Pregnancy and motherhood can be the most joyous experience in a woman’s life, but for many Black women in the United States, pregnancy is a frustrating experience that subjects them to mistreatment, poor maternity care, complications, and even death.
The United States has the highest maternal mortality rate amongst developed countries. Black women face maternal deaths three to four times more than white women, according to the Centers for Disease Control and Prevention. Black women from different walks of life and across income spectrums are at risk of dying from preventable complications.
Over the past couple of years, the mortality rates amongst Black women have alarmed politicians and lawmakers in California, especially following the media attention that was geared towards Serena Williams and Beyoncé’s own life-threatening experience during childbirth.As a result, California Governor Gavin Newsom passed the “California Dignity in Pregnancy and Childbirth Act,” which requires perinatal healthcare providers to take implicit bias tests and training to prevent maternity-related deaths amongst Black women.
The bill, which was authored by Senator Holly Mitchell, also requires all health clinics and facilities to publicize data and information on pregnancy-related deaths.
Founded by Janisha Howard, Sayida Peprah, Devona Robertson, and Celest Winfrey, Sankofa Birthworkers Collective is an organization that devotes itself to matters concerning the health and wellness of Black mothers in California and looking to reclaim their rights to birth through connection, cause, and community.
In an interview with the founding members, they expressed some of their thoughts and concerns about some of the incidents leading up to the bill and the effectiveness of the bill itself.
“For me it’s like a double-edged sword, it’s almost offensive that it would take a celebrity to bring attention to this issue, when Black women have been dealing with this before Serena and Beyonce, but at the same time I am grateful that they spoke up and said something,” Robertson, chief executive officer of Black Women’s Empowerment Foundation said.
The bill signed by Governor Newsom has suggested implicit bias training as a way to solve the disparity within maternal mortality rates and cope with institutional prejudice within the healthcare system. As indicated by the American Academy of Pediatrics, implicit bias is a significant contributor to the way Black female patients are treated in medical settings and counseled for treatment options.
Sayida Peprah, who is a clinical psychologist and a professional doula, shared her experience of incorporating implicit bias training in maternal health groups in the past two years.
“I know there are organizations, hospitals, and individual providers that would never do it simply because they don’t want to be uncomfortable,” Peprah said. “But now that its a bill, which hopefully will turn into a law, they will have to do it and I think that it can be helpful.”
Sankofa’s founding members have also conveyed their concern for the ways the implicit bias training will be facilitated and how that may project its overall effectiveness.
“How many hours of training are we talking about? Is this continuous training? As a professional midwife myself, I work on the floor with doctors and nurses and I see how African American women and women of color are treated differently,” Winfrey, an International Board Certified Location Consultant in the greater Los Angeles area, said in an interview. “So I’m wondering who’s going to be doing the training? it’s hard enough to do field training with nurses and doctors are their own entity. So I don’t know how they are going to address these issues.”
The bill requires health care providers to complete an initial basic training through a program and complete a refresher course every two years, or on a more frequent basis if deemed necessary by the facility. The bill does not specify who the program facilitators are and seems to designate a large portion of the responsibility towards hospital faculty, which reinforces some of Winfrey’s concerns regarding its effectiveness.
“Learning about implicit bias does not mitigate your implicit bias necessarily,” said Peprah. “It may make you more aware of it, but ultimately its the challenging of your own implicit bias in a space where someone skilled that can provide you with the proper feedback and comb you through some of that stuff. That’s the real work.”
While the language may be vague, the bill demonstrates a step in the right direction in recognizing the huge disparity in maternal mortality rates. Organizations like Sankofa are keen on continuing to advocate for policies that better Black women’s health and wellness, as they provide birthing families with the resources and information needed to ease their transition into parenthood.
“Our mission is to foster wellness in the Black birthing community through direct birthing services, education, and advocacy. We have psychologists, therapists, lactation consultants, midwives, doulas, yoga instructors anyone that touches or has some type of influence on the birthing family is who is involved in our collective,” Howard said.