Major Nursing Org Embraces Racial Discrimination and DEI Activism

The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) has the ostensible mission to “support nurses caring for women, newborns, and their families.”

However, several of the organization’s position statements reveal another agenda: advocating for injecting radical identity politics into healthcare.

AWHONN’s position statement on “Racism and Bias in Maternity Care Settings,” citing several examples of racial disparities in health outcomes, asserts that the role of nurse should include advocacy to confront supposed systemic racism in healthcare.

“Nurses must seek to change the structures, institutions, attitudes, beliefs, and practices that have legally or otherwise perpetuated racism, discrimination, mistreatment, and lack of treatment of Black women in the U.S. healthcare system,” the statement reads.

One such way nurses can do this, the position statement suggests, is through confronting “implicit bias.” Keep in mind that “implicit bias” is a poor predictor at best of any real-world health outcomes.

Nevertheless, AWHONN maintains that it will work to “[e]ncourage all states and territories to develop legislation such as the California Dignity in Pregnancy and Childbirth Act (2019), which requires perinatal health providers and staff to receive training on implicit bias.”

Other policy recommendations are to:

• “Encourage states and health care organizations to provide funding for nurses to receive anti-racism, bias, and cultural competency education during clinical training and practice”;
• “Expand equitable access to models of care that provide the most optimal outcomes, such as community-based programs, full spectrum doulas, and midwifery care”; and
• “Expand funding to support research efforts to examine the role and impact of racial bias.”

Most disturbing, however, is the statement that AWHONN will “[s]upport programs and initiatives to diversify the current nursing and health care workforce.”

It’s unclear how, exactly, AWHONN aims to achieve this without calling for explicitly discriminatory hiring and recruiting practices.

But we don’t have to speculate. 

AWHONN’s “Nursing Workforce Diversity” position statement is rife with explicit commitments to engage in these discriminatory practices.

Here are just a few recommendations that make clear how AWHONN is committed to DEI:

• Ensure that recruitment and educational materials represent a diverse nursing workforce.
• Implement holistic admission review policies by academic institutions.
• Provide equitable clinical opportunities for students based on course and program outcomes.
• Identify barriers that hinder admission for and successful graduation of underrepresented students.
• Expand tuition assistance and other financial agreements for underrepresented students.
• Increase recruitment of diverse nursing faculty and academic leaders.
• Recruit, hire, and support a diverse workforce of nurses that represents the communities they serve.
• Provide training and educational resources that support and represent workforce diversity.

Several of these recommendations are worth expanding on.

“Holistic review” refers to admissions practices that devalue metrics of academic achievement in favor of “softer” factors such as personal traits. That AWHONN believes implementing this process will increase diversity is extremely telling, as it’s suggesting that holistic review is really a proxy for racial discrimination. And for what it’s worth, in the medical school context, we have strong evidence that it is.

Providing “equitable clinical opportunities” would appear to entail some form of discriminatory system that allocates opportunities to acquire clinical experience on the basis of race. This is, admittedly, speculative, but does seem par for the course when viewed in conjunction with the other recommendations.

All told, it’s clear that AWHONN is intent not only on serving as a vehicle for DEI activism in healthcare, but also as an engine of discrimination in nursing.

Racial discrimination has no place in healthcare: not only is it unethical and unfair, but it degrades the quality of the healthcare workforce by prioritizing identity over merit.