BIRTH EQUITY 2023
► First 5 Alameda County (First 5) is committed to advocating for and achieving equity by focusing on racial and economic justice to ensure that all children in Alameda County are born healthy and that community and family conditions exist that support well-being and growth. First 5 strongly believes that all women and birthing people have a right to the conditions that support optimal birth outcomes and we seek to eliminate disparities to advance racial, social, and economic justice.
The National Birth Equity Collaborative defines birth equity as “the assurance of the conditions of optimal births for all people with a willingness to address racial and social inequities in a sustained effort.” In the United States, Black people who are pregnant and giving birth disproportionately experience health inequities. Decades of research, advocacy, and storytelling point at deeply rooted systemic racism as the driving force behind disparities in maternal and child health outcomes Recently, California has made commitments to advance a series of policies and initiatives to address maternal morbidity and mortality, including passage of Senate Bill 65: the California Momnibus Act and expansion of Doula Services as a Medi-Cal benefit However, there are additional opportunities to prioritize and center the needs of Black women and birthing people. In the Bay Area:
Black women & birthing people are 3x more
like to die during pregnancy or childbirth and experience more maternal health complications.
Black babies are 3-4x more
more likely to be born too early, too small, or to die before their first birthday.
Black women & families are 2x more
more likely to live in poverty or experience hardships during pregnancy.
Ensuring that all babies have a strong start at life begins with investments in practices, programs, and policies that center the lived experiences of Black women and birthing people. National and local thought leaders like the National Birth Equity Collaborative and Deliver Birth Justice have identified recommendations for policy makers and systems to dismantle negative pregnancy and birth outcomes that impact Black birthing people, babies, and families. To ensure Black women and birthing people have safe and healthy births, policymakers and systems leaders can start by increasing and advancing policies and investments in the following 4 target areas:
Promote&ProtecttheRighttoReproductiveHealth&Autonomy
Thisincludesincreasingaccesstoaffordablereproductivehealthservices,continuityofcareand insurancecoverage,removeeconomicbarrierstocare,andprotecttherighttobodilyautonomy.
►LocalStrategy:ReproductiveFreedom
DreamYouthClinicofRootsCommunityHealthCenterprovidescomprehensiveyouth-led healthcareandculturallycompetenthealthcareservicestoyoungpeople,includingthosewho don’thavesecurehousingorarevulnerabletosextrafficking.Abortionisusedasa reproductive-freedomtoolforyoungpeoplewhoareaffectedbytrafficking theyhaveariskof pregnancythatisfivetimeshigherthanotheryoungpeople.
►LocalAdvocacy:ChampioningReproductiveJustice
First5denouncedtheoverturningofRoevs.Wadeasaninfractiononbasichumanrightsanda threattohealthequityandtheeconomicsecurityofchildren0-5,pregnantpeople,women,and theirfamilies Californiahastakenstepstostrengthenthestate’srobustabortionrights protections.InNovember2022,voterspassedProposition1toamendthestateconstitutionto guaranteetherighttoabortionandcontraception.GovernorNewsomalsopassedapackageof 12billsaimingtoimproveaccessandprotectpatientsandclinicians.
ImproveQualityofMaternalHealthCare
Tosupportmaternalhealth,localandstatehealthagenciesmustensurethatqualityhealthcare servicesareavailabletoeveryone—nomattertheirabilitytopay.Systemsneedtoimplement strategiesthatimprovethequalityandcontinuityofprimary,preconceptioncare,prenatalcare, post-partumcare,andcareforpeopleatrisk;expandcoverageofdoulaandcommunitymidwifeprograms;andprioritizesafeandrespectfulmaternalhealthcare.
►LocalInvestment:FamilyNavigation&LegalSupports
First5isthefoundingfunderofDevelopmentalUnderstandingandLegalCollaborationfor Everyone(DULCE),aninitiativeoftheCenterfortheStudyofSocialPolicy,atHighlandHospital toprovidehealthcare,familynavigation,andlegalservicesoutofthepediatricclinictofamilies withbabiesbirthtosixmonths.
►LocalStrategy:CenteringModels
AlamedaHealthSystemandAlamedaCountyPublicHealthDepartmentoffersBElovedBIRTH BlackCentering,auniquemodelforprovidinghigh-qualitygroupprenatalandpostpartum care,by,forandwithBlackpeople.Thismidwifery-ledandteam-basedprogramprovidesBlack birthingfamilieswithaBlackcareteamofhealthcareprovidersincludingBlackmidwives, familysupportadvocates,doulas,breastfeedingspecialists,doctors,nutritionists,psychologists, andmore.
