Lina Buffington, PhD
Lina (she/her) is a “maker” with a love for clay and textile arts; this creative spirit informs her social entrepreneurship, which spans the non-profit and for-profit sectors. She believes that we must take a holistic and creative approach to our work if we hope to close the persistent equity gaps plaguing humanity. Lina is an experienced Program Officer, Executive Director, and Entrepreneur with over 15 years of experience developing and leading mission-centered organizations. While her diverse experience spans multiple sectors, they are all aligned within an unwavering passion for social justice and equity. In addition to her leadership experience, Lina has over 13 years of experience developing curriculum and teaching in institutions of higher education. Before coming to NSRH she co-founded the East Bay Permanent Real Estate Cooperative. Lina earned her BA in Philosophy from Spelman College and a PhD in Philosophy from Emory University. She is based in Chicago, IL.
In this episode we interview Dr. Lina Buffington, the Executive Director of Nurses for Sexual and Reproductive Health (NSRH). NSRH and the resources they offer are another great tool for clinicians, especially for folks providing abortion care. We cover the goals and mission of NSRH, the value of being a member, and the specialized training they offer to nurses. We also get into some great conversations about gaps in sexual and reproductive health care and how the recent Dobbs decision is impacting sexual and reproductive health. Be sure to check this episode out if you want some hope for the future of sexual and reproductive health care.
Main Questions Asked
- Let’s start out a bit broad, can you first tell us about NSRH, including their mission and goals, and how it started?
- What is your role with NSRH?
- What are the benefits of being a member of NSRH?
- What makes NSRH unique from other resource or membership groups?
- What gaps do you see in sexual and reproductive health care and how is NSRH working to address those gaps?
- How has the recent Dobbs decision impacted the work NSRH is doing?
- What does the future look like for NSRH?
- What is the one thing you would want all clinicians to know about NSRH?
- Are there any other resources related to sexual and reproductive health that you would like to share with our listeners?
Nicole: [00:00:00] Hi everybody, and welcome to the Woman Centered Health Podcast. Today we are speaking with Dr. Lina Buffington, the Executive Director of Nurses for Sexual and Reproductive Health or NSRH. We felt that NSRH and the resources they offer would be another great tool for clinicians. We also want to let our listeners know that we are undergoing some strategic changes so that we can improve our listener experience and streamline our processes.
We’ll no longer be offering our traditional show notes, and we’ll instead include takeaways, resources, and transcripts directly on our website. However, we would still love and appreciate your support and you can find ways to support us on our website by going to www.womancenteredhealth.com and clicking the support us tab.
Also, nurses can now earn CE for listening to the WCH podcast. Just check out mycehq.com download the C E H Q app or again, visit our website, www.womancentered health.com to learn more.
Stephanie: [00:01:00] All right. Hi, Dr. Buffington, or Lina thank you so much for being a guest on our podcast today. We’ve been excited to have you on for quite some time. So the first question we always ask is, could you give our listeners a little bit of details about your background?
Dr. Lina Buffington: Sure. My background is a little all over the place. I once had a supervisor who described me as, what did she say? A professional dilettante or something like that. And I actually thought that that was a, a really wonderful thing. Because I have lots of different interests and have done lots of different things. So I was an academic, so I have a PhD in philosophy and started out kind of in higher education, then went into higher education administration. I’ve worked in non-profit sector a long time. Really the bulk of my work had been with young folks. I started out in my non-profit career really supporting underrepresented first-generation youth in college. So working with them once they actually got to college. I’ve even done work [00:02:00] in real estate. I helped co-found the East Bay Permanent Real Estate Cooperative when I lived out in California. And then started doing executive director work. So came to NSRH as their first kind of official executive director about four years ago.
Stephanie: Wow, that is quite the path. That’s awesome. A lot of perspective I’m sure you have. So the other question is about your perspective. So what we always ask our guests is what informs your perspective? So in other words, why do you do what you do and what is most valuable to you?
Dr. Lina Buffington: why do I do what I do? You know, so, I see really the work that I’ve taken on, you know, in this portion of my career, which has really been more about kind of organization building. That’s really been the work that I’ve done. As I said, the last several kind of roles I’ve held have really been about kind of founding and building organizations. And you know, I think one of the things that I’ve become more aware of is the importance of how organizations are run, . I think especially in the non-profit sector, we focus a lot on, you know, we, we have these missions, . We want to do good in the world, you know, we want to do all this lovely stuff.
But the reality is that a lot of our organizations are not healthy, . Are not sustainable and the ways that we work are not sustainable. And sometimes even the ways that our, our organizations work can be trauma inducing, So I’ve really been interested in really wanting to build organizations that are in alignment with the mission and values of the organization in terms of structure, policy, infrastructure, et cetera.
So, you know, especially in this case, this organization is focused on this notion of health and wellbeing. And so really trying to do the work of figuring out what does it mean to actually build an [00:04:00] organization that facilitates wellness as well and facilitates health in terms of our culture and the way that we do business.
Right. So I think that that’s really, kind of what has informed my work over the last several years. So it’s content is doing good work. And as I said, I’ve kind of worked across various sectors, so I think that’s manifested in different ways. But in terms of the, the actual way that I have chosen to go about it most recently has been about really trying to build organizations that can do good work in a good way.
Stephanie: That’s really awesome and sounds really hard.
Dr. Lina Buffington: It is
Stephanie: It feels like everybody fails at that.
Dr. Lina Buffington: It’s hard. It’s hard, and I, and I fail a lot too. I mean, you know, it’s, it’s definitely an iterative process.
Nicole: But it sounds like there’s probably a lot of space that healthcare can learn from you,
Dr. Lina Buffington: yeah, lets hope!
Nicole: All right, so like we said, today we’re going to talk about [00:05:00] NSRH. So let’s jump right in and my tiny person is recording next to me. So those are all the extra noises. All right, so let’s start out a bit broad. Can you first tell us about NSRH, including their mission and goals and how it started?
