Alliance Webinar with Black Mamas Matter Alliance on Reproductive Justice and Early Childhood Advocacy

Jacy Montoya Price, Alliance’s Senior Director of Policy and Issue Campaigns, opened the webinar by sharing information about the Alliance for Early Success and the ways that maternal health fits within the Alliance Theory of Change. To reach the Alliance vision that every child in every state has what they need to reach their full potential, the Alliance works with its partners to create a powerful, diverse and durable constituency for early childhood. Collaboration with the reproductive justice movement helps to create this sustainable base of power.  

About BMMA

Stephanie Aristide, Policy & Advocacy Associate, and Phoebe Wescott, Senior Manager for Training and Technical Assistance, with Black Mamas Matter Alliance introduced themselves and Black Mamas Matter Alliance. BMMA is a Black women-led cross-sectoral alliance that centers Black mamas and birthing people to advocate, drive research, build power, and shift culture for Black maternal health, rights, and justice. BMMA uses a human rights framework to ensure that all Black mamas have the rights, respect, and resources to thrive before, during, and after pregnancy. Their work includes changing policy, cultivating research, advancing care for Black women, and shifting culture. ­­­­

Birth and Reproductive Justice

The reproductive and birth justice movements and BMMA were developed within the historical context of racial prejudice in America and the policing of Black women’s bodies and reproductive decisions. Slavery, medical experimentation, public policies that excluded Black midwives, coerced and forced sterilization, and more have created the disparities that persist. Understanding and acknowledging this history is an essential foundation for systems change to reduce inequities. Birth justice comes from Black women-led activist movements fighting against inequitable and unjust birthing practices, policies, and experiences, in particular during the perinatal period. BMMA believes:

• • Birth justice acknowledges that all individuals have the human right to birth and create families.
  • Birth justice emphasizes the importance of access to holistic and culturally centered healthcare during the childbearing years and throughout the pregnancy spectrum.
  • Birth justice embraces an individual’s right to make all decisions regarding pregnancy.
  • Birth justice respects an individual’s decision to breastfeed and access breastfeeding and lactation support.

Reproductive justice refers to the intersectionality between reproductive rights and social justice. Reproductive justice is the human right to maintain bodily autonomy, have children, not have children, and to parent in safe and sustainable communities. Reproductive justice integrates reproductive rights and social justice by addressing the impact of oppression on one’s reproductive health outcomes. 

Current Issues

The maternal and early childhood health landscape in the United States reflects a complex combination of policy, health outcomes and legislative actions under the current political administration. Attacks at the national level on social support programs directly impact the health and wellbeing of young children and their families.  

Community-based organizations have been at the forefront of advocating for reproductive justice and addressing systemic inequities. Early childhood and reproductive justice advocates are increasingly collaborating to promote environments where parents can nurture their children safely and healthily. The reproductive justice framework addresses the socio-economic and political power necessary for individuals to make informed decisions. The evolving political climate and threats to federal programs and funding raise significant concerns among advocates. Collaborative advocacy efforts offer pathways to overcome these barriers and support to empower families.

Maternal and infant mortality are impacted by structural and social determinants of health. Jessica Roach of Restoring Our Own Through Transformation (ROOTT) developed the Web of Causation to depict the intersection of structural determinants, like slavery and Jim Crow, with social determinants, like food stability and housing. Unlike for white women, income and education are not protective factors for Black birthing women, which emphasizes the ongoing impact of racism and structural determinants on health outcomes.   

Maternal and Infant Data Trends

Black birthing people and their babies continue to be impacted by health disparities that result from systemic racism. Though maternal mortality rates recently decreased for white, Latina, and Asian women in the United States, the rates for Black women and birthing people have not improved. Current health policies do not address the roots of health inequity and, in fact, can compound them. Infant mortality rates increased by 3 percent between 2021 and 2022. Rates range from 3.32 in states like Massachusetts to 9.11 in states like Mississippi. Southeastern states are especially impacted by infant mortality and preterm birth. Access to prenatal care can be facilitated or hindered by state policies, particularly for low-income individuals, marginalized communities, and those living in rural areas. State policies also impact food security and the extent to which families can access programs like WIC and SNAP.

Overview of State and Federal Policies   

The BMMA team highlighted a handful of federal and state policies that impact infant and maternal health. Paid family leave, which enables new parents to take compensated time away from work to care for their newborn, ranges from state to state and employer to employer. Currently, 13 states and D.C. have mandatory paid family leave and nine have voluntary programs through private insurance. Parental leave is a vital program to support the health and wellbeing of families in the perinatal period. Comprehensive reform is needed to ensure that all new parents can access paid family leave regardless of their income, gender, where they live or who employs them. 

Medicaid expansion from 60-days to 12-months postpartum is another key policy impacting maternal and infant health. The expansion helps postpartum people access the care they need to address pregnancy-related complications and chronic conditions. Forty-nine states have adopted the 12-month expansion.

Pregnancy and parental criminalization refers to policies and practices where individuals, and particularly women, face legal penalties or state intervention due to their pregnancy decisions or actions as a parent. In the 1990s, laws passed under the Clinton administration led to the increased criminalization of pregnancy and parenting for birthing people and their families, including termination of parental rights for parents whose children are in the family regulation system. Family policing violates children’s rights, parents’ right to raise children in safe and healthy communities, and the right to bodily autonomy.

