Last year, Black infants born in Alameda County were less than half as likely to survive past their first birthday than white infants, according to data from the California Department of Public Health. Black newborns were also twice as likely to face low-birth weights compared to white newborns, a condition that can result in immediate and long-term health problems. These statistics reflect systemic racial inequalities in the delivery of healthcare to pregnant people.
A group of Black birth workers in Oakland are organizing to reverse these trends by providing a new model of care.
“It’s really an empowerment-based model where people get to take more ownership and learn more about their own health,” said Certified Nurse-Midwife Jyesha Wren.
Wren co-founded BElovedBIRTH Black Centering in 2018 to provide better prenatal and postpartum care “by, for, and with Black people.” BElovedBIRTH’s organizers say they are already seeing higher enrollment rates compared to other prenatal care programs in the Alameda Health System, the county’s public hospital network.
Jyesha Wren, BElovedBIRTH co-founder and program coordinator. Credit: Amir Aziz
BElovedBIRTH’s work is based upon a combination of three evidence-based strategies. The first of these is a nationally used approach called Centering, a model of prenatal care that offers group meetings led by healthcare professionals throughout the course of pregnancy. Participants are grouped by due dates so they can form relationships with others at a similar stage in pregnancy.
Typically, Centering groups meet in person and participants receive individual health evaluations from their midwives, and also share their experiences with the larger group. Adapting to a virtual platform due to the pandemic, BElovedBIRTH provides participants with blood pressure cuffs and teaches them how to take their own vitals at home, as well as document their health in a pregnancy log.
During virtual meetings, healthcare providers lead informational sessions on topics such as nutrition, stress management, labor and delivery, and breastfeeding. Centering has been implemented in over 400 sites nationally and has reduced the risk of preterm births by 41% among Black parents, according to the Centering Healthcare Institute.
The Centering approach traditionally does not require that caregivers and participants share the same race, which is where BElovedBIRTH’s model differs. Wren said that “racial concordance,” or the intentional practice of matching patients with healthcare workers of their own race, is the second strategy of BElovedBirth Black Centering.
“When we have this racial and cultural concordance, the overall quality of care improves, the communication improves, the level of trust and understanding improves,” said Wren. “All those things are so important in a patient not experiencing discriminatory, racist care.”
After delivering two children, one in a birthing center and the other in a traditional hospital setting, Oakland resident Danielle Mason was determined to have her third birth at home. Mason, who is Black, said that the legacy of medical racism shaped her previous experiences with health care.