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Doulas: A Formal Part of CA Health Care System – Birthing While Black Part 2
BLACK VOICE NEWS — While California boasts one of the lowest pregnancy-related mortalities in the nation, the latest available data from the California Department of Public Health (CDPH) that covers the period of 2017-2019 shows that the pregnancy-related mortality rate is 47.3 per 100,000 births for Black people compared to 11.1 for White people, 12.6 for Hispanic people and 14.0 for Asian people.
The post Doulas: A Formal Part of CA Health Care System – Birthing While Black Part 2 first appeared on BlackPressUSA.
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CA acknowledges doula services as part of the solution to reduce maternal mortality
By Breanna Reeves | Black Voice News
The topics of Black maternal mortality and pregnancy-related death have become more prevalent over the last decade as the U.S. has been identified as having one of the worst maternal mortality rates among high-income countries.
A report published by the Commonwealth Fund found that the U.S. had the highest maternal mortality rate among wealthy nations: 23.8 deaths per 100,000 live births in 2020. That rate is double for Black maternal mortality: 55.3 deaths per 100,000 live births.
While California boasts one of the lowest pregnancy-related mortalities in the nation, the latest available data from the California Department of Public Health (CDPH) that covers the period of 2017-2019 shows that the pregnancy-related mortality rate is 47.3 per 100,000 births for Black people compared to 11.1 for White people, 12.6 for Hispanic people and 14.0 for Asian people.
Available data for maternal mortality rates across race/ethnicity for Riverside and San Bernardino Counties are not available for public access. According to a representative from the California Department of Public Health, the agency “does not publish pregnancy-related death counts or pregnancy-related mortality ratios (PRMR) by race/ethnicity at the county or regional level to maintain data confidentiality and ensure statistical stability,” but noted that across the state, Black birthing people “continue to have the highest PRMR.”
The disproportionate rate at which Black women and birthing people die from pregnancy-related deaths is not new to Black doulas.
Chantel Runnels has been a doula for 14 years, something she said she was “called to do.” Family history of fatal maternal health care, a desire to see public health care change and her own pregnancy experience served as catalysts for her becoming a doula. She was introduced to the Sankofa Birthworkers Collective, an Inland Empire-based organization, through a friend who is a midwife.
A midwife is an individual who is medically trained to assist with labor and delivery and provides prenatal, intrapartum and postpartum care, as well as family planning care. The Sankofa Birthworkers Collective consists of a well-rounded group of birthworkers including licensed midwives, postpartum doulas, lactation specialists, maternal mental health experts and midwives-in-training.
“To be around other Black women who may have secondary or tertiary lines of work that affect Black maternal health care or are directly in Black maternal health care was really attractive to me,” Runnels explained. “To be a part of a community of women who live across the [Inland Empire], who come from different demographics, but want to support each other and just wanted to come together was super attractive.”
Married for nearly 15 years and a mother of four, Runnels provides services to a diverse clientele, some who pay out of pocket for private services, others who receive free services through community-based programs like Sankofa or through insurance programs like the Doula Access Program.
Chantel Runnels explains her role as a doula during a panel at the Inland Empire Perinatal Equity Provider and Community Summit at Cal Baptist University in Riverside, CA on September 16, 2022 (Aryana Noroozi for Black Voice News/CatchLight Local).
Runnels explained that as the need for doulas grows, doula training is that much more important to help ensure that they are trained to meet the needs of the community and have the availability to serve clients.
“This is why compensation for doulas is important, too, because the wages that doulas are paid can’t really compensate for the availability that’s required for the job,” Runnels explained.
As the state began to recognize the invaluable services provided by doulas, legislation to implement doula services throughout the state was introduced prior to the start of the pandemic.
Elevating, expanding, standardizing and compensating doulas in CA
In February 2020, Majority Leader of the California State Assembly Eloise Gómez Reyes (D-Colton) introduced Assembly Bill 2258 which aimed to lower maternal and infant maternal mortality rates in California by launching a three-year Medi-Cal pilot program to provide doula services in 14 counties with the highest birth disparities. The bill fell through when the COVID-19 pandemic shifted priorities in March 2020.