Dr. Lina Buffington: Yeah. So Nurses for Sexual Reproductive Health, so our mission is to provide nurses and midwives and the students of those professions with education and resources to become skilled care providers and social change agents and sexual reproductive health and justice.
Like, so that’s really our core mission. And the organization began with nursing student activism. Like that’s what birthed the organization. And we’ve actually gone through several different iterations in the last, like, I’m bad with time. I think the organization has been around what, like 14 years But the organization spent the bulk of its life as Nursing Students for Choice. That was the first iteration of the organization. Then the organization was rebranded [00:06:00] as Nursing Students for Sexual Reproductive Health. There was, I mean, this is well before my time. You know, but I’m imagining that a part of what happened was just some conversation around really wanting to rethink and, and move beyond the choice framework to a sexual reproductive health framework with the intention of really, challenging the ways that abortion care and abortion access have been siloed in healthcare and really saying, no, it’s a part of healthcare. This is what it means. This is a part of what is required in order to be able to provide people with comprehensive healthcare. We also have to deal with the fact that, people have organs that allow them to have sex and reproduce. That’s just a part of the whole enchilada, it’s not some separate thing that should be treated separately.
And so then right before I joined the organization about four years ago, the organization had another kind of transition to broaden its scope and mission even more, and became Nurses for Sexual Reproductive Health. So [00:07:00] rather than just serving students, which is what the the organization had done for the bulk of its history we now are working to figure out what it means to serve nurses and nursing students.
Knowing that nursing is a very broad, very large, the largest kind of, workforce sector in health care. You know, really just kind of working to figure out what it means to be a resource specifically in this space of sexual reproductive health and justice for, this very large kind of important portion of the healthcare workforce.
Nicole: When I was creeping around on website, like we do. I found that it actually started, or part of it was started out of Winona State University, which is actually where I got my nursing degree from. Yeah. So I was like, oh, small world. I’m like, but how did I miss that organization while I was there?
Dr. Lina Buffington: Yep. Yep.
Nicole: that seems like a very natural fit for me, but I, I’m like, where was I? So [00:08:00] I kinda had to laugh that I was like, I had no idea. And here we are connecting in this way.
Dr. Lina Buffington: Hmm mm-hmm. . Mm-hmm.
Stephanie: Well, and I, I honestly don’t know. I feel like there’s not any great, or at least at, not that I knew of student organizations and nursing that were, you know, like something like this until we really started doing this podcast and we learned about that organization which is about four years. I mean, we’ve maybe been doing this for almost five years, but, you know, early in the podcast recording, we learned about you all and how awesome it was. Okay, so you kind of already talked about you being the executive director of NSRH. Can you talk a little bit more about your role and what you do there?
Dr. Lina Buffington: So, that’s changing. When I first came in, it was two and three quarter staff. That was the total organization. So I did a little bit of everything and have been trying to expand the team so that I can do [00:09:00] less and really focus, you know, much more on the strategy. You know, growth, financial sustainability of the organization, those kinds of things that I think an ED should really focus on and have less of my hands and kind of day-to-day operations and program work.
But as I said, because when I came on we were so tiny. We were very, very small, very young organization. Cuz as I said, I mean it was a major mission shift before I came in. So I consider this organization startup, because Nurses for Sexual and Reproductive Health has only existed for four years.
And it’s such a change in mission. Most of the words are the same. But making a shift from serving just nursing students to serving both nursing students and nurses is a significant mission shift. And it’s required a lot of restructuring of infrastructure. Like we really had to kind of build the kind of organization that could serve nurses really through their career, right from nursing student, you know, on through their career to continuing education, et cetera, et cetera. We had to build out a lot of infrastructure. We [00:10:00] had to create new programs. So yeah, I’ve, I’ve done a, a little bit of all the stuff and I’m trying to do less stuff as the team continues to grow.
Nicole: So I’m not sure if you had mentioned this, Lina, but can you talk about like the structure of NSRH like is this like a membership type space and then what are the benefits of joining this space?
Dr. Lina Buffington: So, as I said before, the organization started out primarily as a chapter organization. Like that’s, that’s in the bulk of the history is that the, majority of the work really happened on campuses being led by nursing students taking leadership role, building the chapters, really making them happen with support from NSRH, with the the mission shift we continue to do our chapter support work.
That continues to be a very important part of what we do. But, how do we serve nursing professionals. [00:11:00] And so, through the last several years and, and we launched a bunch of new programs in like the last year, So we went from of one program to now like six programs but the membership is a program. Like that’s one element of the work that we do. So that membership you know, one of the things that became clear was that in order to one, do a better job of really capturing the nursing students that we were working with, cuz we, we weren’t really doing a great job with that before cause we didn’t have kind of a national structure and place to make sure that we were really kind of capturing who these students were, we certainly didn’t have the programming to continue to support these folks once they were no longer nursing students in nursing student chapters.
So a part of building out kind of this national membership program, it allowed us to do that work. Which meant that we could, get folks when they were nursing students and doing their work on campus and [00:12:00] also stay with them over time and continue to provide resources and support as they move through their careers as professionals.
So the nursing, membership program was an important piece of that and you know, so we have both a nursing student membership and that, and that was also important because, it allows us now to serve nursing students who are on campuses without chapters. Cause that was another thing before we could not serve nursing students unless they were on a campus with a chapter.
So now, we have a much broader reach, even in terms of nursing students. And we also are now able to serve nursing professionals in, and bring nursing professionals into this, community network. So that’s one piece of the work that we do, this nursing program, which is critical. We’re the only nursing organization that focuses specifically on sexual reproductive health and justice. There, are tons of, professional nurse programs out there; organizations that nurses can belong to. But [00:13:00] none of them really create the safe space for folks who are working in sexual reproductive health, in particular in abortion care provision and access with the space to really engage around that subject matter in a safe way. Where they don’t have to worry about, potential ramifications or, you know, et cetera, et cetera. We also have our online institute, we’ve always had a curriculum but it was kind of old school. We had a bunch of PowerPoint slides that nursing students could use on their campuses. Because a part of the point of Nursing Students for Choice when it was started was this idea that nursing schools were not providing adequate training if any educational training in sexual reproductive health, in particular, abortion care provision. And so we created this curriculum, this Abortion Care Elective or ACE is what it was called, that was basically this kind of out of [00:14:00] box curriculum that nursing students could take onto their campuses and find a professor, to lead or, almost, like I said, treat it as an elective course, but it was PowerPoint slides.
