Communities Lifting Communities

Cherished Futures Workshops Delve into Birth Inequities in Los Angeles

Communities Lifting Communities (CLC), the Public Health Alliance of Southern California (Alliance) and the Hospital Association of Southern California (HASC) recently held the latest in a series of Cherished Futures for Black Moms & Babies (Cherished Futures) collaborative and lunch-and-learn events this year. 

Cherished Futures is a joint initiative of CLC, the Alliance and HASC. The program is a multi-sector collaborative initiative to reduce Black infant deaths and improve patient experience and safety for Black mothers and birthing families in Los Angeles County.

April 20 marked the first collaborative workshop of the implementation year for Cohort 2 hospitals (MemorialCare Miller Children’s and Women’s Hospital Long Beach, Torrance Memorial Medical Center, St. Francis Medical Center, Antelope Valley Medical Center, and UCLA Health) and community partners. It highlighted the hospitals’ first-quarter progress on implementation plans, fostering knowledge exchange and peer learning.

The session focused on deepening participants’ understanding of building institutional capacity for implementation through expert-led sessions, interactive exercises and real-world case studies, empowering them to drive sustainable change within their organizations. Attendees also gained valuable insights into recognizing and addressing micro-aggressions, enabling them to cultivate a more inclusive and supportive health care environment.

One participant shared appreciation for “the open honest discussion about how all parties are affected by negative outcomes, and specifically about how we have been conditioned to remove humanism from our roles in health care. This is a deeply rooted issue, and the conversations are difficult to make space for in the health care space when there isn’t much support. I truly appreciate the Cherished Futures team dedicating space to this so that we can freely listen and understand each other.”

The July 20 workshop continued to delve into the historical context of race-based medicine and foster understanding of its impacts on maternal care disparities. Additionally, guest speaker Dr. LaShay Harvey, interim associate dean of graduate studies at the Maryland Institute College of Art in Baltimore, spoke about the nuances of trust-building processes and cultural markers. These nuances can act as barriers to patients from diverse backgrounds embracing medical treatments and health recommendations.

In Dr. Harvey’s presentation, Communicating Respect, Empathy, and Increasing Trust with Black Patients, she called for participants to reflect on the ways in which they communicate. She suggested saying to themselves, “There’s so much that goes into the unspoken ways that we show up in the world… How many spaces, and how much time, do we give ourselves to question what we’re communicating before we even have an opportunity to say anything to birthing people?”

Hospital teams also presented their progress in clinical, institutional and community domains for the second quarter. “The updates from each hospital team were amazing!” said one participant. “They all have done a tremendous amount of work and seem very engaged and enthusiastic about bringing positive outcomes and changing the culture of their organizations.”

All hospital teams have shown progress on implementing strategies related to data, clinical, institutional and community-level interventions.

  • To address inequities that disproportionately affect Black moms and babies, all hospital teams reviewed their perinatal data by race and ethnicity to identify areas for clinical improvement and created a procedure to actively review the data.
  • One hospital addressing exclusive breastfeeding launched a Black breastfeeding support group and saw lactation consults for Black patients increase from 30% to 100%.
  • Two hospitals reviewed and improved clinical protocols for Cesarean sections, reducing their NTSV rates for low-risk first time Black mothers from 33% to 22% and 41% to 23%, respectively.
  • Another hospital has improved the Black patient experience in eight of nine patient-reported experience measures, with the measure “the team listened and respected my wishes” improving from 80% to 91%.
  • The fifth hospital in the cohort has designed a comprehensive survey tool to learn from Black moms’ experiences in their hospital over the past year. It also is launching a Patient and Family Advisory Council specific to the Black population it serves.
  • Most hospitals are working to increase access to doula services.

Additionally, Cherished Futures hosted community advisor lunch-and-learn webinars to further increase community partnership engagement, knowledge building and dialogue around Black birth equity. On August 24, Adjoa Jones, director of outreach and engagement for the LA County African American Infant and Maternal Mortality Prevention Initiative at the LA County Department of Public Health, presented on community outreach and engagement.

On September 26, Dr. Brandi Desjolais, co-founder and director of the Black Maternal Health Center of Excellence at Charles R. Drew University of Medicine and Science, spoke on midwifery integration as a birth equity strategy. Lastly, on October 26, Mashariki Kudumu, community advisor at Cherished Futures, explored innovative approaches to center the patient experiences of Black birthing families in the neonatal intensive care unit.

Most recently, at the final collaborative convening on December 1, 2023, hospital teams gave further updates on their progress. They also discussed program sustainability efforts beyond the Cherished Futures initiative, which will sunset at the end of 2023. For nearly five years, the Cherished Futures team has proudly convened two annual cohorts, reaching nine hospitals across LA County. Team leaders continue to encourage hospitals’ ongoing commitment to birth equity for Black families.

For any questions, please contact Claudia Pacheco, CLC program manager, by email or at (213) 538-0730.