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- Photo by Drew Costley
- Chinyere Oparah, a professor at Mills College and co-founder of Black Women Birthing Justice, cautioned against what she called the "culture of fear."
But the women also told stories of stressors in everyday life. Dalia told of moving out of her home in Oakland after a stray bullet landed on her family's piano. She and her husband wanted to have another child and realized the place that was supposed to be their "safe space" couldn't be that.
A mother named Dana recalled a harrowing year spent in and out of jail, during which she also endured the loss of her father, the murder of a brother who was "shot 34 times," and the loss of her baby when she was two months pregnant.
Chinyere Oparah, a professor at Mills College and co-founder of Black Women Birthing Justice, said it's important to acknowledge the disparities in health outcomes for Black mothers but cautioned against what she called the "culture of fear." "Yes, Black women in California are four times more likely to die," she said, referring to the California Health Care Foundation data, released in 2016. "However, most Black women are not going to die," Oparah added.
"It is an incredibly uncommon thing to have a mother die," agreed Calhoun, who's been at Kaiser Oakland for 13 years. During that time, she said, about 28,000 babies were born at that hospital and there has been only one maternal death. (The woman who died was not African American, she added.)
Still, Oparah said, half of the women who participated in the Black Women Birthing Justice study recalled their time at the hospital as a frightening experience. They "were terrified, not only of the pain but of the possibility of death or that the baby might die or be disabled," she said. "We even had participants talking about the kinds of statements that were made by nurses and physicians in full knowledge of that fear, saying things like, 'Well, you don't want a dead baby, do you?'"
In addition to researching and writing their report, members of Black Women Birthing Justice have worked to raise awareness of these inequities through social media and blogging; trained 16 women to become doulas (who have since formed a group of their own, the Roots of Labor Birth Collective); and edited a book, Birthing Justice, which includes "critical analysis to get people to really understand what the whole scope of birth justice was about," said Oparah.
They also wrote a chapter about the research methods they used for the study for Research Justice, a book edited by Andrew Jolivette. "Research justice is a way of recognizing that research has historically undermined and disempowered communities of color. Oftentimes, we've been the victims of research rather than the beneficiaries," said Oparah. "To change those power dynamics, research justice puts research tools into the hands of community members so that we can then develop community-driven research where we actually decide the research agenda, how the research should be conducted, how you analyze the findings, and what you should do with them in terms of action."
Oparah believes improving maternal health outcomes is part of a broader push to improve the lives of people of color. "We should be looking at not just the streets and the police and the prison system and how Black people are losing their lives there, but actually we should be looking within our maternal healthcare system and the unnecessary deaths happening there both for Black women and infants," she said.
While the Preterm Birth Initiative and Black Women Birthing Justice focus on birth and women's experiences with health care, a third group, the Best Babies Zone Initiative (BBZ), is trying to provide social support and alleviate inequities among women before they actually get pregnant. "Our work is really focused on the social determinants of health," said Mariela Uribe, program manager for the initiative's Oakland site.
BBZ Oakland, which has been working since 2012, focuses on the East Oakland neighborhood surrounding Castlemont High School because, Uribe said, "data told us that there were clearly some birth inequities there."
The initiative's work is different every day, Uribe said, but at the core, they focus on using "community leadership and resident engagement" to connect "people to traditional health services" and encourage economic development.
A couple of the initiative's key projects, said Uribe, are the community market they host in East Oakland during which "local entrepreneurs get to showcase their talent" and test-sell their products. "We have community health outreach workers going out and referring people to case management programs and connecting them to resources, when needed," she said.
Who is in leadership is important. McLemore, of the Preterm Birth Initiative, said the lack of diversity in the health care profession needs to change, and the poor outcomes faced by African-American women are related to "a real inability for us to diversify our workforce."
Calhoun, of Kaiser Oakland, echoed this concern, saying that there's data showing that "patients will hear you differently if you are of a similar race or ethnicity." Patients taking the advice, and feeling heard in return, "is associated with better outcomes," she said.
Calhoun said her hospital tries to intentionally recruit doctors that can best support their patients, 25 percent of whom, she said, are Black. "As an African-American physician, myself, I've heard anecdotally countless stories from patients about how they felt listened to differently," said Calhoun. "Did they get the right prescriptions? Sure. Did they get the right admission or non-admission to the hospital? Sure. But that experience of being listened to by your doctor and respected by your doctor is really where it makes a difference on the margin. Not the big data outcomes, but really at the edges."