The momentum to introduce legislation that addressed maternal mortality picked up again when Governor Gavin Newsom budgeted funding for a Medi-Cal benefit, which will allow doulas to be reimbursed for full spectrum care rendered to Medi-Cal enrollees. In order to add these services as a benefit, the Department of Health Care Services (DHCS) is required to submit a State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS) and receive federal approval — essentially an agreement between the state and federal government on how their Medicaid program will operate and assures the state will abide by federal rules.
Over the last year, DHCS has worked with stakeholders from across California including birthworkers, doulas and community organizations to develop a comprehensive SPA that specifies what doula coverage will look like under Medi-Cal, including the scope of services. Following the first draft of the SPA, a coalition of stakeholders made recommendations for an updated version of the SPA that requested the need for specific language to define doula care and services.
The letter recommended revising the definition of a doula to specify the types of services and support they offer. Part of the letter recommended that the SPA add: “The doula care provided will offer any and all aspects of full-spectrum doula care, including prenatal and postpartum or post-pregnancy doula care, continuous presence during labor and delivery, and doula support during miscarriage, stillbirth and abortion. Doula care includes physical, emotional and other nonmedical care.”
Alexis Robles-Fradet is a Health Policy Analyst at National Health Law Program (NHeLP) in Los Angeles, CA, and drafted the coalition letter in April. Alongside Amy Chen, a senior attorney at NHeLP and member of the stakeholder group, Robles-Fradet has published several reports about the components of successful doula programs and pilot doula programs in other counties as part of the Doula Medicaid Project, launched in 2018.
One of the biggest challenges with finalizing the SPA has been the reimbursement rate offered. The initial proposed rate was one of the lowest rates in the country. Upon receiving the first draft of the SPA from DHCS, the coalition noted in the letter: “We do not believe this benefit will be successful if the reimbursement rate is $450.”
After receiving and reviewing a draft of the State Amendment Plan, a coalition of stakeholders and advocates drafted a letter in response, outlining changes to the plan such as defining a doula’s role and recommending an increase to the offered reimbursement rate of $450. (Graphic by Breanna Reeves).
With the high cost of living in California and the amount of time doulas spend with their clients, Robles-Fradet explained that $450 is not a living wage and would be a barrier to getting the necessary workforce to cover Medi-Cal patients. Medi-Cal covered more than half of all births in California in 2019.
“Doulas deserve to be paid a fair wage. I know we talk about [a] living wage, but I think we should shift into thriving wages, like they’re doing great work and they’ve been doing this great work for so long,” Robles-Fradet stated. “They know how to support their communities.”
Robles-Fradet explained that listening to the doulas and making sure that the benefit will be equitable for them are important factors that will contribute to the success of the Medi-Cal benefit.
As a member of the stakeholder group, Runnels said that the group has worked “tirelessly” to demonstrate that the situation is nuanced. One of the first tasks for DHCS and the stakeholder group was to define doula services and qualifications since it isn’t defined in state law.
“The doula stakeholders did emphasize to us that the length of service in terms of time that they were spending with individuals needed to be considered since doula services typically last significantly longer than other visits with a licensed practitioner,” said René Mollow, Deputy Director of Health Care Benefits & Eligibility.
Mollow explained that doula services as a benefit will be offered through both the Medicare fee-for-service delivery system and Managed Care delivery systems, so doulas will need to be enrolled as Medi-Cal providers and will have contracts with Managed Care plans.
“The majority of covered populations in our program here in California are served through Medi-Cal managed care plans,” Mollow added. “So, that’s where we would expect to see the bulk of the services being provided.”
Following several stakeholder meetings, feedback from birthworkers and Governor Gavin Newsom’s revised 2022-23 budget, California’s current proposed reimbursement rate has increased to $1,154 with one initial visit paid at $126.31, eight perinatal visits paid at $60.48 per visit and one labor and delivery visit paid at $544.28.
