Toward a New Narrative of Black Women, Birthing and Prematurity by Monica McLemore

On November 17, 2015, World Prematurity Day, a landmark initiative was launched at the University of California, San Francisco, the UCSF Preterm Birth Initiative (PTBi). Worldwide 1 in 9 babies are born too soon (prematurely) and Black babies are most likely to not reach their first birthday. Black and Hispanic women are three times and two times more likely than White women to experience a preterm birth respectively and together account for 29.3% of all preterm births in the United States. Poor birth outcomes for Black women have been well documented and this initiative hopes to finally move the needle on this persistent epidemic.

A large part of ameliorating the health related disparities that contribute to prematurity is ensuring quality care across the lifespan for Black birthing women. Historically, midwives and doulas have been an essential component of care for Black women and these traditional birthing practices have been replaced by technology and interventions in birth that contribute to some of these poor outcomes.

My research team and I were presented with an incredible funding opportunity, namely to provide a community based doula training for FREE with only one catch; a proportion of our participants would need to have some experience with the criminal justice system. We made a conscious decision to partner with the Birth Justice Project and Black Women Birthing Justice in the summer of 2014 to develop a woman of color, community based doula training to provide these traditional skills to women of color and to provide doula support to women who need it most – poor women who are least likely to be able to afford a doula.

The response to our training was incredible and we were honored to enroll 16 women in our program some with experiences of incarceration, some without, but all who deeply wanted to serve birthing women and provide support to them and their families. In total, our doulas served over 60 families and continue to provide this vital service across the Bay Area.

In addition to our doula training, our team expanded the health education classes we were conducting in San Francisco and have now been providing them at Santa Rita Jail in Dublin, CA. In this work, the partnership between UCSF, the Birth Justice Project and Black Women Birthing Justice is called the East Bay Community Birth Support Project and we are still taking referrals and support pregnant women.

We can be contacted at: and please consider making a donation so that we can continue our part of this important work – providing culturally appropriate and competent traditional childbirth care that is centered in the power and majesty of birthing women.

Dr. Monica R. McLemore Ph.D. MPH, RN is an Assistant Professor in the Family Health Care Nursing Department at the University of California, San Francisco School of Nursing and a clinician-scientist at Advancing New Standards in Reproductive Health, a program of the Bixby Center for Global Reproductive Health, also at UCSF.

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