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Spotlighting Birth Equity: The Ongoing Call for Transformative, Systemic Change during National Minority Health Month

Impact Story | April 27, 2023
Los Angeles, CA (Public Health Alliance of Southern California)--April is National Minority Health Month, a time to reflect on the persistence of racism in our healthcare system, which continues to lead to preventable Black maternal deaths and near misses, creating a cascade of trauma and loss in communities.  National Minority Health Month stands as an urgent call to action, demanding a collective immediate, and sustained commitment to eradicate the long-standing crisis of Black maternal health disparities.

The Heartbreaking Reality

 In 2021, the United States saw a significant opportunity to improve maternal health as more than 1,200 U.S. women died during pregnancy, or shortly after childbirth, according to the CDC; this marks a six-decade high.  Yet, there remains a dire need to address systemic disparities in maternal health outcomes. In California, Black people die from pregnancy complications at a rate nearly four times higher than the general population.  

As we move through 2023, it is essential to honor the memory of individuals like Bridgette Cromer and April Valentine, who both died while delivering at Los Angeles-area medical centers.

Cromer was just 32 years old when she passed on March 2nd, 2023. Cromer’s husband says she never got to hold her precious daughter, Divinity. In this GoFundMe campaign, he explains hours after giving birth; she lost her life due to massive internal bleeding with no explanation.

Valentine's family is also sharing her story to emphasize the need for attentive and comprehensive care during childbirth. Valentine died on Jan. 10, 2023 at just 31 years old. Her family has told news outlets despite her pleas, pain, and numbness in her legs went ignored, leading to an emergency cesarean section and her sudden death. Her daughter Aniya was born without her mother's warm embrace; her family is now dedicated to ensuring that other mothers receive the care they deserve during pregnancy and childbirth.

Changing the Narrative

However, advocating for systemic change cannot solely rest on the shoulders of affected families. We must transform the shared narrative and foster systemic accountability as our nation’s Black Maternal Mortality Crisis stems from multiple factors, such as professional and institutional failures and biases entrenched in historical and cultural norms.  

Kimberly Seals Allers' article, Ending the Doom & Gloom: Shifting the Narrative about Black Maternal Health advocates for a transition from focusing on this crisis as individual medical diagnoses to addressing the systemic issues at the core of these disparities. Allers states recognizing birth as a natural event rather than a strictly medical one can help alleviate fear, disempowerment, and silence among Black women. By celebrating positive and empowering birth experiences, Allers explains we can reshape the narrative to emphasize the resilience, strength, and wisdom within Black communities.

The Path Forward

The tragic losses of Cromer and Valentine underscore the pressing need for deliberate and enduring efforts to bring about transformative change within the healthcare system. By placing Black voices at the forefront, our dedicated Cherished Futures for Black Moms & Babies team persistently strives to improve clinical outcomes, elevate patient experiences, and identify opportunities for meaningful institutional reform.  

We would like to thank our ten remarkable Community Advisors, a group of dedicated philanthropists, researchers, and clinicians, who are all Black women passionately engaged in this work on both professional and personal levels. Working directly with our expanded 2022-2023 Cohort II, our advisors support individual hospital teams, contribute strategic guidance to the Cherished Futures project design, and amplify the voices of Black experiences.
"Our Community Advisors' Work transforms data into a resonant reality, ensuring that even those removed from these experiences can grasp their profound significance. We cannot institute systemic change without placing Black voices and experiences at the helm of decision-making. We must shape policies and procedures with an acute awareness of the lived realities of those most impacted," Dana Sherrod, the Director of Cherished Futures’ Birth Equity & Racial Justice Initiatives, said.  
Our 2022-2023 Cohort II increased the capacity and reach of Cherished Futures and now covers approximately 45% of all Black hospital births in Los Angeles County. By the completion of our first 2021-2022 Cohort, hospitals implemented intentional, deep-dive reviews of perinatal data by race and ethnicity. They also improved hypertension protocols and established new partnerships with Black-led community-based organizations.

 We understand these changes do not represent an end-solution but rather a beginning on the road to system-level change.

New Cherished Futures Reports Aim to Improve Outcomes

 We are excited to share two new Cherished Futures Reports that have been developed to enhance clinical results and promote heightened accountability.
“These reports are the culmination of tireless efforts and extensive research, offering a powerful roadmap toward dismantling systemic barriers that hinder the health outcomes of historically marginalized communities. We firmly believe that our Cohort and partners will leverage these reports to create a lasting, systemic impact. Our ultimate hope is that community-based organizations and health systems across the nation will draw inspiration from these reports and adopt them as their best practices, driving progress toward a more equitable future for all,” Sherrod said.  
 
"Engaging Community Members and Key Stakeholders in the Development of a Birth Equity Hospital Designation"
This report emphasizes the need to create a birth equity hospital designation in California, finding there is no widespread hospital evaluation or methodology that measures birth equity.   This approach will foster responsibility within hospital systems by facilitating the evaluation of improvements and promoting transparency for Black birthing families as they determine the most suitable location for childbirth.  

“Advancing Birth Equity in Los Angeles County: Clinic Interview Findings and the Impact of Structural Racism in Black Neighborhoods”  
This report presents a strategy for promoting birth equity in Los Angeles, utilizing clinical staff interviews and data to devise practical recommendations. It identifies the root causes of birthing disparities and suggests solutions within and beyond clinical settings. The report utilized the California Healthy Places Index to reveal racial disparities in LA County's built environment, highlighting predominantly Black neighborhoods' exposure to toxins and air pollution linked to preterm births and low birth weight.

Reflection

National Minority Health Month marks a new phase for Cherished Futures as we are developing innovative new projects to advance birth equity and eagerly anticipate sharing more details soon!

 However, this journey is undeniably tough, especially for Black professionals deeply involved in this work. We stand in solidarity with those perpetually impacted by racial health disparities and with the children and families who now bear unthinkable loss and grief.

 We would like to end by expressing our appreciation to our partners for their collaboration, support, and commitment to progressing this essential mission. We cannot walk this path alone and are energized to continue this critical work alongside you.

You can support April Valentine’s family by participating in her
virtual 5K walk fundraiser

Please also consider supporting Bridgette Cromer’s loved ones by contributing to her family’s  
GoFundMe campaign

Want to learn more about Cherished Futures?  Watch our Cherished Futures for Black video featured
by the American Public Health Association