“California is such a large state. We have so many births a year. The cost of living for doulas and families in San Francisco varies greatly to doulas and families that are serving Barstow,” Runnels clarified. “And so, helping them understand that the original rate…was embarrassing. Even other states do better than that. And the rate that they’ve come to now is still embarrassing.”
There are more than 400,000 births each year in California which is roughly one-eighth of all U.S. births, nearly half of which are paid for by Medi-Cal, according to the California Health Care Foundation. Comparatively, in 2020, there were 39,817 births in Oregon. In June 2022, Oregon updated its SPA to increase the doula reimbursement rate to $1,500.
“I am so grateful for the work that the State Plan Amendment workgroup is doing to really work on this,” Runnels stated. “[But] also, it still does not reflect how critical the role of a doula is in addressing maternal health care in the state of California, particularly for those most vulnerable, which are Black women.”
Stakeholder meetings are ongoing as the group continues to discuss the SPA and work on developing a Provider Manual. DHCS plans to publish a public notice and formally submit the SPA in September.
This article is the second in a series produced as a project for the USC Annenberg Center for Health Journalism’s 2022 California Fellowship.
The post Doulas: A Formal Part of CA Health Care System – Birthing While Black Part 2 appeared first on Black Voice News.
____________________________________________________________
Photo Captions:
Chantel Runnels explains her role as a doula during a panel at the Inland Empire Perinatal Equity Provider and Community Summit at Cal Baptist University in Riverside, CA on September 16, 2022 (Aryana Noroozi for Black Voice News/CatchLight Local).
After receiving and reviewing a draft of the State Amendment Plan, a coalition of stakeholders and advocates drafted a letter in response, outlining changes to the plan such as defining a doula’s role and recommending an increase to the offered reimbursement rate of $450. (Graphic by Breanna Reeves).
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COMMENTARY: The National Protest Must Be Accompanied with Our Votes
Just as Trump is gathering election data like having the FBI take all the election data in Georgia from the 2020 election, so must we organize in preparation for the coming primary season to have the right people on ballots in each Republican district, so that we can regain control of the House of Representatives and by doing so, restore the separation of powers and balance that our democracy is being deprived of.
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By Dr. John E. Warren, Publisher San Diego Voice & Viewpoint Newspaper
As thousands of Americans march every week in cities across this great nation, it must be remembered that the protest without the vote is of no concern to Donald Trump and his administration.
In every city, there is a personal connection to the U.S. Congress. In too many cases, the member of Congress representing the people of that city and the congressional district in which it sits, is a Republican. It is the Republicans who are giving silent support to the destructive actions of those persons like the U.S. Attorney General, the Director of Homeland Security, and the National Intelligence Director, who are carrying out the revenge campaign of the President rather than upholding the oath of office each of them took “to Defend The Constitution of the United States.”
Just as Trump is gathering election data like having the FBI take all the election data in Georgia from the 2020 election, so must we organize in preparation for the coming primary season to have the right people on ballots in each Republican district, so that we can regain control of the House of Representatives and by doing so, restore the separation of powers and balance that our democracy is being deprived of.
In California, the primary comes in June 2026. The congressional races must be a priority just as much as the local election of people has been so important in keeping ICE from acquiring facilities to build more prisons around the country.
“We the People” are winning this battle, even though it might not look like it. Each of us must get involved now, right where we are.
In this Black History month, it is important to remember that all we have accomplished in this nation has been “in spite of” and not “because of.” Frederick Douglas said, “Power concedes nothing without a struggle.”
Today, the struggle is to maintain our very institutions and history. Our strength in this struggle rests in our “collectiveness.” Our newspapers and journalists are at the greatest risk. We must not personally add to the attack by ignoring those who have been our very foundation, our Black press.
Are you spending your dollars this Black History Month with those who salute and honor contributions by supporting those who tell our stories? Remember that silence is the same as consent and support for the opposition. Where do you stand and where will your dollars go?
