I worked at an abortion clinic as a bilingual counselor. I was trained to say the same things to my Latina and non-Latina patients–give the same spiel about birth control, have the same discussion about pre- and post-abortion feelings, and review the same medical instructions, except in Spanish instead of English.
This did not play out very well. I learned almost immediately that I needed to change not only the way I talked about reproductive health, but the way I thought about poverty, family, and immigration.
I didn’t learn this in training. I learned this from my patients. Instead of assuming that a patient would have a valid government ID, I learned how to ask about immigration status without sounding like I had INS on the line. I learned about the shameful history of the sterilization of immigrant women, and how to discuss birth control in way that respected this trauma. I learned not to assume that a woman had family members or friends in this country who could care for her emotionally and physically after the abortion. The list goes on and on.
Thankfully, this wasn’t just something that I noticed. In their recently released report, California Latinas for Reproductive Justice talked to Latina/os about their views on family, pregnancy, and reproductive justice. One of their key findings was that a “lack of understanding about Latino culture is a greater barrier to accessing reproductive and sexual health services than language.” Interestingly enough, Latina immigrant respondents said that providers not understanding their culture is a larger barrier than providers not speaking their language.
What does this mean?
It means that if we want to provide “culturally competent” health care services (and I’m not just talking about abortion care), we need to be constantly learning from and with our patients. We have to be more than “culturally competent.” We need to be culturally fluent. How do we do that? Well, you can start by reading CLRJ’s report to educate yourself about real Latina/o attitudes about sexuality, abortion, adoption, teen pregnancy, and parenting.
The National Latina Institute for Reprodcuctive Health this week asks,”what’s the real problem behind the targeting of immigrant women?” There are enough to fill volumes. But one is specifically clear to me: a lack of understanding of the diverse Latina/o cultures keeps immigrant women from getting the care they need. Lack of cultural understanding breeds intolerance and scapegoating. We need to speak more than Spanish; we need to comprehend the language of experience.