Hennepin County is working with many partners to address the maternal health disparities that Black and American Indian people face. Through this work the Birth Justice Collaborative was created. The collaborative is made of members, providers, and organizations involved in Black and American Indian maternal health. Their work has been to create a Birth Justice Strategic plan that Hennepin County will use as a guide in addressing and advancing Black and Indigenous maternal health.
Solutions that are driven and led by the community are effective and sustainable. The communities most affected by the disparities are the ones who know what will heal them.
Black and Indigenous maternal health
“I felt like I wasn’t listened to...” while being in the hospital for eight days while giving birth, says Ashley Johnson, Maternal Health and Child Systems manager for Hennepin County Public Health, and Black mother. “I would have my husband, who’s White, speak up and say the exact same things... and they would listen.”
This story is unfortunately far too common for Black and American Indian people who give birth. Maternal health care is an important and critical component of having a healthy community. However, due to current and historical racism, Black and American Indian communities experience far worse maternal health outcomes compared to White people.
“While we have this great health care system in Minnesota, it doesn’t work as well for Black folks and Indigenous folks, for people of color...” says Makeda Zulu, executive director of Robert J. Jones Urban Research and Outreach-Engagement Center, “And that’s dangerous.”In Minnesota, 13% of the birthing population is Black and 2% is American Indian, yet they represent 23% and 8% of maternal deaths in our state, respectively (Minnesota Maternal Mortality Report 2018).
A movement is building to address this. Black and Indigenous people have been working to create better outcomes for decades, and in 2021 Hennepin County used pandemic response funds to join the movement. These funds are being used to advance maternal health and we've partnered with Black and American Indian community members to lead a path forward.
To create solutions that make progress and work to heal the disparities for Black and Indigenous maternal health, Hennepin County turned to the community. Solutions that are driven and led by the community are effective and sustainable. The communities most affected by the disparities are the ones who know what will heal them.
This is how the Birth Justice Project was started. The project is made up of a collaborative of community members, providers, and organizations involved in Black and American Indian maternal health. Their work has been to create a Birth Justice Strategic plan that Hennepin County will use as a guide in addressing and advancing Black and Indigenous maternal health.
The desired outcomes that the Birth Justice Collaborative would like to see are
Measurable improvements, reported by families themselves, on birth outcomes and the birth experience within the health care and other systems
Measurable behavior changes in providers and systems that improves birth experiences as reported by families
Increased access for families to have cultural support and resources for pre and postpartum.
To read more about the strategies and outcomes, please visit the Birth Justice Collaborative webpage.
Throughout this process, over 300 community members gathered for multiple sessions to discuss what they know will work for them. These groups talked “about the things we were being challenged by and ... about strategies on how to resolve those conditions and coming up with really, really inventive ways to address that,” says Anthony Stately, (Ojibwe/Oneida), executive officer of the Native American Community Clinic.
“One of the things that I have found to be really quite wonderful and very different from so many other initiatives I've been involved in is the amount of intention we take,” says a collaborative member. “As a collective of people who are really dedicated to this work - to build relationship, build trust, between and among each other.” Hennepin County strives to make this type of community-led work the norm for other projects in the future.
The Birth Justice Collaborative includes:
Liberty Northside Healing Space
The University of Minnesota Robert J. Jones Urban Research and Outreach-Engagement Center
Minnesota Indian Women’s Resource Center
Native American Community Clinic
The Division of Indian Work
The Cultural Wellness Center
Coordinating organization, Collective Action Lab
The Birth Justice Project
The Birth Justice Strategic Plan will implement community-centered solutions to help Black and American Indian birthing people and their families be empowered in all stages of the birth process. This includes the prenatal, pregnancy and postpartum stages as well as being able to make decisions and have healthy outcomes for themselves, their babies and their communities.
While creating the plan, collaborative members said how they felt like their voices were being heard and their ideas were taken seriously noting that has not been the case in past projects within the county and other organizations. Collaborative members expressed sentiments about how including so many people involved in these communities created a very meaningful plan.
The plan highlights ways to address the impacts of racism, calls for radically reforming policy and payment for health care delivery, and establishing a community-endorsement process and a provider network, among many other strategies. This project is just getting started. Initiatives that they are currently working on are:
Pilot a post-partum support program for the first year after birth.
Collectively pursue a shared advocacy agenda that furthers our desired outcomes.
Create a cultural advocate and navigator pathway and recruit/train community members.
Design and implement an anti-bias report card program.
Establish a community-endorsed cultural provider network for families and systems.
The collaborative members say they are excited to continue to share and implement the plan and recognize it is “...going to make some significant contributions to some change in the not just the city and the county, but likely the state...” (Collaborative member)
To learn more about the initiative please visit the Maternal Health Initiative webpage
Image 1: Andres Guzman
Image 2: Noah Lawrence-Holder
Image 3: Andres Guzman