Every day, in Baltimore City, in Maryland, and in every part of the United States, Black people are inhaling and exhaling trauma. It runs through our veins, lines our nostrils, and sits in our skulls. The outlook is more concerning when you consider Black maternal health, specifically.
According to the Centers for Disease Control and Prevention, Black women are three times more likely to die from a pregnancy-related cause than White women. The reasons for this are social and economic and extend from birthing person to offspring. A study published this month by the American Journal of Psychiatry found that structural racism literally alters children’s brains.
“In the United States, Black children are disproportionately burdened with…adverse life experiences compared with White children,” researchers wrote. “These racial disparities are not random. Rather, they are deep-rooted structural inequalities that result from a history of disenfranchisement of racially minoritized groups (e.g., slavery, segregation) that reinforce themselves through societal norms and practices (i.e., systemic racism),” researchers said.
And while these things are grim and real, that doesn’t mean there isn’t cause for hope. There are people working all over the country and here in Baltimore City to alleviate the stress of structural racism on the bodies and lives of Black birthing people and their families.
Stacey Stephens is the director of B’more for Health Babies Promise Heights. There is a citywide B’more for Healthy Babies Initiative, which began in 2012, but there are also place-based offshoots that focus on parts of the city where life is especially hard for birthing people and their offspring. There are B’more Healthy Baby community collaboratives in Upton/Druid Heights and Patterson Park North and East to address those disparities. Stephens, who specializes in social work and has been with the organization for 12 years, is the program director for the Promise Heights office, which covers the Upton/Druid Heights community.
She says both the citywide effort and the more localized efforts have been successful. By 2012, the citywide effort had reduced infant mortality to 9.7 deaths for every 1,000 births — something the organization says is Baltimore’s lowest point ever. The Promise Heights program has provided services for over 500 families. There have been no fetal deaths in the Upton/Druid Heights neighborhood since 2014.
“We’ve had a tremendous amount of success. In both communities…we were able to eliminate the disparity between Black and white infant deaths,” she says. They’ve accomplished it by seeking out families and educating them. She says once organizers teach birthing people and their families, those people then often want to spread the word themselves.
Stephens says organizers began by focusing on safe sleep habits, but over time their focus has expanded. Now, they educate about keeping the home environment safe (for example, limiting the amount of secondhand smoke a pregnant person is exposed to), the dangers of stress, and even the toll gun violence can take. All of these can influence whether a baby is safely carried to full term and then thrives after birth.
Stephens says they can undertake the gargantuan task of keeping Black people safe in a world where they are not safe through partnerships and community. The initiative is sustained through grants, through collaboration with the University of Maryland School of Social Work, the University of Maryland School of Medicine, and even large corporations like healthcare company Carefirst BlueCross Blue Shield.
Ana Rodney, who runs the postpartum doula program MOMCares, has been working to address those health disparities since she became a doula over a decade ago.
“So first of all, I want to stop and say that studies show that mentally, physically, and emotionally you’re not recovered from birth until about three years, okay, best case scenario, right? So this 42 days, six weeks, ‘I’mma snap back, I’m fine,’ is bullshit. Because mentally, physically, emotionally, spiritually, energetically, it takes time to remember yourself,” she says.
The organization helps usher Black birthing people through high-risk pregnancies and through the fragile and sometimes tumultuous time after a baby is born. Additionally, they offer services like doula training, mentorship opportunities for parents, lactation support, and community education — all for free.
Rodney was moved to do this work after helping a friend of hers through pregnancy, and also through her own experiences when her son was born prematurely.
“We worked really hard to make sure that our mamas know that we’re here, whether they’re in the program or graduated, that we’re continuing to be a resource,” she says. “So we get a lot of, ‘I don’t know what I would do without you. Where have you been?’”
She says that it’s important that this work is done and that it focuses on birthing people of color because those are the people most likely to be ignored and underserved by traditional medicine.
“The urgency that we see around different epidemics is not present for the maternal mortality issue or the infant mortality issue,” she says.
“There have been a number of campaigns throughout history that have sought to create a caricature of the Black woman, and that has impacted the way that we are seen, the way that we are treated, the way in which we are listened to and received.”
The Baltimore Abortion Fund addresses maternal health in other ways that are still important, although perhaps less direct — making sure that people who don’t want to give birth don’t have to.
“One statistic that sometimes surprises people is that the majority of abortion patients are already parents,” says Priya Hay-Chattopadhyay, the organization’s communications manager. “So they already have children of their own. And pregnancy can put a big strain on parents physically, mentally, and financially, especially for those who have recently given birth. No one should have to accept those challenges simply because they can’t afford or access abortion.”
The Baltimore Abortion Fund, as its name implies, helps access money for people who want to get abortions. They also provide other means of support like arranging rides and childcare, or translation assistance.
The organization often helps people coming into Maryland from states where abortions are banned, but they also help people who live here, too.
“There’s kind of a concentration of cluster of abortion clinics in metropolitan areas…and access in other parts of the state, or rural and remote parts of the state, is very limited,” Hay-Chattopadhyay says. “A lot of the support we provide is just logistical support to people who would otherwise have to find some way on public transit.”
And again, much of their work is tied to community-building.
“Part of how we’re connecting with the community is being on the ground and being intentional about when we’re having in-person events. Where are we going to be located? What businesses are we moving in to provide catering? A lot of connecting with the community has to do with where we’re being present on the ground.”