Pregnancy and Birth Equity

By almost every measure, Black women and babies fare worse through pregnancy and infancy than mothers and babies of other races or ethnicities.

  • Black mothers are two to three times more likely than White mothers to die in childbirth or face serious complications.
  • Black infants are more than twice as likely as White babies to die before their first birthday or be born at a low birthweight, which can have long-term impact on a child’s health, development, and learning.
  • Birth outcomes for Latinx mothers and babies are not as good as for their White counterparts but are far better than for Black women and infants. 
Source: MDHHS Vital Records & Statistics.

Across the United States, Michigan, and Kent County, those disparities have been normal for decades. Overall infant mortality has declined significantly, including for Black babies, but the disparity has persisted. 

“The disparities can be traced back to racism – institutional racism, not having adequate housing, not having safe neighborhoods for families, Black women not trusting or being trusted by health care institutions,” explained Marissa Brown, Fetal Infant Mortality Review coordinator at the Kent County Health Department. 

The Fetal Infant Mortality Review (FIMR) program is funded by the Ready by Five Early Childhood Millage and has two primary functions: study local deaths in childbirth and infancy to understand the causes and make recommendations and provide community education to prevent more deaths.

Brown believes that requires a combination of programmatic or “downstream” approaches that support women of childbearing age and families with young children as well as “upstream” solutions to address the social and environmental conditions that impact health and wellbeing, known as the social determinants of health

The increased risks for Black women cut across all income and education levels. High-profile moms ­like tennis star Serena Williams and Olympic gold medalist Allyson Felix have shared the stories of their life-threatening experiences. Felix is part of a campaign from the Centers for Disease Control and Prevention called “Hear Her”, aimed at raising awareness of the warning signs for complications during and after pregnancy and improving communication between women and their healthcare providers. 

“It’s an upstream approach to have more education on health disparities so providers and government officials can understand it to decrease some of the stigma and racism,” Brown said.

While pushing for long-lasting systemic change, the Kent County community is also investing in direct services and support that improve outcomes for women, their partners, and their babies. One such approach is a community-based doula program serving women of color, particularly U.S.-born Black women – the population most at risk of pregnancy and birth complications.

“Doulas provide support by centering women and birthing families, making sure they feel seen and heard,” Kiara Baskin, program manager of Day One Doula Collective, explained. “Our hallmark is to provide continuity of care, where we are the bridge between clinical and community care.”

That continuity of care starts in pregnancy and continues through childbirth and early infancy. Doulas provide information, education, emotional support, and physical comfort every step of the way. 

Day One Doula Collective, which is housed within the Baxter Community Center, was developed through a collaborative effort, led by KConnect, focused on birth equity. The two-strategy, system-level response connects expectant women of color with doula services, prioritizing women who may be at risk of having a baby born at a low birth weight.

The second strategy equips a cohort of women of color in Kent County with the skills and certifications needed to achieve a career as a doula and earn a sustaining wage. Nine women have graduated from the collective’s 18-week training program.

Day One Doula is currently grant-funded, with no cost to clients. Baskin is part of a statewide group advocating for Medicaid and private insurance to cover the costs of doulas. 

“Everyone has a mother, and our mothers are our first homes. We must take care of them. One way to do that is to prioritize women and families, making sure everyone has access to the services they need, and doulas are an important part of that.” 

A combination of programs and policies that support women and their families and community-wide work to address systemic racism and the social conditions that impact health is necessary to change our current normal, which has never been enough for moms, their babies, and our community. 

Additional resources:

Read the Kent County Health Equity Assessment, which includes information about maternal health and birth outcomes.

Read Michigan’s Mother Infant Health & Equity Improvement Plan from the Michigan Department of Health and Human Services.

Learn more about Day One Doula Collective.