Through a new pilot program, approximately 150 lower-income Black and Pacific Islander pregnant women in San Francisco will receive a $1,000 monthly stipend in an effort to curb high rates of deaths related to pregnancy and childbirth.
The reason: These two groups are most at risk for preterm births and infant and mother deaths during pregnancy and childbirth, San Francisco Mayor London Breed and Expecting Justice said during last week’s launch of the pilot program called Abundant Birth Project.
They announced their plans to help lower-income Black and Pacific Islander women for the duration of their pregnancy and at least the first six months after their babies are born.
Participants can use the funds as they wish, pediatrician and public health expert Dr. Zea Malawa with Expecting Justice told CNN. She said they will decide which expenses are most necessary for their households and the health of their babies.
“Maybe you’re struggling with food insecurity this month,” Malawa said. “Or maybe you need to pay your car note. That should be the mothers’ decision to make.”
Expecting Justice, based in the San Francisco Department of Public Health, works with the University of California, San Francisco and is funded in part by the Hellman Foundation to tackle persistent birth inequity.
Challenging income inequality
San Francisco — a city bolstered by the tech industry — is not immune to the structural chokeholds of income inequality and racial disenfranchisement.
Because of the city’s widening wealth gap, Black and Pacific Islander families experience unique challenges from inadequate housing, heavily policed neighborhoods and poorer-quality nutrition options.
According to Breed’s office, the median annual household income for Black and Pacific Islander families in San Francisco is close to $30,000 and $67,000 respectively, compared with about $104,000 citywide.
“Providing guaranteed income support to mothers during pregnancy is an innovative and equitable approach that will ease some of the financial stress that all too often keeps women from being able to put their health first,” said Breed in the announcement.
The city’s high cost of living, plus the stress of structural racism, the mayor said, negatively impact the health outcomes of pregnant Black and Pacific Islander women.
According to UCSF and the Hellman Foundation, nearly 16% of Black infants are born too early, compared to 7.3% of White infants. Pacific Islander infants have the second highest rate of preterm birth at 10.4%.
First pilot of its kind
The pilot, the first of its kind, according to Breed, will work to increase economic support for those most impacted by San Francisco’s high cost of living. Health researchers from UCSF say even a modest increase in income can improve birth outcomes for mothers.
According to Centers for Disease Control and Prevention findings, Black, Native American and Pacific Islander women are two to three times more likely than White women to die from pregnancy-related causes. Even in regions with the lowest number of pregnancy-related deaths per 100,000 live births, and among women with higher levels of wealth, significant differences in birth complications persist.
Racial stereotyping impacts Blacks and Pacific Islanders in medical spaces as well, according to Expecting Justice, which adds their concerns are sometimes not listened to with the same urgency as those of White women.
“I think it’s important to know that nationally, Black women die in childbirth four times as frequently as White women,” Malawa said.
Getting support for Abundant Birth Project
Expecting Justice has a specific focus on anti-racism practices and community input. During the research process for the Abundant Birth Project, Expecting Justice trained four Black and Pacific Islander women on how to conduct qualitative research in their neighborhoods. IThey interviewed 21 other Black and Pacific Islander mothers to identify which of their unmet needs were most prevalent during pregnancy.
Equipped with provided iPads and their recorded findings, the mothers convened virtually with public health officials in July to finalize the project’s structure.
ABP has received more than $1 million in donations and $200,000 from the San Francisco Department of Public Health.
Malawa said she hopes the Abundant Birth Project pilot expands to other parts of the state. On the issue of sustainable long-term funding, she offers this solution: Money could be used from earned income tax credit policy to provide cash to marginalized families across California — including to Bay Area mothers priced out of San Francisco.
“Instead of trying to help Black women and other women be more resilient in the face of ongoing racism, what would it be like to decrease the burden of racism instead?” Malawa asks. “I just don’t think that that has been tested enough. And so that’s what we’re trying to do.”