Re-imagining Maternal Health

Why this matters

Black women face unacceptably high rates of maternal mortality. Black mothers across the U.S. (including here in California) are more than three times as likely to die from pregnancy-related complications as white women, and this holds true across incomes and education levels. While all women giving birth in the U.S. face poorer health outcomes than people in similarly developed nations, Black women and infants persistently experience the worst morbidity and mortality rates. This is unconscionable, and complex. Previously, BWWAP passed a bill to require hospital staff to be trained on implicit bias– one obstacle Black women commonly face when accessing health care– but pregnant women need a full range of services to support them throughout pregnancy, during delivery, and after giving birth.

What our bill does

We have put together a comprehensive legislative packet aimed at reducing maternal mortality and morbidity as well as expanding and redefining maternal healthcare in California. The package includes:

  • Expanding full spectrum doula coverage in MediCal
  • Extending Postpartum coverage in Medi-Cal
  • Codifying and expanding California’s Maternal Mortality Review Board
  • Updating Fetal and Infant Maternal Investigation
  • Expanding access to midwifery programs
  • Universal Income for low and middle-income pregnant people
  • Updating data collection on mortality and morbity experienced in Lesbian, Trans and Gender Non-Confirming communties
  • Reviewing climate impact on birthing outcomes
  • Requiring recommendations to close racial disparity gaps

Legislative Victory

We are thrilled to share that this bill was signed into law on October 4, 2021. Much of the funds needed to implement our proposed policy changes were also included in the California state budget signed by Governor Newsom in July 2021. This is a historic step forward in the fight for reproductive justice, and we thank the Governor, Senator Skinner and her staff, and the many advocates and community partners who worked hard alongside BWWAP to make this happen. We look forward to continuing to build on this success.

Right after the bill was signed, our team went to work reaching out to and educating folks who might benefit. We are spending the last months of 2021 knocking doors and calling women and families to make sure they know about the new law. Find out more about Momnibus benefits and our outreach campaign.

You can learn more about this by watching the Governor’s virtual bill signing ceremony (featuring BWWAP’s Executive Director, Nourbese Flint!), reading our Op-Ed in CalMatters, and in our press release.

CA Momnibus Act

Black mommas and babies face disproportionately high rates of maternal and infant mortality. For years, BWWAP has advocated for solutions to address this complex problem. We’ve tackled implicit bias in the health care system and expanded access to certified nurse-midwives. Now, in our most comprehensive legislative package yet, we helped re-envision what maternal health can look like in our state. In 2021, we were proud to be a lead co-sponsor of the CA Momnibus Act (SB65 – Skinner). This new law gives low-income families access to pregnancy support professionals like doulas, as well as financial support. Now, our team is in the field knocking doors and calling folks to educate them about their new benefits. Watch Governor Newsom sign the bill or read our OpEd to learn more.

Did you know…?

  • Pregnancy related death rates for Black mothers in California are 4x the state average
  • Compared with the average rate, Black babies are more than twice as likely to die

What does the new Momnibus Act do?

  • It requires Medi-Cal to now cover doula care services. This is brand new. Before this bill passed, people would have to pay out-of-pocket if they wanted the support of a doula during or after pregnancy, which made this kind of care inaccessible for a lot of low-income families. Doulas can offer unique, culturally appropriate support that improves the health of mothers and babies– so it was really important for us to make sure all communities got access to this kind of care. 
  • It requires Medi-Cal to cover maternal health care for 12 months postpartum (in other words, for one year after the baby is born). Before this bill, Medi-Cal coverage only extended 60 days after birth– so this is a big improvement.
  • It gives eligible pregnant people earlier access to CalWORKs aid. Now, folks can have access to this support at once pregnancy status is confirmed/verified.  
  • It gives eligible pregnant people an increase in their CalWORKs pregnancy supplement. Before this bill passed, eligible people received $47 to support them during pregnancy. Now, that amount has been increased to $100. This reflects the high costs of living in our state, and means that families can focus on their new baby and worry less about having enough money to cover their basic needs.
  • It requires our state to empower a committee of community members and health care professionals to collect data and examine the role of racial disparities in maternal deaths and severe injury. This committee will then make recommendations for reducing racial and other disparities so that all mothers and babies get the care they deserve.
  • It aims to expand the midwifery workforce by incentivizing midwifery schools to recruit from underrepresented populations. This is important because it means pregnant women will get care from professionals who reflect their own communities and cultures.

When do the Momnibus benefits kick in? 