And a lot of it was out of date over time. Those things are kind of hard to keep, update, et cetera. So, and really thinking about, okay, so now we’re broadening, we wanna be able to serve, folks throughout the trajectory of their careers. We wanna kind of take this content that we have and make it more useful and also make it much easier for it to continue to be expanded and kept up to date.
We transitioned into online modules through a learning management system. So we have an online learning institute where, we also provide continued education hours for nurses as well. Through this, this curriculum is content and through our learning management system, folks have access to interactive online modules as well as webinars, So one of the things that that we’re really looking to do over the next several years is build out some, real kind [00:15:00] education pathways for specifically for, different kinds of nurses to be able to provide abortion care provision within their scope of practice. That’s one of the things that we’re kind of building towards.
And the online institute is an important piece of that. We also run a training and abortion care residency program. There are not very many places where nurses can get clinical training and abortion care. And so that’s a, a program that we launched this past year in clinics in Kentucky and Tennessee.
And then the world blew up and we had to scramble, but whatever it happened, we made it through. And that’s another program that we’re gonna be offering. We’re trying to figure out where the next clinical sites will be for that program. We also run a fellowship Karen Edlund Future Nurse Leader Fellowship, which is really focused on cultivating nurse leadership amongst BIPOC nurses who, remain kind of underrepresented in the sector. That’s one of the, the challenges in the sector [00:16:00] equity and diversity is, is really a challenge. And so this fellowship, provides an opportunity for us to really kind of focus on providing targeted resources to nursing students of color who are interested in sexual reproductive health and justice and are interested in, providing more support in terms of kind of entering into the field and doing work in the field.
And we are, most recently, we are in the process of, figuring out kind of the legal pieces to launching an abortion nurse core. And the, the idea behind this is really to be able to provide clinics, in in high impact areas with nurses who already have experience in abortion care provision, like a travel nurse program for abortion clinics. And we felt like this was something that we started working on before the overturn of Roe because the writing was kind of on the wall and we were kind of thinking about, both the fact that because we were already seeing it with [00:17:00] Texas. Like we were already seeing what was happening in New Mexico, you know, and just imagining what was gonna happen when more and more states were gonna be flooded with, folks looking for abortion care provision in states that would still be providing it. And then also thinking about what would happen to the providers who are in states that are no longer able to do that work and wanting to provide a way to kind of match up this kind of talent with this increased need across geographies in a way that can help, even on a temporary basis, plug some gaps and potentially, lead to folks having a vehicle to which to move states if they need to.
So that’s the newest piece to the puzzle for us. And I think a really important piece in that, we start with, nursing students. This chapter support program, our student membership, the fellowship [00:18:00] moving through to online institute the clinical training and now actually providing opportunities for nurses to practice in abortion clinics.
So that’s kind of this full pipeline to abortion care training and provision that we are trying to create for nurses.
Stephanie: So can you tell us what makes NSRH unique from another resource or another membership organization? I’m thinking obviously AWHONN is the Association of Women’s Health and Obstetric Neonatal Nursing, so it covers a lot more than just sexual and reproductive healthcare, but can you kind of just talk about the unique space that you’re in?
Dr. Lina Buffington: Yeah, we’re the only organization that sits at the intersection of nursing, sexual reproductive health and justice. So yes, like as I said before, you know, you have these kind of larger nursing [00:19:00] organizations, but because they do address so many other areas of interest, it’s not always easy for those organizations to be able to talk about abortion care provision in particular. Because oftentimes those organizations can also be a bit conservative. Their members can be a bit conservative. So it’s, it’s not necessarily the case that you’re going to, to be able to get specifically the kind of resources and training that we offer because of our specific focus.
And I think it’s important that we focus down in the way that we do, because then it also allows us because when I say sexual reproductive health and justice that justice piece is a very important piece for us. Because a part of what we, we try to do, in the curriculum that we build and the way that we do our work and think about our programs, et cetera, is we really want to, and we’re really working on cuz it’s a work in progress. Like we are really working on being an organization that is also taking seriously [00:20:00] reproductive justice as in its relationship to sexual reproductive health. So, when we’re doing the work that we do, when we’re talking about the work that we do, you know, we are very mindful. And we are very particular about making sure that we are speaking to the needs of Not just, cisgendered women or, or people with uteruses or people, you know, with uteruses that consider themselves women, et cetera. But really thinking about all the kinds of folks, who may need sexual reproductive healthcare, and that’s everybody.
Like everybody needs such reproductive healthcare. It’s not just a woman’s issue, it’s an everybody’s issue and everybody, and the way that those bodies may be configured and the, and the way that those bodies may be presenting to healthcare professionals. So a piece of what’s really important to us in terms of, the way that we’re talking to our providers and the way that we are structuring our curriculum is really also wanting to make sure that folks are [00:21:00] prepared to provide dignified care.
So it’s, it’s not just about understanding the content or understanding the clinical elements, but it’s also about, how do you, when you are providing care to someone who may have a very different experience or a very different, background from what you might be used to, how do you make sure that you’re providing that person with the best possible care and also empowering that person to make the decisions that are gonna be best for them. So that’s all a piece of it. And that’s very specifically the work that we do. And we do it unapologetically. I don’t really worry about offending people or upsetting people or, you know, we, we don’t tiptoe around things.
