Data, Research and Storytelling

Data, research, and stories are used to develop a deeper understanding of Black maternal-child-health. Describe opportunities for and practical uses of data, research, and stories.

Breastfeeding Education, Support, and Promotion: Pennsylvania’s Story

Dottie Schell, BS, RN, CLC, CBE & Devon Gilinger, MPH,CHES,CLC – PA Chapter of American Academy of Pediatrics

TRACKS: Data, Research and Storytelling, Breastfeeding Groups and Peer Counseling, Northeast

The EPIC-BEST (Educating Practices/Physicians in their Communities: Breastfeeding Education, Support, and Training)

This program targets education and resources on breastfeeding to practices in Southeast and Southwest PA. As an EPIC program, the focus is on promoting the initiation of breastfeeding and increasing the duration of exclusive breastfeeding for about the first 6 months of the infant’s life. EPIC-BEST will address this goal by working with primary care practices on achieving the principles of a breastfeeding friendly office.

BEST Plus

This program aims to provide guidance on how to create a breastfeeding-friendly medical home for mothers and their families. It expands on EPIC-BEST to include all office staff who might come in contact with mothers and their families. Practices receive guidance towards becoming a Community-Based Breastfeeding Friendly Practice Model. Through BEST Plus, a Maintenance of Certification (MOC) project was created: Improving Exclusive Breastfeeding Rates in the Pediatric Practice.

Keystone 10

This hospital-based quality improvement initiative is aimed at improving the protection, promotion, and support of breastfeeding for all Pennsylvania infants, mothers, and families. Funded by the Pennsylvania Department of Health, Keystone 10 assists Pennsylvania’s birthing facilities in adopting and implementing evidence-based maternity care practices with the goal of improving individual facility and state level breastfeeding care and rates and ultimately improving the health of mothers and babies. 83 of the 88 Pennsylvania birthing facilities participate in this initiative through the completion of the nationally-recognized, evidence-based “Ten Steps to Successful Breastfeeding.” Hospitals can apply for the 10 Steps to Successful Breastfeeding one step at a time. This initiative is engaging Pennsylvania’s birthing facilities in local, regional and state level efforts to improve the initiation, duration and exclusivity rates of breastfeeding across the Commonwealth of Pennsylvania.

First Food

This breastfeeding program fosters collaboration opportunities with community partners across the Commonwealth to promote breastfeeding which ensures the healthiest start for babies. Funded by the Pennsylvania Department of Health, First Food is committed to partnerships and collaborative efforts to increase the number of organizations throughout Pennsylvania that establish policies and programs to support breastfeeding. Community partners will identify their target needs in order to promote, support and protect breastfeeding among their breastfeeding participants, employees or members. Breast milk as a “first food” will be emphasized, as well as the health benefits to mother, infant and the community, when breastfeeding is a cultural norm. First Food promotes the Breastfeeding-Friendly Community.

Learning Objectives:

State the four main Pennsylvania Initiatives
Identify the value of each program
Connect the importance of education ,support, and promotion between, hospitals, practices and community organizations

Navigating Category 4s during Covid: Lessons learned about infant feeding during emergencies from in Louisiana from Hurricanes Laura & Ida

Tyra Gross, PhD, MPH & Malaika Ludman – Birthmark Doulas

TRACKS: Disaster Preparedness, Data, Research and Storytelling, Community-based Doulas; Southwest

Breastfeeding is the safest infant feeding option during emergencies, according to the World Health Organization (WHO), Centers for Disease Control & Prevention (CDC), and other health authorities. Since the onset of the COVID-19 pandemic, Louisiana has experienced two Category 4 hurricanes. Hurricane Laura struck Southwest Louisiana on August 27, 2020 and Hurricane Ida struck Southeast Louisiana a year later on August 26, 2021. The New Orleans Breastfeeding Center (NOBC) mounted an emergency response to support pregnant and parenting people with children under 2 years affected by these storms as part of their Infant Ready emergency preparedness program. During Hurricane Laura, doulas and other staff did infant feeding assessments at an evacuee resource center. This also included mounting a free 24-hour perinatal emergency hotline in the wake of the storm. Callers were also supported through follow-up texts. For Hurricane Ida, NOBC partnered with Mom2Mom to train them to staff the perinatal hotline while NOBC staff and their families sheltered in place or evacuated to safety. Since Louisiana has some of the lowest breastfeeding rates in the United States, efforts to improve breastfeeding can promote resilience for future emergencies. NOBC received a pilot grant in partnership with Xavier University of Louisiana to research infant and young child feeding during emergencies in a low-breastfeeding population in Louisiana. To date, we have analyzed field notes from almost 100 hotline calls, analyzed 70+ infant feeding assessments from Hurricane Laura, and conducted interviews with families, birth workers and local stakeholders about their experiences navigating these storms. Experiencing a severe natural disaster during a pandemic compounded stress for mothers and their families. Most had to put COVID-19 pandemic concerns on the backburner as they tended to more pressing issues such as lack of food, water, utilities and property damage. Infant feeding assessments revealed a low rate of breastfeeding. Formula was the number one supply requested through the hotline for both disasters. Callers faced breastfeeding challenges such as mastitis, nipple pain and latching issues, plugged ducts, relactation, combination feeding, and weaning. Given the increasing frequency and intensity of natural disasters due to climate change, we are confident our project provides important lessons on IYCFE for communities beyond Louisiana.

