OneRouge Community Check-In - Week 114

Week #114

The focus of the conversation is a continuation on our 9 Drivers of Poverty series on Maternal Health & Teen Pregnancy with a focus on "The Medical Divide: Gaps In Care Leaves Gaps in Families "with featured speakers:

• Robin Gruenfeld (Director of Collective Impact, March of Dimes)

• Deneen Robinson (Director of Religions Policy Strategy, National Birth Equity Collaborative)

Enlight, Unite, & Ignite!

Quick Links: Notes, Community Announcements

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Speaker Notes

Robin Gruenfeld (Director of Collective Impact, March of Dimes)

Rev. Deneen Robinson (Director of Religions Policy Strategy, National Birth Equity Collaborative)

This month we are doing a program talking about maternal mental health for those who are experiencing maternal mortality. There are two things that come to mind for me. We don’t really understand the connection between access to comprehensive reproductive health care and infant mortality. When it comes to legislation, especially in the south, while folks care about mothers not dying, they’re also not sure. In situations where the mother is at risk, the baby is also at risk. If we’re not dealing with the structural issues, then these things are going to continue in this country.

What do we mean when we say the words infant mortality and why are the numbers in Louisiana not changing in any meaningful way?

Robin Gruenfeld - The numbers have not changed in 10 years. In our most recent ranking, we’re second highest in the nation for infant mortality rate. Infant mortality is death within the first year of life. Death is happening in the first 27 days. Top causes are extreme low birth weight, sleep death, and congenital anomalies. Nearly half of those deaths are from extreme prematurity. And that’s why we’re seeing it in the first 27 days. We have to talk about mom’s health. Infections, diabetes, and other infections due to mother’s health are resulting in births that are too soon. When we disaggregate - black infants are more than twice as likely to die as their white counterparts. We can’t have a conversation about babies without having a conversation about the health of Black families.

If Black babies are at higher risk, what can we do?

Rev. Deneen Robinson - I believe that it can get better. The question is not whether it can, but are we willing to do as a society what it needs to get better. Those of us doing the work are both part of the problem and the solution. We have to have conversations about how racism shows up in our work and as people. We have to have conversations about whether or not we want to have true equity when it comes to distribution of power and are we willing to own what’s happening in the world right now as it relates to policy and forcing folk to remain pregnant. We have to push back against the idea that fear is really driving how everyone is showing up and unfortunately fear causes people to make decisions that are harmful to the least of these, which is not just the babies. You also have to talk about and be willing to be real about the laws that are being passed in our nation and the decisions that have been made, none of which support a healthy family. If we don’t have a healthy environment, none of us are going to be able to survive. IT is a hostile environment when the parent has to go through all these barriers to get to care. If I don’t have transportation, if I don’t have paid sick leave, if I don’t have the ability to respond to my own health issues, how can I parent? How can I create a safe and loving environment for this person brought into the world. If we as a society can’t provide that, then why are we forcing people to do that.

Can you share the connection between anti-aborition and white procreation?

Rev. Deneen Robinson - In doing my own research to understand why we got here I found a book called Birth Dearth, in which they lay out the strategy they are proposing. The number of white men in our country has gotten to being low and it’s impossible for them to be the majority as it stands right now. The three pronged strategy was to incentivise folks to have children. They would make Black and Brown the working poor. Northern Europeans don’t want to come here. The people who want to come are Black and Brown and poor people. The only option was to take away abortion access. Understanding that it was a risk, but that they would get white babies out of it. We end up perpetuating harm on people. They hope the harm will be Black and Brown folk.

Are there Brown numbers and where do they fall when we’re talking about forced birthing? How does this work for those that are neither one or the other?

Robin Gruenfeld - The first thing I know is that for Latin X families. Brown is not monolithic. When we say Brown, I’m going to start with Latin X. The first thing I want to point out is that Latin X falls between white and Black on the prematurity measures. For native populations we have a maternal health crisis. It depends on who we are talking about. In southeast Louisiana we don’t have a huge population of native folks but we do have a growing population of Latin X folks. As the population is growing, the prematurity rate is growing faster. What we’re saying is that as people are living in the country, when they first move here, they have normal birth weight, and then the longer they live in America the worse they get. The longer they experience racism in America, the worse the outcomes.

From what I've heard, medical textbooks and training are still centering around white cis people. Is that changing? Are we making moves towards understanding/believing women's cues for pain? Or how to assess physical symptoms without racial bias?

Rev. Deneen Robinson - No.

Robin Gruenfeld - We only started aggregating data by race at the CDC starting in 2017. If you don’t disaggregate, you can’t see it.

Can anyone talk about the connection between healthy food access and pregnancy issues, like pre-eclampsia?

Robin Gruenfeld - Modern medicine has diminishing returns. There is no pill as good as handwashing at diminishing disease. What we really need to do is dismantle racism. 53% of pregnancies in Louisiana were unintended. Those are people who just got pregnant. Intention is huge. When we’re talking about mom’s health, we’re talking about stress, not going to the doctor, etc. The big thing is when it comes to healthy food - the disparities of prenatal care doesn’t explain anything about the disparity. Access to prenatal care is great, but it’s almost too late. We have to talk about adequate transportation systems, we have to talk about reducing barriers to healthcare access.

