California’s maternal health blueprint ignores systemic racism, community solutions

by McKenzie Jackson, California Black Media

Black mothers in California experience a maternal mortality rate that is three times above the average in the state.

The California Coalition for Black Birth Justice Co-Founder and Executive Director Dana Sherrod said although Black women have higher rates of chronic conditions going into pregnancy, the root cause of their high maternal mortality rate is racism.

“When all things are equal when we look at protective factors — education level, healthy weight, marital status — they aren’t as protective for Black women,” she explained.

“We see Black women without pre-existing conditions, who have protective factors and are still fairing worse — having worse birthing outcomes,” added Sherrod. “Racism is really what is undergirding this crisis and it’s been prevalent and evident for centuries.”

To reduce the maternal mortality rate for all women in the state, particularly Black women, California Surgeon General Dr. Diana E. Ramos unveiled the California Maternal Health Blueprint and announced the Strong Start & Beyond movement in September.

The 20-page blueprint serves as a strategic framework for improving reproductive and maternal health by cutting the maternal mortality in the state by 50% by December 2026. The blueprint also calls for reproductive-aged individuals to understand the health risks they could encounter in future pregnancies by completing a questionnaire over the next 25 months.

In her announcement, Ramos highlighted that the best way to ensure a newborn’s health is to ensure the health of the mother.

“By leveraging powerful partnerships and pioneering cutting-edge solutions,” she said, “we can help California mothers, pregnant people and newborns have a strong start and healthy future.”

Late last month, though, Sherrod and various health advocates and experts — midwives, doulas, physicians and community organizations — sent a six-page letter to Ramos urging her to delay actions the blueprint recommends due to concerns they have about omissions and oversights in the document.

Sherrod says moving forward with the blueprint as it is may “cause harm” to Black and Indigenous communities.” She says there are shortcomings in the document’s development process, and its analyses blame individuals for health challenges rather than addressing systemic failures.”

“Black women, in particular, have been pushing against these harmful narratives for years, and this feels like a significant step backward,” Sherrod said.

Members of the collective met with Ramos, according to Sherrod, but the surgeon general seemed to be moving forward with the blueprint.

“We are hoping to have an open dialogue to redirect some of the strategies in the blueprint,” Sherrod said.

In an email to California Black Media last week, the Office of the California Surgeon General expressed its commitment to engaging the community to enhance existing programs that support new mothers during the postpartum period.

“The immediate opportunity for the community lies in the fact that over 62% of maternal deaths occur after delivery, when the mom is at home and in the community,” the statement read. “Community resources will be the bridge between the healthcare system and the pregnant person and new moms.”

The office said the Strong Start & Beyond initiative aims to showcase an array of existing programs and best practices to improve maternal outcomes and that communication channels like social media and webinars will be used to highlight the campaign.

“The most impactful action in reducing maternal mortality among Black mothers is for local community programs serving Black mothers to cross collaborate with other state and local communities and existing programs to increase awareness of resources for mothers before, during and after pregnancy,” the office said. “An example of one of these programs is the California Department of Public Health Black Infant Health program.”

California First Partner Jennifer Siebel Newsom, who announced Strong Start & Beyond with Ramos, said in a September statement that California has proven initiatives that enhance maternal health and reduce disparities.

“We are setting critical goals to improve maternal health outcomes and creating a robust support network for mothers, from preconception through postpartum care, addressing the diverse needs of our population and setting an example for the nation,” she said.

The blueprint reveals that every five days a mother in California loses her life to pregnancy-related complications. Health statistics show from 2019 to 2021 Black mothers have the highest pregnancy-related mortality rate per 1,000 in the state at 49.7%. Hispanic women had a rate of 17.7%, Asian women were at 14.4%, and white women were at 14.0%.

Sherrod said although the blueprint mentions disparities and outcomes among women from various ethnic groups, not mentioning the racism Black women experience during their pregnancy and when giving birth — which has been noted by researchers and reported by Black women – is a misstep.

“Black women have higher instances of pain or concerns being dismissed or unaddressed,” she said. “That is significant because it tells us we aren’t experts in knowing our own bodies. It tells Black women they are not believable. In active labor, we also see higher rates of unnecessary cesarean sections among Black women.”

The advocates also say state health authorities have not provided details about the blueprint’s development.

“In terms of clinician representation alone, the process did not include participation from midwives,” the letter states. “The contribution of midwifery and of midwife leaders is grossly undervalued in California’s health care system, despite midwives making up nearly a third of birth providers in the state.”

California Black Media, serving California’s Black press, boasts a record of ensuring that the Black viewpoint remains central to all the debates that shape life in California. McKenzie Jackson and other members of the CBM staff can be reached at info@cablackmedia.org.  

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