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Why Black Parents Should Consider Montessori
BLACKPRESSUSA NEWSWIRE — I have found that there are some educational approaches that consistently provide a safer, more enriching, and more affirmative environment for Black children. The Montessori method, developed by Italian physician Maria Montessori and introduced to the U.S. in the early 20th century, is one such approach.
Published
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February 9, 2026By
Oakland Post
As a mother of four children, I’ve done A LOT of school shopping. I don’t mean the autumn ritual of purchasing school supplies. I mean shopping for schools – pouring over promotional materials, combing through websites, asking friends and community members for referrals to their favorite schools, attending open houses and orientations, comparing curriculums and educational philosophies, meeting teachers and principals, and students who all claim that their school is the best.
But keep in mind – I’m not just a mom of four children. I’m a mom of four Black children, and I’m also a psychologist who is very interested in protecting my little ones from the traumatic experience that school can too often become.
For Black children in the United States, school can sometimes feel more like a prison than an educational institution. Research shows that Black students experience school as more hostile and demoralizing than other students do, that they are disciplined more frequently and more harshly for typical childhood offenses (such as running in the halls or chewing gum in class), that they are often labeled as deviant or viewed as deficient more quickly than other children, that teachers have lower academic expectations of Black students (which, in turn, lowers those students’ expectations of themselves), and that Black parents feel less respected and less engaged by their children’s teachers and school administrators. Perhaps these are some of the underlying reasons that Black students tend to underperform in most schools across the country.
The truth is that schools are more than academic institutions. They are places where children go to gain a sense of who they are, how they relate to others, and where they fit into the world. The best schools are places that answer these questions positively – ‘you are a valuable human being, you are a person who will grow up to contribute great things to your community, and you belong here, with us, exploring the world and learning how to use your gifts.’ Unfortunately, Black children looking for answers to these universal questions of childhood will often hit a brick wall once they walk into the classroom. If the curriculum does not reflect their cultural experiences, the teachers don’t appear to value them, and they spend most of their time being shamed into compliance rather than guided towards their highest potential, well…what can we really expect? How are they supposed to master basic academic skills if their spirits have been crushed?
Here’s the good news. In my years of school shopping, and in the research of Black education specialists such as Jawanza Kunjufu and Amos Wilson, I have found that there are some educational approaches that consistently provide a safer, more enriching, and more affirmative environment for Black children. The Montessori method, developed by Italian physician Maria Montessori and introduced to the U.S. in the early 20th century, is one such approach.
The key feature of Montessori schooling is that children decide (for the most part) what they want to do each day. Led by their own interests and skill levels, children in a Montessori classroom move around freely and work independently or with others on tasks of their own
choosing. The classroom is intentionally stocked with materials tailored to the developmental needs of children, including the need to learn through different senses (sight, touch/texture, movement, etc.). The teacher in a Montessori classroom is less like a boss and more like a caring guide who works with each child individually, demonstrating various activities and then giving them space to try it on their own. The idea is that over time, students learn to master even the toughest tasks and concepts, and they feel an intense sense of pride and accomplishment because they did it by themselves, without pressure or pushing.
I think that this aspect of the Montessori method is good for all kids. Do you remember the feeling of having your creativity or motivation crushed by being told exactly what to do, when to do it, how to do it, and why? The truth is that when presented with a new challenge and then given space, children actually accomplish a lot! They are born with a natural desire to learn. It is that spirit of curiosity, sense of wonder, and excitement to explore that Montessori helps to keep alive in a child. But that’s not the only reason that I think Black parents need to consider Montessori.
Fostering a love of learning is great. But more importantly, I think that Montessori students excel at learning to love. It begins with Montessori’s acknowledgement that all children are precious because childhood is a precious time. In many school systems, Black children are treated like miniature adults (at best) or miniature criminals (at worst), and are subjected to stressful situations that no kids are equipped to handle – expectations to be still and silent for long periods, competitive and high-stakes testing, and punitive classroom discipline. It’s easy to get the sense that rather than being prepared for college or careers, our children are being prepared to fail. Couple this with the aforementioned bias against Black children that seems to run rampant within the U.S. school system, and you end up with children who feel burned out and bitter about school by the time they hit 3rd grade.