Please speak to the impact of environmental racism on healthy births. Black people are not cellularly deficient and not creating these issues by eating fried chicken, help me understand how these environmental injustices are tied to infant morality and maternal risks?

Robin Gruenfeld - My background is in environmental health. A lot of time people think about toxic when they think about environmental health. In Louisiana we have cancer alley, but when we talk about the environment we have to talk about other factors. Is your neighborhood bounded by two sides with a railroad track? Do you feel safe taking a walk in your neighborhood? These things contribute very much to the wellbeing of Black families.

Rev. Deneen Robinson - When we talk about the environment we have to talk about the climate, access to food, access to transportation, and the home and the situation the family has to live in. Is there gun violence? Is there lots of crime? Do they have refrigerators? Is there green space? Can you walk in your neighborhood? Do you feel safe? There are so many things that are tied together. It is the way that the lack of these things cause stress in the body. Cardiovascular related issues. Intra Family violence. It is a compounding series of traumas that get us to this place. And racism as the underbelly unfortunately sets the family up for a challenging situation.

Are there state programs?

Rev. Deneen Robinson - There are programs that the state offers to support families as it relates to supporting the mom as they engage in parenting. Planned parent provides nursing support for 2 years after the baby is born, which sets the framework for the success of the parent and a healthy baby. There are programs that offer care items that the person may need. But unfortunately because the crisis pregnancy centers receive the same money.

Robin Gruenfeld - Prenatal quality collaborative is working to reduce the maternal and infant mortality in Louisiana. They are working clinically primarily. We also have at AIM that are focused on the postpartum period, which is very dangerous for mom. If any of you have a postpartum mom, please encourage her to go to the doctor. Those are warning signs that don’t go away. HEAR HER CDC Campaign: https://www.cdc.gov/hearher/index.html

https://www.marchofdimes.org/research/maternity-care-deserts-report.aspx

Criminalizing childhood deaths in children of color when that isn’t the same in white parents. We have a subpar prenatal care system in the carceral systems. How is this side impacting the health of babies.

Rev. Deneen Robinson - We are actually working and watching policy as it relates to prenatal care. We use a reproductive justice framework. IT’s not just one thing. The situation you shared regarding doctors in a carceral environments, I didn’t know that so I’m going to have to go do some work on that. I do know that one of the things we’ve been actively doing across the south is that while folk are incarcerated they are able to be on medical wards and they don’t have to be shackled while accessing care, including giving birth.

Robin Gruenfeld - March of Dimes tries to stay out of abortion. When we start talking about the carceral system, that’s different. The first Black leader of March of Dimes is starting to look in places that it hasn’t looked before. The conversation is shifting, but I don’t think fast enough for the women who are currently incarcerated.

We have not seen black fetuses and black drawings until the last year. Representation matters.

Rev. Deneen Robinson - It does matter. When not everything in your life is measured by the color of your skin, it doesn’t make an impact. That is why representation matters.

Sherreta Harrison - I’d like to lift up that the first time I hadn’t seen a Black baby in utero was in 2021. How is it that I had never seen it and that it never occurred to me that I needed to see it. It is just a reminder how stitched racism is. We’re all fighting the good fight but we have to remember that we have specific biases and blinders. Even seeing the pictures reminded me how ingrained whiteness and white supremacy is in our culture. It doesn’t miss any system or any culture.

Rev Anderson - Inaccessibility to prenatal care for high risk families and the intersection of that to transportation. We don’t have a comprehensive public transit system. A lot of places where people live, Uber and Lift will not go.

There was a study that shows the link between transportation and infant mortality. It looked at the impact of transportation issues.

March of Dimes did a report on maternity care deserts. We took a look at the parishes that have fewer than two birthing hospitals and 60 providers per area. March of Dimes also released a paper about how prenatal care is late. When we looked at 33 causes of disparity, we saw limited connection with most. Racism becomes a wallpaper in our lives, we just don’t see it.

https://www.marchofdimes.org/research/maternity-care-deserts-report.aspx

Liz Sheppard - Check out the JJ Way. At her clinic there’s no judgment. There’s nothing but support. How racism harms pregnant women -- and what can help - https://www.ted.com/talks/miriam_zoila_perez_how_racism_harms_pregnant_women_and_what_can_help?language=en

Aftershock is a movie released on Hulu on the 18th.

Robin Gruenfeld - We send out action alerts periodically. Please sign up to become a march of dimes advocate! https://www.marchofdimes.org/advocacy/action-center.aspx

https://www.aimcci.org/nhsa-aim-cci-racial-equity-learning-series-rels/ - take a free equity training

Community Announcements

Metromorphosis is celebrating its 10 year Anniversary!

MetroMorphosis is launching the 10 for 10 Community Fund as a part of its 10 Year Celebration. And MM Week is July 12-19

Rev. Anderson - The 988 rollout will happen tomorrow. It is to focus on suicide. To not have police intervention unless it is life threatening. It will give you localized resources. I don’t think a lot of people know about it.

Clean up in Zion city 9-1 - Cadillac street near airport

Next week Thursday, July 21, 9am-3pm, we are doin Family Friendly programming. It is only $5 per person that day. We will be featuring the DCRT organization with a special visit from our LG.