We don’t not talk about things because they make some people uncomfortable that like, that’s just, that’s not something we have to worry about cuz we’re not trying to carry a big, broad base. We’re serving very specifically people who are interested in sexual and reproductive health and justice, that’s who we serve, that’s who we talk to, that’s who we create content for and that is unique. And also, let me say this, you know, another thing, and this is a challenge, I think also within the sector, one of the of the issues in the sector, quite frankly, is that so often much of the focus is on physicians, Which, you know, I get, but even though in, in most places, you know, physicians are the folks who have to perform the procedure, that’s not even true everywhere. Whatever scope of practice whole other conversation. But anyway, yes, performing the procedure, and I’m talking about abortion. Being able to provide an abortion is a thing and it’s an important thing. But there are a lot of other things that go into abortion care provision. Lots and lots of other things that are within the scope of practice of nurses and other healthcare professionals. And [00:23:00] often in the sector that is not as that’s not given.
Those things are not given as much attention. and resources are not necessarily put into creating those kinds of programs or those resources. And that’s, once again, that’s what we do. That’s the only thing that we do. That’s our focus. And no one else has that specific focus that we have.
And so I feel like we are really important one in terms of always ensuring, like, whenever I’m in the room, I’m gonna be making sure that nurses are represented. And that nurses are critical to the conversation. Nurses as providers are going to be a part of the conversation because it doesn’t necessarily always happen if there’s no one in the room to kind of insist that it’s happening, .
So I think that’s a piece of kind of what makes us unique and a piece of, I think, what makes us an important [00:24:00] presence in the sector and in the conversation.
Stephanie: I just have so many feelings after all the things that you just said. Like I love, it all
Nicole: Yeah. People can’t see us, but Stephanie and are just like bobbleheading. Yes. Like just like every, everything you’re saying is our love language. It’s why we have a podcast all about communication. Like we are here for everything you just said,
Stephanie: Well, and, and it’s almost making me a little emotional because as a nurse who has, has worked with abortion providers, I felt like as a, a nurse, I was invisible. And I, you know, there I definitely have a little, I don’t know. Trauma, I mean light, I’ll say. And there was no group that I could go to, that would support me or that we could support each other through that. So I think that is an amazing, [00:25:00] and empowering space that you created. And especially the nurse part, like making sure that a nurse is at the table because yeah, at the end of the day, I was the one as the nurse or all of us nurses that worked there were the ones who held a patient’s hand or talked to them. I mean, a lot of the times the provider is doing the procedure and that’s that. And well, yeah, that is important. But we’re the ones counseling the patient giving them their discharge instructions, helping them emotionally. And we really didn’t even have the tools to do that either. So, which is not great for the patient side of things.
And nurses want those tools, but there just wasn’t a place to get ’em. So, even though I’m not in that role anymore, I would totally love this organization for that, that purpose entirely. I think that’s amazing. And yeah, like bigger organizations aren’t doing that work. So aside from that, I also wanted. [00:26:00] Nicole and I have done a couple different episodes on reproductive justice, but I wondered if you could define reproductive justice just for the listeners who maybe that’s like a newer term to them, or they don’t know that much about it.
Dr. Lina Buffington: Let me give this caveat. we are not a reproductive justice organization. I do not make those claims, and that’s really important. We respect the work of reproductive justice and as I said, what we are really working towards is an organization is making sure that we are grounding our work in particular, the curriculum that we build and the content that we put out in a kind of a reproductive justice framework. And there are lots of places that folks should go to understand that movement a lot better. Like, I actually just came from Black Mamas Matter Alliance conference in DC. Absolutely amazing, mind blowing. But I’d say an organization like that, I definitely, you know, would look to them, look to [00:27:00] Sister Song, look to some of these organizations that are really doing the work in the field.
Look to the folks like Loretta Ross and the people who actually kind of created the movement, et cetera. That is not NSRH, not our lane. and we do not make any claims, to that lane whatsoever. but I’ll just say, just to say a little bit about it from my understanding, one, reproductive justice was very much grounded, I think in the, in the work of Black women who were really interested in thinking about and really wanting to push the conversation beyond just the notion of choice or the notion of abortion.
And abortion care and abortion access. And really saying, look, you know, there. Lots of other issues that are impacting folks around these questions of, having a child, not having a child, and if one has a child, the ability to raise a child in a safe environment with adequate housing and access to food and, you know, all these kinds of things, .
Like there’s [00:28:00] just this bigger, more intersectional conversation that needed to be happening around, all of these kinds of topics. And it’s very much a field that’s, that’s still, very much growing and developing. But I think that’s the piece often, you know, like kind of that intersectional piece, .
Like that piece of, what does it mean to think about and ground this conversation around reproduction. In a way that acknowledges the various things that impact people’s ability to reproduce, . The people’s decisions not to reproduce and the ways that people can raise their children if they do reproduce and have children, .
So this kind of bigger broader conversation. That’s kind of how I understand reproductive justice. But as I said, there, there are places that I would go if folks want to really understand the movement.
Nicole: And for our listeners, it is episode seven. We actually speak with Tony Bond [00:29:00] Leonard about reproductive justice, abortion, and religion. That is quite an episode. Buckle up for that one. It’s amazing.
But yeah, that’s, you’ll get a very in depth perspective on reproductive justice. Incredible. Okay, so from your perspective, Lina, what gaps do you see in sexual and reproductive healthcare, and how is NSRH working to address those gaps?
Dr. Lina Buffington: Oh, so many gaps. So many , so many, I’ll just, I mean, I’ll just focus on the ones that are, are, relevant to our mission, our particular work. Like I said, there’s so many, we don’t have all day, so as I said, I’ll focus down on the, you know, kind of where NSRH comes to table on some of these things.
Right. and we’ve already kind of alluded to some of these gaps already, but I, I will articulate them much more clearly. One issue, one gap with sexual reproductive health has certainly been, the siloing of sexual reproductive health, treating it as this kind of [00:30:00] separate entity or separate category as though all human beings don’t have the works.
you know, Like we all have the works, . We all have the, you know, the, the reproductive stuff happening . As a part of our humanity. And that intersects with all elements in, in various elements of our health. So this is not, these issues are not just for people in gynecology, .
Like, they’re not just for people who are dealing with, obstetrics. It’s not, it’s not limited to specific specializations, it impacts everyone and everyone in the healthcare sector at some point is going to have to, to work with a patient or is gonna get questions from a patient or wanna serve a patient in a way would be helpful for them to understand themselves.
