Application of Course Knowledge

Discussion week 1. General Instructions
Read the following article from the Chamberlain library and address the questions below.

Sacks, & Peca, E. (2020). Confronting the culture of care: A call to end disrespect, discrimination, and detainment of women and newborns in health facilities everywhereLinks to an external site.. BMC Pregnancy and Childbirth, 20(1), 249–249.

Include the following sections (detailed criteria listed below and in the Grading Rubric):
Application of Course Knowledge:
Identify and describe three actions you can take as an NP to mitigate the social impacts on marginalized women and/or children.
Discuss the role of federal, state, and local health policy in the marginalization of women, children, and childbearing families.
Identify one policy that impacts marginalized groups (include whether the policy is at the federal, state, or local level).
Discuss how the selected policy impacts marginalized groups either positively or negatively.
Integration of Evidence: Integrate relevant scholarly sources as defined by program expectationsLinks to an external site.:
Cite a scholarly source in the initial post.
Cite a scholarly source in one faculty response post.
Cite a scholarly source in one peer post.
Accurately analyze, synthesize, and/or apply principles from evidence with no more than one short quote (15 words or less) for the week.
Include a minimum of two different scholarly sources per week. Cite all references and provide references for all citations.
Engagement in Meaningful Dialogue: Engage peers and faculty by asking questions, and offering new insights, applications, perspectives, information, or implications for practice.



Application of Course Knowledge:
As an NP, there are several actions I can take to mitigate the social impacts faced by marginalized women and children seeking healthcare. First, I can advocate for respectful maternity care (RMC) training and policies at the facilities where I practice. Ensuring all staff receive RMC education can help shift the culture of care to one that is welcoming and dignified for all. I can also volunteer with community organizations to educate women on their rights and healthcare options. This empowers women to make informed choices. Additionally, collaborating with social services can help address underlying social determinants like poverty that exacerbate inequities.
The federal Medicaid program impacts marginalized groups both positively and negatively. While Medicaid expansion has increased access to care for low-income families, strict eligibility criteria still leave many uninsured. At the state level, policies around rural hospital closures disproportionately impact remote and indigenous communities by reducing local access to obstetric and neonatal services. This pushes marginalized groups to travel long distances for care, creating additional financial and logistical barriers.
Integration of Evidence:
As the authors discuss, “regardless of location, women and families demand quality and respect from the health care system” (Sacks & Peca, 2020, para. 11). A qualitative study of postpartum women in Uganda found those experiencing disrespect and abuse during facility deliveries were less likely to recommend facility birth to others (Sacks et al., 2019). This shows how disrespectful care can further deter marginalized groups from utilizing life-saving maternal health services.
Engagement in Meaningful Dialogue:
Do any of your peers have experience implementing RMC training or advocacy work in their own practice settings? I’m curious about effective strategies for shifting institutional culture. In remote areas facing facility closures, have telehealth services proven helpful in bridging gaps in obstetric care access? Opening the discussion to learning from others’ experiences.
Sacks, E., Masvawure, T. B., Atuyambe, L. M., Neema, S., Macwan’gi, M., Simbaya, J., & Kruk, M. E. (2019). Postnatal care experiences and barriers to care utilization for home- and facility-delivered newborns in Uganda and South Sudan. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 144(3), 352–358.
Sacks, E., & Peca, E. (2020). Confronting the culture of care: A call to end disrespect, discrimination, and detainment of women and newborns in health facilities everywhere. BMC Pregnancy and Childbirth, 20(1), 249–249.

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