Not all benefits will start at the same time. This is common when new laws are passed, because it takes some time for the state to figure out how to implement the changes. The extra CalWORKS supplement will hopefully go into effect on May 1, 2022. It may be a bit longer before Medi-Cal starts covering doula services. There are some administrative pieces to put in place before this program can go live, but we are hoping that folks will have access to doulas starting in July, 2022. 

Who will be eligible for these benefits? 

Different components of the bill will affect different groups of people. Anyone who is pregnant and covered by Medi-Cal will have access to doula care. Several factors are considered for CalWORKS eligibility. It is not just one minimum income amount. Factors considered include income, family size and dependents, and pregnancy and employment status. For more information, visit the CalWORKS website. If you think you’re eligible for benefits under a certain program, we recommend contacting that program directly to make sure you qualify.

Why is data collection important? 

Data collection is important for gaining a more accurate understanding of any issue. Data provides evidence of a problem, which means that it is more likely to be recognized as a problem and receive the attention and resources needed to fix it. 

What is Doula Care?

Doulas are trained people, usually women, who support mothers during pregnancy and after childbirth. Doulas are not medical professionals, but they can play an important role in the birthing process by providing coaching and emotional support, and advocating for mamas to have the best experience possible. 

What is Medi-Cal?

Medi-Cal is our state health insurance program. Many low-income people and families qualify for this program. The threshold to qualify is an annual income of less than $17,774 for an individual, or $36,570 for a family of four. 

What is CalWORKs?

CalWORKs is a state program that provides cash assistance and services to eligible families that have at least one child in the home. Families are able to receive both short-term and long-term support, including money each month to help pay for housing, food, and other basic things. 

Where can I go to learn more?

This is a brand new bill, so information about how it’s being implemented is still forthcoming. The Department of Health Care Services is the department implementing doula coverage and postpartum Medi-Cal extension, and you can check their website for information about those items. The CalWORKS website has information about how to check your eligibility and apply. You can also call them at (866) 613-3777.

What other legislation has BWWAP passed to support Black mommas and babies?

Senate Bill 464 (Mitchell)– the California Dignity in Pregnancy and Childbirth Act. This law requires all health care providers that take care of pregnant people to receive implicit bias training every two years. It also requires that patients are given information about how to report discrimination in health care services. Research confirms that discrimination and implicit bias contribute to the quality of care that Black folks receive and it has been identified as a reason for the disparity in pregnancy related deaths and health outcomes for Black pregnant mommas. Implicit bias is the idea that negative attitudes, stereotypes or beliefs about a group of people unconsciously affect our understanding and treatment of that group. 

Assembly Bill 1237 (Dodd)– the Justice and Equity in Maternity Care Act. This law expands access to perinatal care providers by removing the physician supervision requirement for nurse-midwives. This means more people will have access to nurse-midwives. This is especially important in geographic areas of the state where there aren’t many doctors– currently, at least nine counties in California do not have an OB-GYN. Nurse-midwives are advanced practice nurses who have completed training in both nursing and a higher education program (obtaining either a master’s or doctoral degree) with a focus in midwifery.

Governor Newsom signs BWWAP co-sponsored Momnibus bill!

BWWAP was proud to participate in Governor Newsom’s virtual bill signing ceremony of SB 65, authored by Senator Skinner and known as the CA Momnibus Bill. Together, we publicly recognized California’s commitment to addressing our state’s deep racial disparities in maternal and infant health outcomes. This bill is one historic step forward, and we look forward continuing this journey toward reproductive justice with our state’s elected leaders and community advocates.

Press Release: Governor signs California Momnibus bill

Monday, October 4, 2021 – Today, California Governor Gavin Newsom signed The California Momnibus Act (SB 65) into law, marking a significant victory for reproductive justice and the battle against the Black maternal and infant mortality and morbidity crisis in the United States.

BWWAP Co-Creates California Future of Abortion Council

In the wake of anti-abortion legislation enacted in Texas, BWWAP joined ACCESS, NARAL, NHeLP, and Planned Parenthood Affiliates of California in forming the California Future of Abortion Council. We will convene to discuss policy solutions that help California ensure equitable abortion access. Already, our state has enacted laws aimed at protecting the rights of patients.

Op-Ed: How to Improve California’s Deadly Record of Outcomes for Black Births

BWWAP Executive Director teamed up with our partners at Western Center on Law and Poverty to publish this piece in CalMatters.org. A recent report from CA Dept. of Public Health shows Black mothers in our state face higher maternal mortality rates than the rest of the country. We identify solutions to this ongoing and widening disparity, and urge the Governor to take action by signing SB 65 into law.

