“I have taken trauma and turned it into triumph,” says Brittany “Tru” Kellman, founder of Jamaa Birth Village in Ferguson, Mo. At the age of 13, Kellman found herself in an unfamiliar city, running away from a violent home, and pregnant. At 37 weeks into her pregnancy, a physician decided to induce her labor without explanation. When she got to the hospital, she was further traumatized at the hands of her care providers.
“No one looked me in the eye. No one explained anything. People were coming in and out, sticking their fingers and hands anywhere and everywhere,” she recalls. The only time someone did look her in the eye was after she expressed concern about having an emergency cesarean section. A nurse looked at her and yelled, “Do you want your baby to die? Your baby is going to die if you don’t let us take you back there.”
A few years later, during her second pregnancy, Kellman requested to give birth vaginally, also known as a vaginal birth after cesarean (VBAC). Her physician automatically told her no, saying she was high-risk. Kellman remembers thinking, “This cannot be real. This cannot be the way.”
After a botched c-section, postpartum depression, and a series of unhelpful mental health care providers, she did what many black women exposed to unsupportive and harmful systems do so often—she decided to create her own way.
Now, Kellman is the first black certified professional midwife in the state of Missouri and is in the process of expanding Jamaa Birth Village from a pregnancy resource center to a full-service birthing village that provides well-person care, prenatal and postpartum care, labor and delivery services at home or in the birthing village, and mental health care “for Black folks, by Black folks.” In 2012, Kellman gave birth to her third child vaginally (a VBAC-2) at home with the support of a midwife and two doulas. “That was success for me,” she says.
Success is just as important for Marsha Jones, CEO and co-founder of The Afiya Center, a reproductive justice organization providing HIV/AIDS, abortion, and maternal health programming and services in Dallas. Jones believes black people must define success for themselves, especially because many think we lack the knowledge, expertise, and solutions to the issues of our own communities. “We know what impacts our lives and many times we have the solutions, which may not necessarily look like a medical solution. But we’re not always trusted with the answers,” Jones shares.
The Afiya Center was built by black women for black cis and trans women. According to Jones, that’s what makes it so effective. “We are intrinsically connected to the community we serve. We know what’s going on in the community,” she says. Through its work, The Afiya Center identified the need for higher-quality, community-based maternal health care. Recently, they trained eight doulas through Ancient Song Doula Services to provide care to their clients. Now, they are raising funds to open a birthing center in southern Dallas, where black residents have the least access to necessary care.
For black people, few advancements have come from outside our community.
Depending on others to save us is not a viable option. Kellman puts it plainly: “We cannot take solutions from the same people who strategically planned to kill us when slavery ended.” As awareness about rising maternal mortality rates and racial inequity in maternal health continues to grow, black people must continue to lead on black maternal health with ample financial resources to do so. As the following examples show, black women do have the answers and are making innovative strides in technology, health care, and policy.
Author Kimberly Seals Allers created the Irth app to eliminate bias in maternal and infant health care. Irth (Birth without the B for bias) will allow users to share and read hospital and clinician reviews filtered by identity, creating a mechanism for accountability in healthcare quality. “It is very important to me that Irth is from the community and rooted in the lived experiences of black women and birthing people from other marginalized groups,” says Seals Allers.
“Women deserve a tool that informs their healthcare decision making on the front end and allows us to use our collective experiences to inform and protect each other before we visit the doctor or hospital,” she adds. Her hope is that the app will ultimately be a powerful tool for change.
Black Mothers’ Breastfeeding Association (BMBFA), based in Detroit, was awarded $100,000 in July 2019 to begin developing an app to revolutionize breastfeeding data collection. The app is the brainchild of BMBFA founding executive director, Kiddada Green, who wanted to gather and present data on black breastfeeding in a respectful and non-exploitative way. The app, which will be informed and driven by the stakeholders using it, will help breastfeeding entities across the U.S. stay in touch with families and better track breastfeeding practices.
And in August 2019, BMFBA held their first hackathon in Detroit to innovate both high-tech and low-tech solutions to breastfeeding challenges. “What happens often is that we’re left out of the innovation space, though black people are creators by nature. People have ideas but they don’t have space, place, and time to bring those ideas to life,” Green explains. “When it comes to technology, our voices get lost. With the hackathon, our voices and solutions are amplified.”
Melissa Hanna developed the Mahmee platform to better connect health systems, obstetricians and pediatricians, outpatient care providers, and clients. Mahmee is supported in part by professional tennis player Serena Williams, who publicly shared her near-death postpartum experience. A company press release notes, “Mahmee links mom and baby’s health history and data, proactively engages, checks on and monitors patients through ‘maternity coaches’ and escalates concerns to doctors so that mom and baby’s care plan stays up to date and critical red flags aren’t missed.”
