The state of Black maternal health in the Bay Area

April is National Minority Health Month, and each year, one week is dedicated to education and awareness around Black maternal health.

Driving the news: San Francisco is home to some of the country's most sought-after physicians and medical establishments, but when it comes to maternal deaths, racial inequities remain.

State of play: Black women in the United States die at rates three times higher than white women.

• San Francisco's overall maternal mortality rate has been lower than the national figure, but the disproportionate impact on Black women is just as prevalent.
• Between 2007 and 2016, Black mothers had four out of 100 births but made up half of all maternal deaths in the city, according to a report by the San Francisco Health Improvement Partnership.

Between the lines: Systemic racism like redlining and segregation have long determined the kind of care a Black patient gets.

• Black women in particular often have less access to resources like prenatal care due to income inequality.
• Discrimination also remains a pervasive source of anxiety for Black women, who often have to fight false beliefs about race-based biological differences, assumptions about drug use, and doctors' refusal to recognize their symptoms.
• Compared to other racial groups, Black women in San Francisco County are more likely to report worries about experiencing racism or being treated differently because of their race.

What they're saying: When Black women are asked what they envision as their perfect doctor, many respond that they "just want to be treated like a human being," Linda Jones, a doula and co-founder of the Bay Area-based collective Black Women Birthing Justice, told Axios.

• "In the past and even now, Black women who speak up for themselves get labeled noncompliant or angry," she said. "But we have to teach people how to work within the system ... and help them understand how they're supposed to be treated."

What to watch: The conversation around how to better serve pregnant Black people is starting to shift to center on the need for safety and security.

• San Francisco is piloting a program to provide a monthly income supplement of $1,000 to roughly 150 Black and Pacific Islander participants throughout pregnancy and their baby's first six months.
• At the onset of the pandemic, the volunteer-run group One Love Black Community began delivering boxes of diapers, fresh produce, and other necessities to expecting and new Black parents.
• Meanwhile, more Black women are turning to doulas who can serve as trusted advisers in hospital settings, or other forms of non-clinical care like home births.

The bottom line: To address longstanding racial inequities, the U.S. will need to focus on "the ways in which our society is structured around racism that makes Black mothers vulnerable to adverse health outcomes," epidemiologist Shawnita Sealy-Jefferson warned in a 2022 study.