Some things about how sexual reproductive health intersect with other health issues. We have one nurse, who’s in, [00:31:00] neurology and was talking about, I’m trying to remember, I’m trying to get this right. to We, we interviewed her, she’s in, her interview is in, in our blog somewhere, but I think she was talking about a patient who was, paralyzed and was wondering about their ability to continue to have sex, .
And wanting to understand kind of their sexual health and things like that. You know, it’s relevant like you, you know, people don’t necessarily think about neurology and sexual reproductive health, but guess what, they impact each other, . Like people don’t necessarily think about, gerontology and sexual reproductive health.
But guess what? Elders are still sexual beings and they still have the works even though they, they are working differently so the ways in which it’s gotten siloed I think is, is a huge problem. because sexual reproductive health should simply be a, part of training to healthcare providers, period.
. Cause it intersects with, with all elements of health, . so I think that’s one major issue. And you know, and that’s one of the things that, We really focus on, in our [00:32:00] organization is, really trying to help nurses understand that regardless of your specific area of specialization sexual reproductive health is something you should be thinking about and understanding how it impacts your patients.
Right. I think another issue, one that we’ve, we’ve already kind of talked about is the ways in which, nurses and other parts of the healthcare team, have really been relegated to the margins of the sector. it’s a problem, . It’s a big problem and it’s becoming more obvious how big the problem is, especially with, the increased needs that we’re seeing With the ways in which our politics have, made it even more diff. I mean, they’ve been making it difficult for a very long time, . Like this is, they just kind of made it official, but for a very long time, our politicians have been making it more and more difficult for people to, to get access to all the, the care that they need.
And quite frankly, the sector’s, lack of [00:33:00] interest in the ways in which all members of the healthcare team are really critical to ensuring full access to abortion care provision. Has caused lots of problems, . One of the problems being that there simply are not enough providers, . Part of the, the problem of provision is not just about, physicians, it’s also also about scope of practice, .
And really thinking about the ways in which nurses could really be empowered to do more. They’ve been empowered to do more in different, you know, certain states have expanded, you know, scope of practice, but there’s certainly room for scope of practice, to be expanded, So that we can expand, who can actually do the procedure, but as I say, Even beyond that, Too much focus has just been on who can do the procedure and not enough focus has been put on making sure that the entire team has the resources and skills that they need to work up to their scope of practice, whatever that scope of practice may be in that [00:34:00] setting.
. Cause that’s also an important part of ensuring access and Ensuring that clinics are running efficiently, And it’s, ensuring that patients are getting excellent care, . Not just, whatever care is available, but excellent care, . and that’s another issue.
And then, I mean, certainly that, that’s all our work, . Like that’s what we do, . Like that, that piece right there, that’s, that’s a, that’s a huge piece of what we do is really by centering nurses in the conversation we are really able to address all of those other elements of abortion care provision that do not get the attention that they deserve within the sector, .
And really trying to elevate those experiences and elevate that work. you know, I think another major issue in the sector has been as I said, equity and diversity, I think that, there has been. A real kind of, what’s the word? Well, anyway, I, I think that there has been just a, a lack of awareness. That’s what it is. I think there’s been a real lack [00:35:00] in lack of awareness in the sector around all the other things that impact this question of reproduction besides abortion and abortion access. And, and that’s, and that’s, you know, that, that I think points us back to the re the importance of reproductive justice and the importance of sexual reproductive health organizations.
Also really working, to include a, reproductive justice lens in their work. Is that, you know, this is not just about getting access to abortions, . Like that’s, that’s a small piece of the puzzle. There’s a much bigger, conversation that needs to be had around these things. and when we fail to have those conversations, we also often fail to account for the experiences of people who have been marginalized by things like structural racism, hetero sexism, all those things in healthcare, Have an impact on the kinds of care that people receive, where people can get care, all that kind of stuff, .
So we, we always have to be [00:36:00] engaging with those various elements if we’re gonna be serious about, sexual reproductive healthcare, which as I said, just needs to be considered a part of healthcare, period, . So really it should be healthcare. That’s what it is. It’s healthcare. We want everybody to have it.
We want everybody to have it, have ready access. We want everybody to be treated with respect and dignity when they’re seeking out care. Right. so I hope I answered the question. Those are the words.
Stephanie: The top three
Dr. Lina Buffington: Yeah.
Stephanie: So you hinted at this a little bit early on, but more specifically, how has the recent DOBS decision impacted the work NSRH is doing?
Dr. Lina Buffington: Yeah. You know, that’s an interesting question. I was actually having a conversation with Kwajelyn Jackson earlier over at Feminist Women’s Health Center in Atlanta about this very thing because it’s interesting. It’s this kind of. You know, on the one hand it’s terrible, . Like it’s, it’s crap, .
Like it’s, [00:37:00] you know, it’s made all of our lives harder, On the other hand, there’s this way in which sometimes the worst thing has to happen in order to shake things up. And in order to kind of force folks outside of, kind of a standard way of, doing things, which wasn’t working in the first place, .
Because the reality is the sector wasn’t working in the first place, .
and There are things that needed to change significantly. and the unfortunate reality of our new political situation has forced people, you know, I think to, make changes and to Think beyond the limits of, some of the ways in which we’ve, thought about things like abortion care and, and abortion access.
. Like it’s, it’s really forcing all of us to kind of rethink how we’re doing our business, . Rethinking our models, which is helpful and is necessary, So it’s, [00:38:00] it’s kind of a, it’s complicated for me, you know, in some ways, . And so, for example, you know, now all of a sudden, we’ve got funders coming to the table that never would’ve come to the table before, including the government
And so now, you know, we’ve got some sates. actually stepping up, . Like we’ve got the federal government like going, oh yeah, vets should have access to abortion care services. . You know, so you’ve kind of got these things happening that’s, it’s a little bit crazy that they weren’t happening before, but having kind of the worst thing happened has forced, some, some shifts and some actions that I don’t know would’ve happened without the worst thing happening, .