The platform has access options ranging from free for standard services to $200 a month for a comprehensive plan designed for “high-risk or high-need moms and babies.” Mahmee has partnerships with both private and Medicaid-focused health plans, which may help to reach high-risk populations.
Kay Matthews founded Shades of Blue Project—an organization that helps women before, during and after childbirth with mental health advocacy, treatment and support based in Houston—after delivering her daughter stillborn and living months without getting the support she needed. Eight months after the loss of her daughter in 2013, her general physician, a white man, was the person to finally listen to her and recommend a support group.
But the group was full of white women and Matthews didn’t identify with anyone in the room. “Their issues were valid but their issues were not my issues,” Matthews says. “We’ve got to come up with our own plan.” Matthews recalls not being able to fully grieve her loss until two years later. “Loss is a loss of friendships, relationships, finances. It included a lot of loss beyond this baby. Everyone was concerned about the baby, but the baby is not here. Something is wrong with Kay. I couldn’t get people to understand that something was mentally not there. All of that didn’t allow me to grieve. I was struggling with who I was. I was just existing, not living,” she shares.
Eventually, she asked herself how she could do more than just exist. The answer was giving back to her community with baby showers for young mothers. Matthews soon realized that the mothers most valued dialoguing with her on a regular basis.
“Shades of Blue Project was me telling my story and exposing myself. It was difficult, but I had prepared myself for whatever happens happens,” Matthews says. “It is all about awareness. I had all these things I was carrying and nobody could see them. Awareness comes from someone seeing someone else do something, and it gives them the courage to do it.”
Most recently, with encouragement from her mom who had also experienced an infant loss, Matthews founded and implemented Black Maternal Mental Health Week to increase awareness of maternal mental health issues affecting black moms. The week will take place again in July 2020.
Midwives Jamarah Amani and Haguerenesh Woldeyohannes founded the National Black Midwives Alliance (NBMA) in 2018 with a goal of having a “representative voice at the national level that clearly outlines and supports the various needs and interests of Black midwives.” NBMA seeks to increase the number of and access to black midwives, raise public awareness that black midwives exist, support legislative efforts led by black midwives, and enhance the black midwifery pipeline through educational pathways, mentorship, and scholarships. NMBA launched their Black Midwife Mentor Project in early 2019 to help student midwives connect with mentors or preceptors.
In April 2019, Representatives Alma Adams (D-NC) and Lauren Underwood (D-IL) launched the Congressional Black Maternal Health Caucus, a coalition of members of Congress dedicated to improving Black maternal health, and raising awareness of and addressing the disparate rates of maternal death affecting the black community. In July 2019, the Caucus held its first summit, where members heard from over 30 stakeholders. Currently, the Caucus is working to develop a comprehensive suite of legislation that could be introduced next spring.
At the state level, Maryland Delegate Jheanelle Wilkins, who represents Takoma Park and Silver Spring, has introduced legislation that requires that the state collect and report race-specific data on maternal mortality. It also ensures that community stakeholders are involved in generating solutions. Delegate Wilkins, who has an advocacy and organizing background, was motivated to take action after a friend posted an article about black maternal health on Facebook and asked, “What are my elected officials going to do about this?”
“Prior to the bill I introduced, the state of Maryland had not touched the issue of maternal death for about 10 years. It’s such a big issue but we hadn’t legislated on it,” Wilkins says. “Even as a woman who has not given birth, I try to make sure that I am making space for women who have, that they are leading me on next steps. I help make sure that people who are impacted—who understand the issue and nuances—are the ones at the table.”
Delegate Wilkins isn’t alone in moving policy at the state level. Earlier in 2019, Georgia State Representative Renitta Shannon, who represents Decatur, introduced a bill to expand access to Medicaid for new mothers for up to a year postpartum.
When will the U.S. save black mothers from dying? Never, without us. To be sure, improving black maternal and infant health care and outcomes requires everyone’s participation. We need white people to work on dismantling racism, eliminating biased behaviors, and becoming better allies. But black women who are experts in our communities and have lived experiences should lead with full resources and support.
Marsha Jones believes in the power of black women but wonders who else does. “If funders care that black folks survive and thrive, they would put their money where their mouth is,” she asserts. “Truly, if we’re going to win this, we have to be all the way in. We’ve got to prioritize black lives and black people. That’s how we win.”
Elizabeth Dawes Gay, MPH is a strategist, advocate, communicator, and convener who turns evidence into social impact for women of color.