Making Maternal Care a Priority

PhD in Public Health graduate Dr. Stacey Pilling’s award-winning dissertation examined how migrant women farmworkers receive and prioritize maternal healthcare.

Dr. Stacey Pilling ’15 was awarded the summer 2015 Harold L. Hodgkinson Award for her dissertation, A Qualitative Analysis of Migrant Women Farmworkers’ Perceptions of Maternal Care Management. This award is bestowed upon the graduate whose dissertation is judged as meeting the highest standards of academic excellence. Her review committee included Dr. Jeanne Connors (chair), Dr. Magdeline Aagard, and Dr. Larissa Estes, who were recipients of the Bernard L. Turner Award.

Dr. Pilling has a PhD in Public Health, but did not pursue her undergraduate degree until she was 30 years old. She currently works in a supervisory role for the environmental support branch for Disposition Services, which is responsible for managing waste disposal for the Department of Defense. She completed her master’s research on water quality in a heavily farmed area of Mexico. When she started looking into the literature for her dissertation, she wanted to focus on something a little different, but still related to the farming industry and public health.

During her search, Dr. Pilling found that there were 88 migrant camps in Ohio alone (where she was living at the time). Questions then began running through her head, particularly: How do these women maintain or manage their maternal health while they are working?

After getting approval from the Institutional Review Board (IRB) and from the farm owners, Dr. Pilling decided to go spend several weekends at the migrant camps. Although she used to work in a penitentiary and, as a result, very little intimidates her now, she still met some resistance. “The first night, I was there for about 5 hours and nobody talked to me,” she says. “Then someone came over to me and told me that no one was talking to me because they thought I was with immigration. I hadn’t even thought of that possibility!

“He told me to come back at 10 the next morning,” she recalls. “After that, they were feeding me, giving me sodas, and kids wanted to carry my clipboards.”

Once that rapport had been established, Dr. Pilling had more interview subjects than she ever could have needed for her study, including many who didn’t meet her criteria but still wanted to share their stories with her. One woman in particular stands out in her memory—she had seven children, and the majority of them were delivered by cesarean section. When Dr. Pilling asked why, she had a hard time grasping the reality of her subject’s response.

“She had worked on the farm right up until the last day of labor,” she says. “She was so exhausted from working in the fields that she just didn’t have the energy to push. I can’t even imagine. And then, 10 days later, she was back at work in the fields, 12 to 14 hours a day. She simply couldn’t afford to not work.”

Dr. Pilling points out that there are some migrant clinics, but they’re not very convenient. She found one clinic that was actually located on a work site, but it was only open 1 day a week, from 8 a.m. until 4 p.m. “Prime working hours,” she says. “And that clinic did not offer maternal care, so they had to go off-site anyway. These women were forced to make the decision: ‘Do I go to the doctor or do I go to work and earn my X dollars today?’”

Dr. Pilling recommends mobile clinics to serve these vulnerable populations, ensuring that they provide maternal care and come on-site in the evenings or on the weekend. She is now in touch with the National Center for Farmworker Health in Texas, discussing the possibilities of coauthoring papers and volunteering with clinics. While this study was far from related to her full-time job, Dr. Pilling still feels a connection to these women every day.

“It’s definitely a passion of mine,” she says. “I love interacting with these women and learning their stories. I loved getting this perspective of a world that’s totally different from my 9-to-5, and seeing how I can help them. I’m looking forward to volunteering at some of the migrant health clinics here in Michigan.”

About the Harold L. Hodgkinson Award
This award is bestowed annually upon a Walden student whose dissertation is judged as meeting the highest university standards of academic excellence. The award honors the life of dedication and the distinguished career of one of the nation’s foremost experts in demography, Dr. Harold L. Hodgkinson. It also recognizes Dr. Hodgkinson’s instrumental role in the establishment and academic development of Walden University.

Read about past recipients of the Harold L. Hodgkinson Award.