►LocalAdvocacy
BlackBirthJustice:First5servedontheSteeringCommitteeforUCSFCaliforniaPretermBirth InitiativeandFirst5CenterforChildren’sPolicyjointreport“TheRoadtoBlackBirthJusticein California,”whichprovidesclearandactionablerecommendationstoimprovebirthoutcomes forBlackfamilies.
CaliforniaTitleVMaternal&ChildHealthBlockGrant:First5wrotealettertothestate supportingtheCaliforniaDepartmentofPublicHealth’sMaternal,ChildandAdolescentHealth prioritiestoadvancehealthequityforwomen,birthingpeople,children,adolescents,and families.
EliminateRacism&BiasinHealthCare
Addressthemanywaysthatdiscriminationmanifestsitselfinhealthcaretomitigatenegative healthoutcomes.Investinanti-racist,anti-biastrainingsandenforcepoliciesthatkeep individualsandinstitutionsaccountablefordiscriminationthatleadstodisparatehealthimpacts.
►LocalStrategy:Systemsbuildingtosupportwomenwithyoungchildren
First5participatesinsystemsbuildingasamemberofAlamedaCounty’sPerinatalEquity InitiativeSteeringCommitteetodismantleunjustsystemsandpracticesthatharmBlack birthingpeopleandtheirbabiesbyaddressingthecausesofpersistentinequalityand identifyingbestpracticestoimproveoutcomes.
►LocalData:ExperienceswithRacism&Discrimination
Parents/caregiversinour2021-22KindergartenReadinessAssessmentstudyreportedwhether theyhadexperiencedracismordiscriminationbasedontheirrace/ethnicity.Experiencesof discriminationwerenearly10timeshigherinAlamedaCountyrelativetoanationalsample. Blackandmultiracialparents/caregiversweremorethantwiceaslikelyasWhite parents/caregiverstoreportexperiencingdiscrimination.
►LocalAdvocacy:Momnibus
First5submittedaletterinsupportofSB65theCaliforniaMomnibusbillwhichwouldreimaginematernalhealthtoimproveperinataloutcomes,closeracialdisparitiesinmaternaland infantmortalityandmorbidity,andimprovedatacollectionandresearchonsocioeconomic factorsthatcontributetonegativebirthoutcomes.TheworkgroupissettolaunchinSpring 2023.
InvestinSocial,Structural&EnvironmentalConditions
Accesstoeconomicsupport(e.g.,paidfamilyleave,universalbaseincome),basicneeds(e.g., housing,food,transportation,utilities),andcommunityresources(e.g.,familyresourcecenters, carecoordination,doulas)arepartoftheconditionsthatsupportoptimalbirthingoutcomes.
►LocalInvestment:
SocialConnection:First5hascontractedwithMothers-for-MothersPostpartumJusticeto supportapilotproject,Honoring&UnifyingGatherings(HUGs) Thisprojectwillpartnerwith localBlack-ownedcafestoprovideasafespacefornewmothers,birthingpeople,and caretakersofinfantsinthecommunitytocomeandconnectwitheachotherweeklyoverafree beverageandpastry.
Healing&FeedingSupport:First5hascontractedwithTLCConsulting&MaternalHealingMidnightMilkProgramtoofferfreeafterhoursinfantfeeding,pregnancy,andpostpartum virtualsupportgrouptoaddressexistinginequitiesinaccessinglactationsupport;and workforcedevelopmentforparticipantsinterestedinbecominglactationpeereducatorsor birthworkers.
FundingPlace-BasedFamilyResources:AspartoftheNeighborhoodsReadyforSchool strategy,First5fundstrustedcommunityorganizationsandfamilyresourcecenterstobuildan ecosystemofsupportforfamiliesinthecommunity.
►LocalStrategy:
NavigationforYoungFamilies:First5’sHelpMeGrow(HMG)initiativeoffersfamiliesearly screenings,forexample,screeningsthroughtheDevelopmentalScreeningProgram;provides carecoordinationandnavigationsupporttofamiliesaccessingneededservices;andconducts communityoutreachandnetworkingeventstoshareresourceswithproviders.
FinancialAssistance:ExpectingJustice,aSanFranciscoBlack-ledcollaborative,launcheda cashbenefitprogramcalledTheAbundantBirthProjectthatprovidesunconditionalcash supplementstoBlackandPacificIslandermothersasastrategytoreducepretermbirthand improveeconomicoutcomes.In2023,theAbundantBirthProjectwillbeexpandingtofour additionalcounties,includingAlamedaCounty.
►LocalAdvocacy:SupportsforUnhousedPregnantPeople
First5submittedaletterinsupportofSB1083toincreaseaccesstohomelessassistance supportforpregnantCalWORKsfamilies.ThebillwassignedintolawinSeptember2022.