Eboni Tomasek expected to take home her newborn the day after he was born in a San Jose hospital. But, without explanation, hospital staff said they needed to stay a second night. Then a third. A nurse said her son had jaundice. Then said that he didn\u2019t. She wondered if they had confused her with another African American mother. In any event, why couldn\u2019t she and the baby boy she\u2019d named Ezekiel go home?<\/p>\n
No one would say. \u201cI asked like three times a day. It was brushed off,\u201d Tomasek said, relaying her story by phone as she cradled Ezekiel, now 6 months old, in their San Jose apartment. She was told only that more tests were being run to ensure \u201ceverything\u2019s good before you leave.\u201d<\/p>\n
She knew that her intensifying anger and fear about the holdup could raise her blood pressure, that Black pregnant women and new mothers are especially vulnerable to hypertension<\/a>, and that it could kill her. Distraught, she called the person she most trusted to calm her, a caseworker for Santa Clara County\u2019s Black Infant Health program.<\/p>\n \u201cShe really did help me to stay centered,\u201d Tomasek said of the caseworker, who tracked her health throughout the pregnancy. \u201cI felt a lot better.\u201d<\/p>\n Since 2000, approximately 14,000 families have participated in Santa Clara County\u2019s Black Infant Health program and related Perinatal Equity Initiative, both aimed at decreasing racial disparities in maternal and infant health. Enrolled mothers are assigned caseworkers and nurses who visit them at home to monitor blood pressure and other vital signs, help with breastfeeding, and screen infants for developmental delays. The mothers also attend support groups to learn skills to buffer the well-documented effects of racism in obstetric care<\/a>.<\/p>\n The programs have measurably improved the health of enrolled women over the past decade, county data from 2024 shows<\/a>, reducing rates of maternal hypertension \u2014 a leading cause of pregnancy-related deaths \u2014 by at least 30% and increasing screenings for other potentially life-threatening conditions.<\/p>\n Experts in the field and program participants stress that this work is urgent \u2014 in California, Black women are at least three times as likely as white women to die from pregnancy-related causes, and, nationally, Black infants have the highest rates of preterm birth and mortality.<\/p>\n While advocates for Black mothers laud the programs\u2019 results as cause for optimism, they are concerned that the climate against diversity, equity, and inclusion, or DEI, initiatives could impede progress. Efforts to improve the health of this at-risk population have been targets of private lawsuits<\/a> before, but since President Donald Trump took office, he has demanded the termination<\/a> of all \u201c\u2018equity-related\u2019 grants\u201d and threatened federal litigation<\/a> against programs he claims illegally favor one racial group over another \u2014 even when they are designed to save lives, as is the case with the Santa Clara efforts.<\/p>\n Santa Clara County has received most of the $1 million-plus in federal funding it expects for Black Infant Health and the Perinatal Equity Initiative programs for the fiscal year ending in June. But county officials say it\u2019s unclear how much, if any, of the remaining money \u2014 which comes from the federal health department\u2019s Health Resources and Services Administration and Centers for Medicare & Medicaid Services \u2014 is at risk amid federal anti-DEI policies and the recent cuts<\/a> at the Department of Health and Human Services. The status on funding for the coming fiscal year is also unknown, county officials said.<\/p>\n Santa Clara stands to lose more than $11 million<\/a> in public health funds due to the federal cuts, including money used to help deliver health services to underserved communities. A list of some of the federal grants<\/a> already terminated includes millions of dollars from at least three programs in other states focused on Black birth outcomes.<\/p>\n Any decrease in federal funding for these types of programs could have dire consequences, said Angela Aina, cofounder and executive director of Black Mamas Matter Alliance<\/a>. \u201cWe will likely see an increase in deaths,\u201d she predicted.<\/p>\n Aina\u2019s group pilots research and promotes public policy on behalf of 40 U.S. community-based organizations focused on Black maternal health. Member programs connect pregnant women to health care, counseling, and nutritional and breastfeeding advice, among other things.