Raena Grandberry drove to Beverly Hills when she became pregnant, thinking she would receive better care in that area of the county, even though she was on Medicare.
“I walked in and people would look at me like ‘what is she doing here,’” she also complained that her visits were only five minutes long, though she had concerns and felt that something was wrong with her pregnancy.
Grandberry woke one night with stomach pains, which she now realizes were actually pre-labor pains. Although she called her doctor and was told “You’re a new mom. Just come in two weeks for your regular appointment,” she gave birth to a stillborn son that night.
During her second pregnancy, she became a participant in the Perinatal Equity Initiative program of the LA County Department of Public Health (Public Health) where she came to the realization that she was discriminated against. Today she is a coordinator with the program.
“Four hundred years of these disparities is enough,” said Brandi Sims, health systems program officer for First 5 LA.
The Public Health and First 5 LA, in partnership with the LA County African American Infant and Maternal Mortality Initiative held a virtual briefing to kick off Los Angeles County’s Black Maternal Health Week. The goal of the week is to raise awareness of the efforts Public Health and community leaders across the county are making to support healthy births for Black families.
The group has as a goal to reduce maternal mortality by 30 percent by 2023.
Although maternal mortality is rarer than infant mortality during pregnancy and childbirth, the numbers are still high. The panel explained that even when educational, insurance, poverty and health issues are taken into account, there is still a very wide gap in the maternal mortality rates of Black women versus White women.
“Black women who have private insurance still have worse birth outcomes,” said Dr. Deborah Allen, deputy director for the LA County Department of Public Health, explaining that even when both Black and White groups smoke or drink during pregnancy, the gap persists. “Black women who do not smoke do worse than White women who smoke.”
“Race overrides smoking in explaining adverse birth outcomes,” Allen said.
She and the other panelists explained that even with adequate prenatal care, the health gap persists mainly because of the racism Black women endure their entire lives. While White women appear healthier having children after age 20, Black women appear healthier in their teen years. This was explained as “weathering.”
“The Black experience ages you before your time,” Allen said, citing examples of how some Blacks are followed while shopping in stores; are threatened with eviction; and/or are discriminated against at school or on the job.
These social experiences cause psychological stress and triggers the fight or flight response, she explained. These cumulative, stressful experiences take a toll on every cell in the body, causing and adding to chronic diseases like diabetes and hypertension.
The answer to minimizing adverse birth outcomes for mother and child is to remove those conditions that are damaging to their quality of life. It is not so much about changing mothers, but in changing the system at its root. Panelists agreed that the Black Lives Matter movement is bringing systemic racism to the light.
Public Health campaigns have begun to raise public awareness: How to recognize trauma; how to help women reduce the impact of stress in their lives; learning how psychological experiences affect their physiological experiences; and the value of having a positive village to help them through pregnancy and giving birth.
“We’re making people feel embraced by a community rather than marginalized and stigmatized.” said Dr. Melissa Franklin, CEO of Growth Mindset Communications. “Reproductive justice is not about transforming the behavior of the Black woman, or the Black pregnant woman, but the behavior of the system.”
The county’s Black Infant Health (BIH) program has been servicing mothers for more than 25 years with free prenatal and postpartum support groups and providing connections with doctors and other agencies. For more information, search BIH at cdph.ca.gov.