Cause that’s unfortunately that, that seems to be how humans work, . Like sometimes we’ve gotta fall off the cliff before we’re like, oh, maybe, you know? So, Yeah. So, like I said, there’s that, and there’s all the bad stuff, . Like all the reality of, providers and patients now having to navigate [00:39:00] all of these crazy laws and trying to figure out what is legal, what isn’t legal, what can and can I do in some cases, what can, and can I say as a provider, . we’ve got tremendous issues with, clinics closing, which, Is of course a tragedy because we already didn’t have enough , we already didn’t have enough clinics.
And now, you know, we’ve got clinics closing because folks can no longer, practice in their states. we’ve got people increasingly having in increased burden of not only, the usual barriers that kept people from having access to abortion care, but now we have increased barriers of, now you gotta travel, .
You gotta travel. Not only do you have to travel, but you gotta get there fast enough. If you’re near a state happens to have certain time based restrictions, . Can I get there fast enough? so it’s, it’s just, it’s both an incredibly horrible thing. . And it’s also oddly, this thing that has created the [00:40:00] possibility of some new opportunities.
That we could potentially make use of to make things better in the longer run. Right. If hopefully we see some of these reversals. Right. My hope is that we will have at least used this time to really, do the work of making the sector better and making our work better. And just doing, business differently and thinking about how we do business differently. so that, we are, we’re just ensuring that, even access means something a bit different. That access doesn’t just mean, oh, there’s this place that I can go to, even if the place is terrible, , at least I can go get an abortion, . Like it no access now means I have options and I have places I can go to get excellent care.
No matter how I’m showing up, no matter who I am showing up, no matter where I live, So, yeah. So it, it’s kind of a. it’s both, this terrible thing and it’s also, I think, opened up some, [00:41:00] some interesting possibilities if we actually take advantage of them.
Nicole: I just wanna say I am so appreciative of you, that first part, like I’ve not heard that a nice, I dunno if I’d call it nice. I’ve not heard that perspective, that, that really, this is, I guess to get philosophical little Thomas Kheun paradigm shift here and that maybe this could be an opportunity for, a much needed better change and I very much appreciate that reframe, and I think it gives me some hope that I maybe didn’t have before. So as terrible as it is, and
Dr. Lina Buffington: Yeah.
Nicole: I, I so appreciate what you said about that.
so then, I mean, obviously NSRH is busy, lots of gaps to address. I mean, the right, your work will never be done, but what does the future look like for NSRH? Just.
Dr. Lina Buffington: [00:42:00] you know, What I’d like the future look like, and this is, once again, this is, this is part of, this is about trying to identify these opportunities that have arisen and they have a small window, . Let’s be clear. People have a short attention span. So , it’s the thing right now, .
Like it’s the thing people are investing in because people are paying attention right now. So, you know, really trying to kind of take advantage of this, this window of opportunity. we’ve really been, trying to, really identify spaces like kind of what’s happening in California right now, what’s happening, you know, with the VA right now, . Like some of these spaces where, you know, the government has actually decided to take positive action in terms of expanding access to care and really trying to step up and say, okay, well, If you’re gonna, you need providers, . And that, and that was a piece I forgot to say too, I don’t know that I’ve quite said it, but I think sometimes people forget, not people, .
But the powers that be, you know, mostly the [00:43:00] people who sign checks, . Like the people who, sign the checks. Because really the people who signed the checks and the way the money comes down, that shapes our reality. That’s just, that’s just how it is, . Like, if we don’t get the money, we can’t do the work.
And I think those folks sometimes forget that, oh, you need clinics, , you can pay for all the abortions you want. Who’s gonna perform them? Where they gonna go? I mean, it sounds silly, but it’s a real deal issue that we have in the sector, . I should have said funding. That was . That was another issue. The way funding happens, .
Like you need providers, . And a part of that means these people have to be trained. Like those things have to happen and they’ve gotta be some place, . You gotta fund clinics and you gotta fund providers and training of providers and those things. Supportive providers especially, you know, we’re looking at, we’ve seen this kind of massive, just general healthcare, provider exodus, coming outta [00:44:00] covid, we’re gonna be hurting for providers, period, .
So you gotta, you gotta support those folks, period. Or there won’t be anybody to do this stuff. , . Like, that’s, that’s a hardcore reality, And so a part of what we want to position ourselves where we wanna be as an organization is to say, Hey, we can train folks, we can get folks this education that they need in order to actually be able to do this work.
. and so, right now we’re kind of in some conversations around, you know, some of The new funding that’s come down in California, you know, and some other places to really think about what it would look like to really build out these educational pathways. . Like just kind of building out this comprehensive, education and training both from kind of the A to Z . From a person, kind of fresh out of nursing school. Who wants to go all in and do all the didactic training and then do all the clinical training cetera, all the way to a person already in [00:45:00] the field who’s just like, oh, I just need, I, I, I wanna learn this new thing, or I need to touch up this skill set.
Right. So, and also, not just for nurses, I mean, one of the interesting things about, the funding coming down in California right now is that it also includes, doulas and medical assistants and other, other folks who are part of the healthcare team that I was talking about earlier.
Right. So, you know, we’re very interested in being able to provide that curriculum Right. And being able to provide that training, because it’s gonna be needed. Right. And especially if, if the good thing happens, And if, you know, states start getting back abortion care rights, people are gonna need to be trained.
that’s a reality. And also another reality is it’s much more difficult for colleges and universities to ramp up fast enough. Like they have to make, changes at, a much deeper level within these kind of large, bureaucratic entities that do not move quickly.
So the reality is, it’s not the case that colleges and universities are gonna get ready quick enough, We wanna push for those changes as simultaneously, like [00:46:00] we also wanna be pushing for these things to become a part of school curriculums, et cetera. But let’s be realistic. It ain’t gonna happen no time soon.
And in the interim, People need to be trained. People need to be educated. And so, you know, so that’s really where we’re trying to position ourselves, as an organization is being able to provide, that training and that education for, members of the team that are not physicians basically.
