getting interesting.

01:10:39 Speaker 2: I know. So last five minutes or so, anyone want to share anything that's on their hearts or minds that really struck them about the conversations in their breakout groups? Anything at all you want to put out there? Feel free to raise your hands and we'll go in the order that you raise your hand.

01:10:54 Speaker 5: I'll make it short and sweet. James. I was doing empowerment. Love it. It just it's just so happens that that was my hand call for.

01:11:06 Speaker 2: Um. Nice. Nice. That's very fitting for you and what I know about you, Jane.

01:11:10 Speaker 5: Well, thank you very much.

01:11:13 Speaker 2: Glad you're here.

01:11:16 Speaker 5: Be to.

01:11:18 Speaker 2: Who else wants to share insights? Just, you know what you're noticing, what you're thinking about, what you're taking away. You don't have to share what you said.

01:11:27 Speaker 6: I'll share memories.

01:11:29 Speaker 2: Thank you. Good to see you. Glad you're here.

01:11:32 Speaker 6: How are you? It's good to see a familiar face. Was like, Is that Whitney? Is that the Whitney? Um, so it's, I think one of the best things. We were talking. We had two different people, one from Wellington University, another young lady who I think works in San Antonio, Texas, which is very. And the spectrums. And I'm here in New York, so I'm like, Wow, that's cool. But we were talking about like the need for trauma informed care, especially in multiple settings, not just in this health care setting. She talked about her experience with her father being a firefighter and how, you know, that there's this lack of mental health concerns or at least any sort of attention to mental health concerns for public servants. And I think that's a big issue. Um, we speak to the criminal system and how it literally traumatizes people on a regular basis every day, particularly when you're being engaged and you're being told that you're denied your humanity, right? Like, I think those are important ways for us to look at how do we interpret that and how do we kind of look at it from their perspective and have empathy, but at the same time use a more trauma informed lens to be a little bit more dignifying in how we treat people and how we come across to people when we talk about their situation, their issues, their concerns, or whatever the case may be. Um, love, love, love the speaker. She was super vulnerable. Sex trafficking, addiction. Those things are very important and they happen on a regular basis, more consistent. But I think one of the biggest thing that stuck out was the fact that 80% of traffic victims actually interact with the health care system and do not receive the care they need, like the fact that people even are being trafficked through the health care system and we don't even recognize it. That they're actual victims is just beyond me. So, you know, those are the salient points that kind of stuck with me that feel like was very important. So thanks again, Whitney. You did an awesome job, as always. Good to see you. And thank you for letting me share.

01:13:15 Speaker 2: Thanks, Rich insights. Appreciate you lifting that up. Sounds like you had great conversation.

01:13:20 Speaker 6: Very great conversation. Our breakout room.

01:13:23 Speaker 2: Love it, Anna. Feel free to unmute and share.

01:13:28 Speaker 7: Yeah. So one of the themes that I noticed is that I feel stigma, shame and sort of the social expectations of women really like filters through all those topics. Um, one of the things that highlighted that for me was the section on significant life transitions and aging, because I feel like we really don't talk about that and we have expectations of women that they're just fine and, you know, don't recognize that as a source of trauma and also the like. Women's burden of caretaking as people age, that can be really overwhelming and burdening and traumatic, um, when caring for a family member. And so, you know, factoring all that in would be really helpful. Um, the one other thing that I noticed is kind of missing is significant health event for yourself. I mean, of course that affects everyone, not just women, but because of the expectations of caretaking and other things like that. If you are a woman going through a significant health event, you're expected to still hold up all of your other roles in the in the process. And that's really traumatic.

01:14:52 Speaker 2: Oh, thanks. Well-put. Thanks for sharing. What struck you. Thanks for sharing your insight. Grateful for you all for showing up for this conversation so fully and thoughtfully. Thanks for your intentionality. This will not be the last you hear from us on this. We're thinking about already sort of how to make this useful for advocates and activists out there in a way that will help equip people with what they need to make an impact. As we are nearing time. Just want to acknowledge our topic for next month is near science, neuroscience, epigenetics spaces and resilience science. Can't wait to see you all there. Thanks so much for being in community today. Be well. I know that the team will hang back. If you want to say anything too.

01:15:34 Speaker 6: Good to see you again.

01:15:36 Speaker 2: You two always be well. Bye.


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