By Genoa Barrow | OBSERVER Senior Staff Writer
April Valentine walked into a Southern California hospital in January 2023 prepared to give birth to her first child, a baby girl. All Valentine wanted was to take her newborn home and shower her with love and affection, but she never got the chance. She passed away during childbirth, a death health advocates say shouldn’t have happened.
Valentine’s official cause of death was listed as blood clots, but public health leader Adjoa Jones says plans for a doula-assisted birth were ignored, and Valentine was not being listened to by medical staff when critical issues developed — definite factors in her tragic end.
Jones, who serves as chief of Los Angeles County’s birth equity unit and director of its African American Infant/Maternal Mortality Prevention Initiative, shared Valentine’s story and that of another laboring Black woman, Bridgette Cromer, who died two months later while giving birth to her own little girl, during a recent briefing on the impact of persistent Black maternal health disparities.
The knowledge that neither of these women got to meet their babies drove home the realities of the human cost of the crisis.
The briefing was hosted by the California Black Health Network in conjunction with Sen. Dr. Akilah Weber Pierson and issued a powerful call to action for comprehensive systemic reform. Despite legislative strides in California, Black mothers are still three to four times more likely to die from pregnancy-related complications than their white counterparts, a statistic that tragically accounts for a disproportionate 40% of maternal deaths nationally.
The “State of Black Maternal Health in California” event sought to provide a “roadmap for policymakers, advocates, and providers to create meaningful change.” The urgency of the matter was underscored by the grim reality that California loses another mother to pregnancy-related complications every five days.
Experts warned that without intervention, this maternal mortality rate could nearly double by 2040. “The blessing of bringing life into this world costs too many Black women their own life,” said Weber Pierson, who is also an OB-GYN. “There is a very popular and very, very dangerous narrative filled with discriminatory rhetoric that almost suggests that we should place the blame on Black women for these staggering statistics.”
A recurring theme throughout the discussion was the pervasive role of racism as the root cause of these inequities.
“The U.S. still has one of the highest mortality rates among high-income nations,” Weber Pierson said. “Even after adjusting for education and income — and this is because of persistent racial disparities — and 80% of those deaths are considered preventable, simply because not enough policymakers, especially in the federal administration right now, have the courage and the power to make impactful change and proudly value Black women and Black value families.”
Dr. Zea Malawa, a Bay Area-based pediatrician and public health professional, cited a March of Dimes study linking racism to racial disparities in preterm birth, leading to health issues such as chronic stress and hypertension in Black individuals. Beyond mortality, pregnancy and childbirth can cause significant disability. Dr. Malawa points to Black infants facing higher risks of low birth weight and developmental challenges.
Despite some legislative progress, including the California Dignity in Childbirth Act (Senate Bill 464) and the California Omnibus Act (SB 65), the gap in maternal mortality rates between Black and white women is, in fact, widening, as confirmed by a recent Centers for Disease Control and Prevention report. SB 464, amended in July 2024, now mandates implicit bias training for all perinatal providers. They were given a compliance deadline of June 1 and civil penalties are supposed to be doled out for those who don’t comply.
Dr. Brittany Chambers, an associate professor at UC Davis, noted that while training increases knowledge, it hasn’t significantly changed providers’ implicit bias or internal motivations, highlighting the need to move from a “train and hope” to a “train and measure” model.
Access to care remains a significant challenge. Sandra O. Poole, a health policy advocate, highlighted the alarming trend of labor and delivery ward closures across California, creating “maternity care deserts.” This lack of access disproportionately affects low-income, Black, Latinx, Indigenous, and rural communities, Poole said, leading to less prenatal care and increased rates of preterm birth. Assembly Bill 55, the “Freedom to Birth Act,” has been introduced to expand access to alternative birthing methods.
Speakers stressed that addressing these disparities demands immediate and comprehensive action. They called for an overhaul of how maternal care is structured and integrated.
The California Department of Healthcare Services is working to tackle these issues within Medi-Cal, which covers 40% of births in the state. Its “Bold Goals: 50×2025” campaign aims to close maternity care disparities for Black and Native American individuals by 50% across prenatal and postpartum care and C-section rates.
Dr. Palav Babaria, DHCS’s chief quality and medical director and deputy director of quality and population health management, acknowledged that many of the department’s maternity policies are outdated, warranting an overhaul.
The DHCS’s “Birthing Care Pathway” report, published in February, outlines 42 committed policies heavily influenced by the voices of Medi-Cal members. These policies aim to address issues such as feeling respected in care, combating discrimination, bridging service gaps, improving program coordination, addressing mental health needs, and increasing awareness of available benefits such as doulas.
Advocates say radical change requires radical solutions. Malawa cited “The California Abundant Birth Project,” a guaranteed-income program that has shown promising evidence in reducing preterm birth and low birth weight by providing economic resources and independence.
Weber Pierson said the path to equitable care is complex, requiring a multifaceted approach of continued advocacy, policy changes and community engagement.
“To repair past damages that have caused generations of pain, we need policy and advocacy efforts to lead that change,” she said.