Right. Which is a whole lot of folks that aren’t physicians who are still very important members of that of that team. and just really continuing to build out, this real, this real kind of workforce pipeline. For nurses, From, you know, working with them as students all the way to providing opportunities for them to actually work in clinics.
And that was another reason why we, we feel like the Abortion Nurse Corps program is, is really critical. And it’s really important, cause we, have seen over the years lot to folks, who are like, oh, well I’d love to, you know, I’d love to have that opportunity to work in the clinic.
But there are only so many clinic jobs and That’s true. so this provides an opportunity for folks who may not otherwise have the [00:47:00] opportunity t o get experience in a, in an abortion clinic, to have that experience even on a temporary basis, . Like to have an opportunity, to go into a clinic that’s, overtaxed and understaffed for a couple months to provide them with much needed relief while also having an opportunity to get this, this experience that they really wanted to have.
So we, you know, that’s why that piece of the pie for us was a really important one to put into place. so yeah, just, you know, like I said, really looking to looking for the resources, . Cuz that’s, once again, without the resources, there’s only so much we can do, there’s only so much we can scale up if we don’t have the money scale.
so Looking for the resources so that we can really scale up, and be able to provide this resource that states are gonna need. They, they’re, they’re gonna need education and training for their people. The VA is gonna need education training for their people. That’s just the reality, . and so that’s what we’re trying to do.
Stephanie: we’re, uh, nodding bigly there because Nicole and I both used to work at the VA. Um, And yeah, [00:48:00] we know, we know the holes there. ,
Dr. Lina Buffington: yeah.
Stephanie: there’s the, the gap that we, kind of like a lot of the stuff you already talked about that happens everywhere. But the VA has so traditionally focused on cis men or you know, male identifying people that when someone that’s more female identifying comes in, like a lot of the providers don’t even know how to do like really basic preventative care.
So then adding like these additional. like sexual reproductive healthcare on top of it, which really, like, you’re right, that should be in everything that everybody does, including for men.
Dr. Lina Buffington: Mm-hmm.
Stephanie: it just wasn’t, and yeah, there’s a, there’s a lot of gaps. And the good thing is I think the VA is really dedicated to that, but you know, it’s the women veterans are the fastest growing. so, there’s hope for the future. But yeah, ,we, we definitely saw that when we were there.
Dr. Lina Buffington: Yeah. Yeah.
Stephanie: So what is one [00:49:00] thing you would want all clinicians who are listening, especially nurses, to know about NSRH?
Dr. Lina Buffington: Well, I mean, I think, you know, one of the things I, I would like folks to know or to understand is a little bit about our approach, cause once again, I mean, and this goes back to kind of that very first question you asked me, that, the stuff that you provide, et cetera, is one thing.
I think that the way that you do things is another. . Right. And, and we’re really committed, as an organization and an iterative process. You know, it’s not perfect. We’re, we’re always kind of learning and making shifts, but we’re really committed to doing things, I think, in a way that is reflective of our values.
and a part Of that means that we are, we’re always kind of testing out new stuff. we’re always testing out ways to do things differently. We are always trying to listen and pay attention to, and hear kind of what’s coming back from our members in our community and shifting accordingly. . and that’s a commitment to how we do work, . Like, even in terms of, some [00:50:00] of the things that we consider even in terms of like the online institute, you know, we were really, and we’ve really been you know, if I can get some more money and get some more stuff, , but, you know, one of the things that we, we really, have a mind to us as well at, is, Things like design, .
Like not just dumping content at people, but making it beautiful, . And making it interesting and thinking about how to chunk up information in ways that make it easy for a working person to dip in and divide a content. Like, you know, really always trying to think about not just putting stuff out there, .
Cause you can, you know, you can make PowerPoints or you can dump out manuals or whatever, but really, are people able to get it . Like, are people able to get what they need from it? So, you know, So we’re always also thinking about member experience and user experience and how we design things and, and the experience of engaging with this organization is also something that we, we take very seriously and we’re always interested in kind of getting feedback and, and [00:51:00] hearing how people are engaging with us.
Nicole: I’m gonna, I’m gonna ask a really big question but I’m curious on your perspective. So then what is the one thing you would want all clinicians to know about sexual and reproductive health in general? Like what, what do you wish you could say to them when they’re providing care?
Dr. Lina Buffington: As I said, I mean, I think the main thing is just, it’s something, everybody needs to know, like every provider needs to know about it, . Like I think that’s just the most important thing. Like everyone needs to have some awareness regardless of your specialty, of the ways in which sexual reproductive health is important for the people that you serve.
Right. Like I think that’s the biggest thing. Just I think cuz you know, cuz that’s a hurdle, . Like a hurdle like you all were pointing to, you know, with the VA, . Like I think that’s just, that’s the hurdle period is helping everyone to understand and know that this is not just something that you have to deal with if you are, like I said, an OBGYN or if you’re in, in, you know, the, obstetrics [00:52:00] department or whatever, that, that’s the only time you have to think about it. No, it’s, or if you’re in urology or something, no, that’s not the only time you have to think about sex reproductive health. People come with it , .
Like if you, if you’re dealing with, with people, then you need to know something about sexual reproductive health. Cause it’s going to impact, your patients, regardless.
Stephanie: Yeah. You know, part of my dissertation research is on reproductive life planning, which is something that providers were supposed to do who worked in Title 10 clinics, which is, very family planning focused. But you look at the rationale behind some of the, like the preconception stuff like, whatever the pregnant person or before they’re pregnant, really like the environment that they’re in or the social structure, and that’s not only stuff that your OB/GYN should be talking about. If you’re like you said a neurologist and you’re putting somebody on a medication and [00:53:00] they could be pregnant in a week, like you probably should know that because that could affect the baby if you know, if, they do have a baby. So, every little bit that we’re doing in healthcare, we really do need to be cognizant of.
Dr. Lina Buffington: And let me say this too, cause I forgot to say this. I, I’ll say one other thing about the, both these questions, I think, you know, cuz another piece of it and, and one of the things that we are really trying to embrace more and more as an organization is pleasure, . Because sexual and reproductive health is not just about making babies or not making babies.
