Expecting Justice wants every birth to be a healthy birth within San Francisco’s Black and Pacific Islander (PI) populations by the year 2030 and that providers, public health professionals, and institutional leaders who interact with pregnant women have a shared understanding of and sense of responsibility to address racism and racial health disparities.
Strategic Focus Areas
Expecting Justice has three strategic focus areas that complement one another to address key dimensions of vulnerability faced by Black and PI women and people during pregnancy and childbirth: interpersonal and institutional racism in the healthcare and public health systems, plus structural racism manifested as the racial wealth gap. Based on deep engagement with community members and other stakeholders, we believe this combined approach is imperative to ensure safe and healthy childbirth for Black and PI mothers in our city.
Pregnancy Income Supplement
In 2021, Expecting Justice launched the first pregnancy income supplement in the United States to reach 150 low-income Black and PI pregnant women and birthing people in San Francisco. The innovative initiative aims to distribute a monthly stipend of $1,000 per month for the duration of a person’s pregnancy and then for the first six months of the baby’s life. If we are able to produce promising results with this intervention, Expecting Justice will pursue a modification in California Earned Income Tax Credit policy to ensure this benefit is available to all California pregnant people in perpetuity.
Abundant Birth Project
In the United States, racial disparities in birth outcomes continue to persist with income inequality being one of the key contributors. Structural interventions that reduce the racial wealth gap are urgently needed and have the promise to narrow long-standing inequities. In a community-academic partnership, Expecting Justice is proposing to pilot the first pregnancy income supplement program in the US which we are calling the Abundant Birth Project (ABP). ABP will provide unconditional cash supplements to Black and Pacific Islander mothers as a strategy to reduce preterm birth and improve economic outcomes for our communities. ABP presents an opportunity to transform San Francisco into a city where all children have a healthy start in life. For more information about the Abundant Birth Project, click here.
Since 2018, Expecting Justice has provided Anti-racism education for San Francisco’s school district, hospitals and clinics, and social service providers. Through trainings, seminars, and skills-building workshops, Expecting Justice helps participants develop awareness to recognize the impact of racism within their institution, self-efficacy to engage in transformative racial dialogue, and accountability to cultivate a sense of responsibility to address racism within their sphere of influence. These individual efforts culminate into shifts in organizational culture and ultimately in policies that lift up Black and Pacific Islander communities.
Expecting Justice designed the Race Equity 101 Toolkit to be used as a menu of tools to integrate racial equity into your existing practices. The tools in this document are organized by Government Alliance on Race and Equity’s “Normalize, Organize, Operationalize” framework from GARE and Race Forward’s” Actions to Advance racial Equity”. We recognize that change can take time, and often needs to be incremental. We also recognize that we need to operate with a sense of urgency and start somewhere. Each tool in this document can be applied to ongoing work in government agencies; we all need to self-reflect, cultivate our workforce, develop communication skills, improve quality of services, and hire or engage with HR. if we cannot apply a racial equity lens in these everyday activities, when do we start prioritizing racial equity? This work starts here, and it starts now.
For the past 2 years, our team has been developing and piloting anti-racist trainings and tools tailored for providers, public health administrators, and institutional leaders. Our trainings were met with enthusiasm, but due to our small staff size, we cannot be available to train everybody.
As we look to create an online resource to help us scale, we recognized that most online racism trainings offered at workplaces are framed as “implicit bias” and do not address structural issues. These online modules are cold, unengaging, and do not show people how to practice being anti-racist.
Expecting Justice is expanding the reach and impact of our race equity training initiative, Health Equity and Anti-Racism Training Up San Francisco (HEART Up SF), to increase racial sensitivity among providers, public health professionals, and institutional leaders who interact with pregnant people. HEART Up SF will help participants develop an understanding that racism is at the root of health disparities, increase self-efficacy to engage in racial dialogue, and cultivate a sense of responsibility to address racism and racial health disparities. These individual efforts will culminate into shifts in organizational culture and ultimately in policies that lift up Black and Pacific Islander communities.
In 2018, Expecting Justice partnered with SisterWeb, the SF Dept of Public Health, and Supervisor Malia Cohen to launch a community doula program. Each year, the program provides 75 Black and Pacific Islander mothers in SF with culturally concordant doula care at no cost. These doulas are specially trained to support mothers facing discrimination and medical racism during pregnancy, birth, and postnatally. Expecting Justice is also helping to lead a statewide coalition that is advancing legislation that would require Medi-Cal to cover doula care in California. If we are successful low-income women up and down the state can have the protection and comfort of a community doula when giving birth.
In 2021, Expecting Justice launched a FREE full spectrum Birth Doula Training for Black, Latine, and Pacific Islander identified community members in San Francisco. Research has proven that community doulas improve birth outcomes for Black and other mamas and babies of color.
Expecting Justice is partnering with the San Francisco Department of Public Health to train 30 new Black Certified Lactation Education Specialists (CLES).
Applications for our 2022 CLES training are now closed. Please stay tuned for future cohorts!