<\/p>\n If these services are cut, advocates fear, the progress made toward reducing racial disparities in birth outcomes could backslide. KFF research has found<\/a> that eliminating such focused efforts could exacerbate the inequities, worsen the nation\u2019s health, and increase health care costs overall.<\/p>\n \u201cOur stakeholders are in a state of confusion right now because the federal workers that still have a job are not allowed to communicate, or there\u2019s some kind of muzzle on their communication,\u201d Aina said. \u201cWe don\u2019t know \u2014 are we going to receive the rest of those grant funds?\u201d<\/p>\n When asked how the state would respond to federal budget cuts to programs like Black Infant Health, Brian Micek, a California Department of Public Health spokesperson, said only that the agency remains \u201ccommitted to protecting Californians\u2019 access to the critical services and programs they need\u201d and steadfast in its mission to \u201cadvance the health and well-being of California\u2019s diverse people and communities.\u201d<\/p>\n Requests for comment from the federal departments responsible for the grants funding Santa Clara\u2019s programs went unanswered.<\/p>\n Communications directors from groups working on reducing racial disparities in birth outcomes declined to be interviewed for this article, citing fears of retribution.<\/p>\n Tonya Robinson, program manager for Black Infant Health, stands defiant in the face of these threats. She sees the federal government\u2019s anti-DEI crusade as an invitation to practice the very skills they teach.<\/p>\n \u201cOur program is working,\u201d Robinson said. \u201cAnd the way it\u2019s working is by empowering women, giving women voices to help them stand up for what is right, and to recognize discrimination and the impact of structural racism on their bodies.\u201d<\/p>\n The government\u2019s antagonism toward her work inspires Robinson to soldier on calmly as a role model for the women she serves.<\/p>\n \u201cWe\u2019re continuing to forge ahead,\u201d Robinson said. \u201cWe want to make sure that we can be an example of how to manage stress at this time, in front of our clients.\u201d<\/p>\n Evidence surfaced that childbirth was deadlier for African American women than white women more than a century ago. But the issue did not gain significant public attention until 2018, when celebrities like Beyonc\u00e9<\/a> and Serena Williams<\/a> began airing their harrowing birth stories, highlighting the striking vulnerability of Black pregnant women and new mothers, even those with unlimited means.<\/p>\n In 2021, then-President Joe Biden proclaimed a week in April Black Maternal Health Week. A presidential proclamation<\/a> marking that week in 2024 read that \u201cwhen Black women suffer from severe injuries or pregnancy complications or simply ask for assistance, they are often dismissed or ignored in the health care settings that are supposed to care for them.\u201d<\/p>\n Eboni Tomasek certainly felt ignored.<\/p>\n Three days after giving birth in September \u2014 and after her Santa Clara caseworker reminded her she had a right to know why she wasn\u2019t being released \u2014 a nurse finally explained that Tomasek\u2019s blood pressure had been too high for the hospital to safely discharge her.<\/p>\n Had she been white, Tomasek believes, the staff would have informed her sooner. \u201cI feel like they were being racist,\u201d she said. She credited her training through Black Infant Health with her ability to calm herself and help lower her blood pressure, allowing her to leave that day with Ezekiel.<\/p>\n Jamila Perritt, president and CEO of Physicians for Reproductive Health, believes that the poor health outcomes Black women and infants face have historical roots and will change only with the help of programs that, like those in Santa Clara, address conditions facing Black women.<\/p>\n \u201cWhat we\u2019re seeing in terms of maternal mortality are race-bound conditions,\u201d said Perritt, an obstetrician who co-chairs Washington, D.C.\u2019s Maternal Mortality Review Committee. \u201cOur policies cannot be race-blind if we\u2019re attempting to address them.\u201d<\/p>\n This article was produced by <\/em>KFF Health News<\/em><\/a>, which publishes <\/em>California Healthline<\/em><\/a>, an editorially independent service of the <\/em>California Health Care Foundation<\/em><\/a>.<\/em>\u00a0<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n