In 2023, Pregnancy Justice reported that nation-wide nearly 1,400 people were arrested or subject to disparate sentencing, bail or probation due to pregnancy decisions from 2005 to June 2022, when the Supreme Court dismantled abortion rights. Since 2022, there has been a significant increase in the number of people being charged for crimes tied to pregnancy in Alabama, South Carolina, Tennessee, Oklahoma and Mississippi. These states are also among the 11 states with the highest infant mortality rates.  

Key Policy Recommendations

BMMA’s work and advocacy were instrumental in creation of the Black Maternal

Health Caucus, led by Reps. Alma Adams and Lauren Underwood. The Black Maternal Health Caucus has introduced The Momnibus Act, a set of 13 bills that will improve maternal health for all birthing people in the United States. Since 2023, the Caucus has enacted over $200 million in Momnibus funding through the federal appropriations process. 

In April 2023, BMMA published “Black Mamas Matter: In Policy and Practice,” which articulates frameworks and a policy vision for the Black maternal health, rights and justice movement. The policy agenda includes the overarching issues of:

1. 1. Structural and social determinant of Black maternal health
   2. Full spectrum maternal, sexual, and reproductive health
   3. Black maternal, reproductive, and perinatal workforce development
   4. Criminalization of Black women, birthing people and families
   5. Research and data transformation
   6. Black women and birthing people’s leadership

Some of BMMA’s recommendations to reform current legislation include:

• • Safety net and wrap-around services
    • Provide sustainable grants to Black-led and -centered community based organizations that deliver wraparound services, navigation, direct financial assistance, child care and resources like healthy food, clean water, infant formula, and diapers to postpartum families
    • Permanently expand the Child Tax Credit to establish a universal child allowance
    • Extend postpartum eligibility for the Special Supplemental Nutrition program for Women, Infants, and Children (WIC) to 24 months
  • Criminalization of Black women, birthing people, and families
    • End mandatory reporting and increase the capacity of health systems to connect patients with non-carceral resources and services
    • Repeal the Child Abuse Prevention Treatment Act (CAPTA), in particular the plan of safe care provisions, which has incentivized hospitals to report to Child Protective Service agents
    • Protect young people in family regulation, criminal legal, and other systems from violence, coercion, and shame and support their sexual, reproductive, and maternal health autonomy and freedom

Black Mamas Matter Alliance also provided recommendations of practical steps for systemic change.

• • Legislative Action
    • Funding for Black Maternal Health: work with policymakers to allocate funding to community-led initiatives addressing racial disparities in birth outcomes (e.g. Black Maternal Health Momnibus Act)
    • Paid Family Leave Policies: push for the implantation of state and federal laws that provide paid parental leave to support maternal and infant health
  • Coalition Building
    • Parent Advocacy Networks: form community groups where parents can share experiences, push for local policy change, and support each other
    • Birth and early childhood justice coalitions: partner with housing, food security, and racial justice organizations to address social determinants of health
  • Community-Led Education
    • Birthing justice workshops: partner with local hospitals, health departments, and birth workers to educate expectant parents about their birth rights, options, and risks of medical racism
    • Early childhood development education: host community classes on nutrition, breastfeeding, and early learning strategies to equip parents with knowledge

Action for Systemic Change

To encourage webinar attendees to identify actions for systemic change, Stephanie and Phoebe set up breakout room discussions. Within the breakout rooms based on role in the early childhood space, attendees were asked to:

1. 1. Identify ONE current issue, you are experiencing in your arena. If you had the power to change ONE thing in the system, what would it be? Why?  
   2. With that issue in mind, discuss these questions:  How can you push the needle forward with decision-makers in your community? How can you engage with impacted communities? How do you begin implementing changes in their systems?

 In the report back, educators shared that the change they want to see is increased access to breastfeeding, including breastfeeding education, as a strategy to promote infant health. They would also like to see increased access to holistic care in the perinatal period, especially those not typically covered by health insurance, including lactation consultants.

To close the webinar, Stephanie and Phoebe shared key takeaways. They reminded attendees that birth and reproductive justice extend beyond abortion rights to include the prenatal-to-three age group and creation of safe, supportive communities for parents to raise their children. Ending health inequities affecting Black women, babies and children, which were created by systemic racism, requires advocates to ask themselves, “How are we responding through policy and advocacy?” Finally, Black-led organizations and Black women must have a seat at the table in policymaking to break down barriers and achieve reproductive justice, influencing essential policies like paid family leave, postpartum Medicaid expansion, and preventing parental criminalization.    

Resources

Black Mamas Matter Alliance, Inc. – https://blackmamasmatter.org/

Definition of Reproductive Justice – https://www.sistersong.net/reproductive-justice

Battling Over Birth: Black Women and the Maternal Healthcare Crisis in California – https://www.blackwomenbirthingjustice.com/bob-report

Web of Causation – https://www.roottrj.org/web-causation

Black Maternal Health Week, April 11-17 – https://blackmamasmatter.org/bmhw25/

BMMA Policy Agenda – https://blackmamasmatter.org/wp-content/uploads/2023/04/0411_BMMA_PolicyAgenda_v5.pdf

Black Maternal Health Caucus – https://blackmaternalhealthcaucus-underwood.house.gov/

Children Thrive Action Network – resource for advocates dedicated to defending and supporting children in immigrant families in the U.S. – https://www.clasp.org/publications/fact-sheet/children-thrive-action-network-ctan-one-pager/

Centering the Experiences of Black Mamas in the Workplace – https://www.abetterbalance.org/wp-content/uploads/2022/03/BMMA-ABB-Final-Report-Web-1.pdf