In my experience, Montessori does a better job of protecting the space that is childhood – and all the joy of discovery and learning that should come along with that. Without the requirement that students “sit down and shut up,” behavioral issues in Montessori classrooms tend to be non-existent (or at least, the Montessori method doesn’t harp on them; children are gently redirected rather than shamed in front of the class). Montessori students don’t learn for the sake of tests; they demonstrate what they’ve learned by sharing with their teacher or classmates how they solve real-world problems using the skills they’ve gained through reading, math, or science activities. And by allowing children a choice of what to focus on throughout the day, Montessori teachers demonstrate that they honor and trust children’s natural intelligence. The individualized, careful attention they provide indicates to children that they are each seen, heard, and valued for who they are, and who they might become. Now that’s love (and good education).
As a parent, I’ve come to realize that many schools offer high-quality academics. Montessori is no different. Students in Montessori schools gain exposure to advanced concepts and the materials to work with these concepts hands-on. Across the nation, Montessori schools emphasize early literacy development, an especially important indicator of life success for young Black boys and men. Montessori students are provided with the opportunity to be
successful every day, and the chance to develop a sense of competence and self-worth based on completing tasks at their own pace.
But I have also learned that the important questions to ask when school shopping are often not about academics at all. I now ask, ‘Will my children be treated kindly? Will they be listened to? Protected from bias and bullying? Will they feel safe? Will this precious time in their lives be honored as a space for growth, development, awe, and excitement? Will they get to see people like them included in the curriculum? Will they be seen as valuable even if they don’t always ‘measure up’ to other kids on a task? Will they get extra support if they need it? Will the school include me in major decisions? Will the school leaders help to make sure that my children reach their fullest potential? Will the teacher care about my children almost as much as I do?’
Consistently, it’s been the Montessori schools that have answered with a loud, resounding ‘Yes!’ That is why my children ended up in Montessori schools, and I couldn’t be happier with that decision. If you’re a parent like me, shopping for schools with the same questions in mind, I’d urge you to consider Montessori education as a viable option for your precious little ones. Today more than ever, getting it right for our children is priceless.
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LIVE from the NMA Convention Raheem DeVaughn Says The Time Is Now: Let’s End HIV in Our Communities #2
Set against the backdrop of the NMA conference, Executive Officers from the National Medical Association, Grammy Award Winning Artist and Advocate Raheem DeVaughn, and Gilead Sciences experts, are holding today an important conversation on HIV prevention and health equity. Black women continue to be disproportionately impacted by HIV despite advances in prevention options. Today’s event […]
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Set against the backdrop of the NMA conference, Executive Officers from the National Medical Association, Grammy Award Winning Artist and Advocate Raheem DeVaughn, and Gilead Sciences experts, are holding today an important conversation on HIV prevention and health equity.
Black women continue to be disproportionately impacted by HIV despite advances in prevention options. Today’s event is designed to uplift voices, explore barriers to access, and increase awareness and key updates about PrEP, a proven prevention method that remains underutilized among Black women. This timely gathering will feature voices from across health, media, and advocacy as we break stigma and center equity in HIV prevention.
Additional stats and information to know:
● Black women continue to be disproportionately affected by HIV, with Black women representing more than 50% of new HIV diagnoses among women in the U.S. in 2022, despite comprising just 13% of women in the U.S.
● Women made up only 8% of PrEP users despite representing 19% of all new HIV diagnoses in 2022.
● Gilead Sciences is increasing awareness and addressing stigma by encouraging regular HIV testing and having judgment-free conversations with your healthcare provider about prevention options, including oral PrEP and long-acting injectable PrEP options.
● PrEP is an HIV prevention medication that has been available since 2012.
● Only 1 in 3 people in the U.S. who could benefit from PrEP were prescribed a form of PrEP in 2022.
Oakland Post
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