September 2022 Advocacy Champion

Siri Fiebiger, MD

• OB Hospitalist
• The Mother Baby Center, Allina Health

Why is being an advocate so important to you?
As a women’s healthcare provider for over 30 years, I listen to my patients describe the social impediments of their optimal health - inadequate access to contraception, poor/absent insurance coverage despite multiple part time jobs, legal restrictions, inequitable/racist healthcare delivery, subsistence wages, inadequate childcare. My MPH studies further fleshed out the multifaceted failures of the US healthcare delivery system as realized in our unacceptably high maternal mortality rates.

The sheer volume of these stories beg response and I realized that my role must include amplifying the voices, the values and the needs of our patients. So, I started testifying against restrictive legislative bills and in a court case in North Dakota, and was part of an ad campaign that helped defeat restrictive constitutional referendums. I served on the Board of Directors of Planned Parenthood North Central States for 6 years, and joined the robust MN ACOG Legislative Committee when I moved to Minnesota, eventually serving as Legislative/Vice Chair.

What health-care related issue(s) have you advocated for over the past year?
Now serving as the MN ACOG Section Chair, we worked with our tenacious and talented lobbyist to get two bills crafted, sponsored and passed in a split legislature in 2021 - an accomplishment recognized by national ACOG with this year’s State Advocacy Award. The new laws are: 1) the 12-month postpartum extension of MA coverage and 2) vacating mandatory substance use reporting in pregnancy. We continue to strategize getting adequate reimbursement for immediate postpartum LARC placement (joining 43 other states) and defining and amplifying best practice care for substance use disorder in pregnancy. Foremost, we’re focused on expanding abortion care access across all healthcare systems, increasing mifepristone best practice utilization and expanding training opportunities. I also serve as MN ACOG liaison on Allina’s post Roe task force and as a resource for Senator Tina Smith’s staff.

Disrupting systemic racism in healthcare delivery is paramount to improving maternal outcomes. I have helped center the anti-racism training, education and leadership of color provided at our MN ACOG Clinical meetings since 2019, and currently at our Advisory Council meetings. I personally pursue regular training and education to uncover my own implicit biases, to increase cultural humility and accountability, to become a better listener and then hopefully to respond effectively. I serve on the DEI & B Action Committee at Allina, representing The Mother Baby Center. On September 14, MMA and MN ACOG are cosponsoring a forum “Examining Maternal Mortality through a Health Equity Lens” with presenters Dr. Emily Hawes-Van Pelt and Dr. Dominique Jones, CNM which I get to moderate.

What advice would you offer to others who are interested in advocacy?
Advocacy comes in many forms. First of all, every time we providers listen generously and respond accordingly, our patient feels seen and heard. They will then ask the same of every future healthcare delivery experience - and that is advocacy! Advocacy is improving the access or delivery of care within our offices or departments. Advocacy is modeling this for our students or residents. I get to serve in TCMS’ Mentorship program with a medical student interested in advocacy.

For those passionate about a particular issue best addressed at a policy or legislative level, please reach out to a colleague already involved or your specialty’s association/college or to the MMA (or attend Day at the Capitol), or to the physicians currently serving in the legislature.  Any of these sources will have a number of ideas on how to engage or who to talk to that they will happily share.

Please speak up as you can because our ideas, energies and efforts potentiate each other and amplify the outcome. The large number of young and diverse colleagues actively engaged in advocacy despite busy practices and private lives provides hope for a better healthcare system and ultimately better health for all of us.