This week, organizations, advocates, and policymakers across the nation are celebrating the fifth annual Black Maternal Health Week and furthering conversations about Black maternal health in the U.S. Last week, the White House issued a proclamation to officially recognize Black Maternal Health Week. Similarly, the Los Angeles County Board of Supervisors unanimously passed a motion in March 2021, declaring April 11-17 as Black Maternal Health Week, and Friday, April 16 the Day of the Black Infant.
In Los Angeles County, the most populous county in the nation, the rate of pregnancy-related deaths is four times higher for Black women compared to White women. The rate of babies born prematurely is also 50 percent higher among Black women than for White or Asian women. Research shows that these gaps persist regardless of income, education, or health status. The disproportionately high rates of adverse outcomes that Black women experience point to systemic racism, toxic stress, and bias in medical care.
Despite the structural failings that have perpetuated these inequities, Black women advocates and community leaders in Los Angeles and across the country are driving systems change on the ground. One such initiative, Cherished Futures for Black Moms & Babies, leads a collaborative of hospitals, public health, health plans, and community members to improve care delivery and experiences by centering Black mothers and birthing people.
The leaders of Cherished Futures say that Black women in the community already have the answers to address the intergenerational issue of systemic racism that effect birth outcomes.
“It is critical to continue elevating the leadership of Black women so that we can bring our lived experiences, wisdom, and community-defined solutions to the front and center of the discussion,” said Dana Sherrod, Director of Birth Equity and Racial Justice with the Public Health Alliance of Southern California, and project lead for Cherished Futures.
Cherished Futures convenes Sister Circles—safe forums for Black women and birthing people to share their personal experiences about pregnancy and birth—in order to identify pathways to advance birth justice throughout Los Angeles County. Since 2020, Cherished Futures has hosted a series of Sister Circles in partnership with the California Black Women’s Health Project and the Los Angeles County African American Infant and Maternal Mortality (AAIMM) Prevention Initiative, collectively bringing together over 60 Black women across Los Angeles to discuss opportunities to improve health care delivery, particularly for Black people.
At a July 2020 sister circle, one Los Angeles-based doula shared, “Anything that comes out of a Black woman’s mouth needs to be heard, needs to be taken action on, and needs to be believed.” These powerful words spotlight a shared sentiment among the group—there is a critical lack of space and capacity to center Black birthing people within the Los Angeles health care system.
During the session, Black participants identified six core recommendations for hospitals to improve care for Black women:
- Create a designated Black maternal health team
- Create space for real dialogue between birthing people, community, and hospital staff
- Demonstrate and acknowledge unique Black experiences
- Share and discuss data with the community
- Create pipeline programs for Black birth workers
- Engage in specialized training that authentically centers Black voices and experiences
In an October 2021 Sister Circle, one Black mother shared, “We need the hospital systems to acknowledge that Black women have a unique experience in birthing that requires a unique intervention that centers culturally matched care.”
Another stated, “[Doctors should] listen to us to understand instead of listening for an automatic response… I know my body and I know when something does not feel right.”
The Cherished Futures team says that recommendations from its Black women Sister Circles are shared with hospital teams who have been receptive and welcoming of community feedback. The community-defined practices have also been incorporated into core Cherished Futures tools used by participating hospital teams.
“Our work is grounded in Black experiences and community thought leadership. We are excited to continue bringing the voices of Black patients and community to hospital decision-makers,” said Asaiah Harville, lactation consultant and Cherished Futures Birth Equity Coordinator.
Cherished Futures is a joint initiative of Communities Lifting Communities, the Public Health Alliance of Southern California, and the Hospital Association of Southern California. The initiative is funded by is generously funded by the Los Angeles County Department of Public Health, First 5 LA, the California Health Care Foundation, Ballmer Group, Health Net, and Centene Foundation for Quality Healthcare.
To learn more about Cherished Futures, please visit www.cherishedfutures.org.
Dana Sherrod, MPH
Director of Birth Equity & Racial Justice Initiatives