A Global Health Warrior

After majoring in history at Brown University, Bethany Golden '90 found herself on the road to being an attorney. But, life had other plans for her: Golden is now a certified nurse-midwife who focuses on strengthening healthcare infrastructure in underserved parts of the world. She's worked to increase access to contraception, reproductive health services and prenatal care.

After graduating from Brown, Golden worked for two years as a development associate at the Rhode Island Women's Health Collective before pivoting to a position as a domestic violence court planner at the Center for Court Innovation in New York, a think tank that works to create a more effective and humane justice system. Golden found her work helping to improve New York's domestic violence courts interesting and fulfilling, but she says she became increasingly uncomfortable with the adversarial nature of the law.

Golden reevaluated her skill set. "A lot of the violence that I saw in the court system happened around parenthood, happened around unplanned pregnancy, happened when people were starting a family," she says. "There was something going on with families who were under a lot of stress at that moment, so I started looking into careers that focus on helping people during that period when someone is going from being an individual to caring for the next generation, and attending to what can be a really beautiful time or a really scary time for people. And that's how I found the midwifery model."

Golden enrolled at the Yale University School of Nursing, where she learned about health access issues. For example, Golden says, she studied disparities in access to healthcare based on socioeconomic class, race and geographical location, and rural access to care.

"The public perception of midwifery is mostly around home birth. That's not at all the population I've mostly worked with," Golden explains. "Midwifery is also based on the idea that continuity of care is a really important thing; that having that support consistently for nine months, and building that relationship, can support someone as they become a parent." Golden focuses her practice on reproductive health and on supporting women through their entire lifespan, from when they begin puberty to when they begin menopause. Golden's practice is based in San

Francisco, where she provides care and reproductive health services to a diverse set of patients. She's also committed to serving women around the world with sensitivity to cultures and the culturally diverse ways in which women relate to their reproductive health. As a student at Brooks, Golden participated in the Exchange Program and traveled to Kenya. She credits Brooks, and the opportunities the school provided for early travel experiences, with helping her become comfortable abroad.

While she was still enrolled in nursing school, Golden co-founded ICAS/Juntos Adelante, a non-profit based in Esteli, Nicaragua. The organization focuses on building community partnerships and sustainable solutions that strengthen health infrastructure and that promote social justice, gender equality, and health and human rights. For example, Golden speaks proudly of Juntos Adelante's success in leveraging financing to provide scholarships for 20 nursing students, all of whom were placed in vacant posts in rural villages.

"This was the perfect example of projects that we like to do," Golden says. "We had women who wanted to be educated as nurses and fill those roles and stay in their villages, and who would have a reason to commit to building their own communities. I think keeping women healthy and keeping women vibrant and keeping their families together and intact allows for larger community solutions to happen. We like to support community leaders who have a very clear vision of what they want to accomplish, but who may not have the resources to do it."

Currently, Golden's work has taken her across the globe again, this time to Fiji. She's working as a clinical study coordinator for a Children's Hospital Oakland Research Institute study on the prevalence and incidence of chlamydia among Fijian women. The study has two goals: First, it works to collect the data the Fijian government needs to secure resources for testing and treatment. Second, the study compares the accuracy of a traditional laboratory test for chlamydia to a newer test that Golden compares to a home pregnancy test. "We're doing a comparison to see if this new test can stand up to the gold standard," she explains. "And, I think it would be really great to be able to collect enough significant data that it influenced public health policy, and that there was a public health policy that had the money and the resources and the testing behind it to make a difference for women who live here."

Golden is very politically aware, and she remains politically active at home in the United States. "There's something about global health that sounds sexier than staying involved in local issues," she says. "But we also need to put our energies into strengthening our own communities and taking care of the inequalities we see at home." She's an outspoken proponent of protecting American women's ability to access reproductive services, and she sees the recent political turmoil as a chance to invigorate a new generation of women.

"The last two years have suddenly motivated a generation to understand what is at risk," she says. "For some of us who grew up earlier, in the 1980s and 1990s, the political and social justice fights that happened in the 1960s were still very much discussed. Whether that was the Civil Rights Movement, the feminist movement, birth control in 1968 or getting an abortion in 1973, those issues were still very raw and the generation before ours was talking about them."

"I think this has rekindled the conversation," Golden continues, "especially for a younger generation that grew up with Obamacare where their birth control is paid for, who suddenly realized that this is not a given. People are walking around feeling as though equal rights have been attained. I don't think they have been, and I think that's been illuminated in everything from equal pay to paid maternity leave to healthcare access to abortion access."