Sex is also about pleasure and it should be, . And, and that’s, that’s a whole nother piece of it, . Like, you know, people’s ability also to enjoy and to have pleasure, . Like that should also be a part of the conversation. And that’s also a part of sexual reproductive health is not just about procreation, .
Like it’s not, it’s not just about that. It’s also about people should be able to have [00:54:00] pleasure, right. And experience pleasure. And we also need to be aware of the ways in which other elements of people’s health, like I go back to the medication issue. Like what are, what are some of the ways that a medication might influence somebody’s ability to have pleasure?
all of those kinds of things should be a part of the conversation, a part of the consideration. And we really need to free sexual reproductive health, . Like the notion of that from this very kind of narrow, kind of utilitarian procreation. . Like, do people have sex to have? That’s not true.
most of the times we having sex, it’s not to have babies. That’s not true. That’s the lie. . So let’s be honest, . Like, let’s be honest, let’s be real once again about what it means to be a human being, .
Who engages in, sex and, you know, all those kinds of things that may or may not lead to procreation and So I think that’s also important.
Stephanie: Now a lot of people are not procreating to have babies,
Dr. Lina Buffington: Exactly.
Stephanie: You don’t it
Dr. Lina Buffington: Exactly. right. That’s a whole, Right.
Yeah, it’s, it’s, I just feel like those things also [00:55:00] have to be a part of the conversation, right. And we have to kind of free the conversation cuz then it allows us to have other kinds of conversations that we haven’t been having because we’ve been so stuck in a particular kind of frame.
Stephanie: yes. Thank you for saying that. That is
Nicole: I agree. And I think what’s really interesting is when you start talking about pleasure, you really start getting into some other layers. And I think, you know, as clinicians, when you tie it to procreation, then you can diagnose, you can, you know, it’s kinda a little more linear, and I feel like, yeah, there is a huge gap when we talk about pleasure and libido and how do we manage these things.
And so, two, when you have that conversation, we’ve had some episodes on this, is you start uncovering sex shame and I think the reason why pleasure is left out is it brings up a lot of shame. It’s, you know, really uncomfortable to people. And so I I it’s interesting that you mentioned that and, and I agree with you, it is absolutely something we need to have more conversations about because the reality is, [00:56:00] is that yes, people aren’t just having sex to have babies.
Dr. Lina Buffington: Mm-hmm.
Nicole: Okay, so Lina, are there any other resources related to sexual reproductive health that you would like to share with our listeners? Like maybe obviously NSRH and you can share how folks can find you, but you know, do you have any other resources that you like?
Dr. Lina Buffington: I mean there’s tons and tons of stuff. I mean, I was thinking about this question and I’ll just kind of point to a couple broad categories I guess. Cuz there’s, I mean there’s a crap ton of resources that really just depends on like, what people are looking for, and what kinds of things people are interested in.
So yeah, certainly NSRH join us. , you know www.nsrh.org it is very, very easy. You can take a look. We’re wonderful. Yes, all that stuff. I think if, if folks are interested in policy, I think one of the organizations I really like and we partner with a lot, All Above All, I think it’s a really good organization if you kind of wanna get into the policy world.
I already Mentioned Black Mamas Matter and Sister Song, some of these other folks. If you wanna learn [00:57:00] about reproductive justice, if you’re interested in research elements, I think like Society of Family Planning and Guttmacher Institute are, I mean, especially Guttmacher. Like whenever we’re, we’re quoting somebody or research, it’s usually come from Guttmacher.
Like, so if you want the data, if you want the stats, I think they’re one of the best in terms of, finding Research to back the stuff we’re talking about. uh, I think for Physician resources Teach is a really strong one. Also MAP the Midwest Access Project for, you know, students, Med Students for Choice.
we partner with them. We do a lot of work with like Med Students for Choice on our student side of things. and in terms Of just like kind of open source, curriculum and, and education. Innovating Ed is a really good one. Like they, they’ve got a lot of different, they’ve got a lot of stuff and all their stuff is open and free to access. And one last piece. Look locally, Right. I think like look at who your kind of local folks are, because I think especially, for nurses, that’s gonna be important in terms of scope, . Like really identifying folks who are speaking within your [00:58:00] scope, and also just local issues cuz everybody’s got slightly different things that are, are key issues in their local areas.
So I’d also say, look, look at your kind of local organizations.
Stephanie: All right. So Lina, I would personally like to thank you so much for your time and commitment to advancing sexual and reproductive health.
Do you have any last thoughts that you would like to add before we end?
Dr. Lina Buffington: I think we got most of it. I, I could have saved the pleasure comment, I guess for this piece, . Cause that was, that was kinda like my, my last little, you know, piece. I think that the thing that I wanted to make sure, you know, kind of didn’t get left out. but no, I Mean, I think, I mean, maybe I’ll just say this one last thing.
I mean, I think one of the, one of the pieces that’s also really been important to us, you know, and I think we’ve kind of been seeing more and I, and I think this is another of those places, I think where this kind of awful space has also opened up opportunities. I think that I feel like I’ve, I’ve more kind of seen space getting created for [00:59:00] BIPOC communities in the sector. which has also I think really led to, a clearer history, right. And, and really placing sexual reproductive health within, understanding that it’s, it’s been a part of everybody’s culture, . . And that, and that there are folks who’ve been doing this work in communities for a very, very, very long time, .
Outside of, I think what folks have traditionally kind of gotten in history books. So I, I think that, once again, I think that there are some, some people should also pay attention to the interesting stuff that’s arising right now. That we have not been seeing. Right. And I think, like I said, I think one of those spaces where a lot of interesting stuff has been arising, I think has really been in, for example, folks really looking to indigenous traditions and acknowledging indigenous traditions around sexual reproductive health, or acknowledging the black midwives.
Right. Or acknowledging, you know, like really just kind of, acknowledging culture and history in the role that folks have played [01:00:00] in getting us, to where we are. that’s, been really interesting seeing that kind of come up and see that, taking center stage in some ways that I had not really before in the sector.