California Did What Needed to Be Done.

California did what needed to be done!

Together we defeated the attempted right-wing power grab and democracy lives to see another day in California! Californians understood the assignment and executed accordingly. This win is not just about keeping Gov. Gavin Newsom in office. It is about Saving Democracy in California and affirming the voice of our state’s citizens. It is about preserving our values and advancing health equity and reproductive freedom.

As an organization, we recognized the implications of this special election. We knew what was at stake — progressive policies that advance the health and well-being of Black women and girls. So, we went to work. Through a robust communications and field campaign, grassroots community and business engagement, as well as strategic partnerships, we galvanized our communities to take a stand for our values.

Leading up to the election, BWWAP:

  • Placed ads statewide from Los Angeles to the Bay Area reaching hundreds of thousands of voters in South LA, Compton, Watts, Inglewood, Palmdale, Lancaster, Oakland, Stockton, Fresno and beyond through mobile app ads, billboards, wheat postings and local newspapers
     
  • talked with more than 6,500 voters on the phones to ensure they understood the process, had a plan to vote, understood what was at stake and the importance of voting no in the election
     
  • Ran No on the recall radio ads heard by over 100 thousand people in Los Angeles
     
  • Connected with 65+ businesses in South LA to share the no on the recall message with them and encourage them to promote a no on the recall message to their clients
     
  • Partnered with BIPOC lead and serving organizations lead by Courage California to host a youth focused stop the recall rally where we engaged, energized and educated attendees on the issues at stake
     
  • Partnered with Naral Pro-Choice California and Planned Parenthood Affiliates of California to host a stop the recall reproductive freedom phone bank that featured elected officials and community leaders who offered their insights with volunteers and underscored the importance of voting no in this special election 

We are deeply grateful to Million Voters Project Action Fund and The Grove Action Fund, for  their financial support, which enabled us to work with our community to secure this win!  Together we were able to make sure that California has leadership that demonstrates an interest in expanding access to healthcare, closing the disparities gaps and advancing health equity. We look forward to working with Governor Newsom as he has been a great partner in BWW’s mission to expand healthcare access and reduce racial disparities maternal health and other health indicators. 

In Solidarity,

Black Women for Wellness Action Project

Racism is a Public Health Crisis

In the wake of the initial coronavirus outbreak, BWWAP fought against proposed budget cuts to public health programs that provide critical support Black women, such as the Black Infant Health Program.

STD Coverage and Care Act

Why this matters

For the past three decades, the rates of sexually transmitted disease (STDs) have continued to climb in California. Chlamydia and gonorrhea are becoming more prevalent and can have long-term health effects if left untreated.  Syphilis has risen at an especially alarming rate (nearly 900% between 2012-2018!) and can cause serious harm to adults and to newborns during childbirth. Young adults and Black people face disproportionately high rates of infection, and addressing this requires removing barriers to testing and treatment.

What our bill does

SB 306 helps to addresses the STD epidemic and improve health outcomes by reducing barriers to STD services and treatment by:

  • Expanding access to STD services and treatment for low-income and uninsured patients through the Family PACT program and provider network
  • Increasing prevention through innovative strategies like home testing + expansion of health professionals that conduct rapid testing in the community
  • Revising current law to support the delivery and increased utilization of Expedited Partner Therapy (EPT). This evidence-based and effective STD prevention practice provides patients who test positive for chlamydia or gonorrhea with take-home medication or perscriptions for their sex partners.
  • Updating state law to require congenital syphilis testing during the third trimester of pregnancy

Healthy Futures for Foster Youth

Why it matters

California’s foster youth and nonminor dependents experience disproportionately high rates of sexually transmitted infections, unintended pregnancy, and poor access to prenatal care. This burden falls heavily on Black youth, who are overrepresented in our state’s foster system by 3.1x their share of the general population. This is a complex and intersectional issue, but there are some immediate ways we can support these youth. Providing financial support to expectant parents is shown to reduce negative maternal and child health outcomes of stillbirth, miscarriage, low birth weight, and complicated pregnancy.

What our bill does

AB 366 improves upon existing law in three ways: it extends expectant foster youth’s infant supplement payments by three months to cover the final term of pregnancy; it ensures foster youth have access to comprehensive sexual health education, rights, and services; and it creates transparency through additional data reporting.