In L.A. County, Black babies die at three times the rate of any other race before their first birthday, and Black women die at four to five times the rate of any other race as a result of complications from pregnancy or childbirth, according to Dr. Melissa Franklin, a Pritzker Children’s Initiative Fellow for First 5 LA.

“Seeing this as an issue within the county, the L.A. County Department of Public Health really took a bold stand by launching an initiative to address this disparity with the frame that the stress and harm of racism and its impact on a Black woman’s body is the root cause, and that’s how we’re going to address it,” Dr. Franklin said. “So if there are interventions, if there’s a response, it’s going to focus on disrupting that stress pathway.”

L.A. County has partnered with First 5 LA to bring together public health officials, mental health professionals, community and philanthropic organizations to change this disparity in the region.

First 5 LA’s mission is to make sure young children enter kindergarten ready to succeed in school and life—hence, the organization's name. The first five years of a child's life are critical for his or her development.

“We really have spent a lot of time on the initiative, sometimes feeling like we’re convincing folks that racism is stressful and it harms us physically, that racism is a bad thing and it’s really prevalent in society,” Dr. Franklin said. “And oftentimes I find it helpful to just describe a day in the life of a Black person or a Black woman. We go out the door and immediately—whether it’s disinvestment in our neighborhoods, or our children being disproportionately suspended and expelled from school, us being looked over for job opportunities, for promotion opportunities, to going to a hospital visit and not being heard or respected—it impacts us. Racism is literally killing us.”

Dr. Franklin hopes that the moment we’re living in after the shootings of George Floyd, Breonna Taylor, Ahmaud Arbery, and others that sparked worldwide protests serves as an “awakening to this injustice… so that we can see real, true, and lasting change.”

At the beginning of the COVID-19 pandemic when hospitals stopped allowing more than one visitor during childbirths, Dr. Franklin said First 5 LA held an all-hands-on-deck meeting to figure out how to support Black mothers.

“Just to think that a Black mother would have to endure a birth by herself in a hospital setting, how traumatic that could be, and how that could result in just a negative outcome and perhaps even death... So we pivoted all of our supports. The doula program that was launched by the L.A. County Department of Public Health began providing support virtually.”

Doulas assist women during the birthing process. They can be at the hospital during the childbirth and also act as advocates for mothers. Since pregnant women can only have one guest with them at the hospital, they have a tough choice to make: Whether to have their partner or their doula by their side.

“Families are making the decision for themselves. Some of them will have a family member present as that one person, and then the doula will support virtually. Others have determined—well, the partner is going to stay at home with other children perhaps or older adults who are in need of care, and the doula goes to the hospital with the family member. So it has been kind of this individual choice,” Dr. Franklin said. “The big learning has been the importance of reaching out to hospitals, finding out about their policies, developing a plan of action, and then engaging their doulas in support of that.”

Dr. Franklin is no stranger to complications during pregnancy and childbirth. Both of her daughters were born prematurely. Her oldest Hannah had heart surgery at just 9-days-old.

“I’ve run into plenty of moms who have had the same birth experience and carry around guilt, and our number one response is: It is not your fault. Many of the women that are involved, Black women that are involved in this movement, have had these same experiences, or worse have lost their babies, or have lost their family members who have died while giving birth. So this is something that we share in common that we really use to encourage Black moms, in particular if they’ve had this experience, to release that guilt. That there is hope, there are things that you can do to support having a healthy and joyous—I say joyous as something I never really thought of related to childbirth—a healthy and joyous birth.”

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