Learning Objectives:

Review the current research on infant and young child feeding in emergencies (IYCFE)
Identify family-centered supports needed to respond to populations with low breastfeeding rates in an emergency
Describe Birthmark Doula Collective’s Infant Ready emergency preparedness program

Stories the Body Tells – Honoring Loss into Life

Laurel Gourrier & Danielle Jackson – Birth Stories in Color

TRACKS: Data, Research and Storytelling, Midwest

Birth Stories in Color (BSiC) is a podcast for Black, Indigenous, Asian, Latino and Multiracial individuals to share their birthing experiences – a space that specifically celebrates, mourns with, and supports them and their transformation through birth. Birth storytelling has the power to contribute to birthing families’ physical and mental healing process. Utilizing oral history in this way not only supports the birthing person in healing, but serves as public accountability to providers who cared for them. It is important because women and birthing people of color have historically experienced bias, racism, and discrimination in medical settings. These transgressions have led to overwhelmingly high statistics in infant and maternal mortality in the United States.

We want to learn how the use of oral history as a means of qualitative care analysis impacts the future and present practices of medical care for women and birthing people of color. Traditional surveys do not provide space for the whole experience to be evaluated.

In our presentation, we will listen to snippets of Marise Angibeau Gray’s birth story. We will facilitate a discussion of the ways her body spoke to her in those moments during and after each birth, acknowledging the dismissiveness of her medical provider as she tried to advocate for herself in a space where Black bodies do not receive respectful care.

In this format, we are a modern-day griot, serving as the storyteller and keeper of the record, telling a story throughout pregnancy about the joy, trauma, and changes that the body has experienced, culminating in both birth and rebirth.

An excerpt of Marise’s birthing experiences:

In the early parts of Marise’s pregnancy of her first son, she experienced spotting, a concern she brought to her care provider, who was dismissive about it—asserrting that it was normal and common. Yet as the weeks continued, things began to worsen, and by the end of the week, she had a spontaneous miscarriage.

These feelings of confusion, heartbreak, grief, and processing through healing would continue on a cycle – as, in the next two years, they would become pregnant twice more and lose two more sons.

When they found out they were pregnant with their fourth child, Marise carried a mantra with her often, “I am a birth giver. I’m able to carry another life, no matter how short or how long,” kept her grounded throughout the pregnancy. Their daughter, Memphys, was born amongst peace and calm.

Key Words: Birth, Storytelling, Joy, Trauma, Body, Healing, Care, Miscarriage, Loss, Motherhood

Learning Objectives:

Demonstrate how the use of oral history is a means of qualitative care analysis.
Compare restorative storytelling to human interest stories.

Impact of Racism and Discrimination on Health Outcomes for Pregnant Black Women

Celestine Ofori-Parku – University of California, San Francisco

TRACKS: Data, Research and Storytelling, West

ABSTRACT

BACKGROUND: The burden of maternal mortality in the U.S. is significantly greater for Black women than for any other racial group. This health disparity is largely attributed to racial discrimination.

OBJECTIVE: To further examine associations between Black women’s experiences of racism and discrimination during the perinatal period and their health outcomes.

METHOD: A secondary data analysis of the Contraception, Human milk, And Research Mechanisms (CHARM) Study, an online survey (n=235) was conducted. The secondary analysis assessed the associations between Black women’s self-reported experiences of racism and discrimination during the perinatal period and hypertension and birth complication.

RESULTS: The proportion of Black women who reported having hypertension was higher (p=0.014) among the 72 who experienced racism/discrimination (23.3%) compared to the 163 who did not (10.4%). Likewise, the proportion of Black women who had birth complications was significantly higher (p=0.008) among those who reported racism/discrimination (45.0%) compared to those who did not (26.1%). Logistic regression analysis indicated that Black women who experienced racism/discrimination during the perinatal period were 2.63 times more likely to develop hypertension (OR=2.63; 95% CI=1.19-5.79) and 2.31 times more likely to have a birth complication (OR=2.31, 95% CI=1.24-4.31) compared to those who did not report racism/discrimination. Controlling for geographic location, educational level, and employment status, individuals who experienced racism were 2.46 times more likely to report having hypertension (OR=2.46; 95% CI=1.09-5.52) and 2.39 times more likely to have a birth complication (OR=2.39; 95% CI 1.27-4.49) than those who did not experience racism/discrimination.

CONCLUSION: Our findings suggest that exposure to racism/discrimination during the perinatal period has significant health implications for pregnant Black women. Interventions need to focus on addressing systemic and structural racism.

Learning Objectives:

Identify the association between Black women´s experience of racism/discrimination and hypertension during the perinatal period.
Identify the association between Black women´s experience of racism/discrimination and birth complications during the perinatal period.

It Takes A Village

Emerald Clark, CBE – Team Pink – It Takes A Village

TRACKS: Black Founder’s Corner, Data, Research and Storytelling, Breastfeeding Groups and Peer Counseling; Midwest

Breastfeeding is the natural, biological way to feed infants. It has been the way infants have been fed for centuries. So, why are breastfeeding rates not higher amongst people of color? This presentation will identify the effects of slavery on black women breastfeeding, how social, economic, and racial disparities affect black women breastfeeding rates today, and what we can do as a collective to change this narrative.

Learning Objectives:

Identify barriers in the community that sways black women from breastfeeding.
Explain how slavery still impacts black breastfeeding rates today.

Diversifying Birthwork, Improving Breastfeeding Outcomes

Esther McCant, CD, CLC, HBCE – Metro Mommy Agency

TRACKS: Black Founder’s Corner, Data, Research and Storytelling, Community-based Doulas; Southeast

How to increase breastfeeding rates by diversifying birth work amongst community-based doulas.

PURPOSE: Birth outcomes and breastfeeding outcomes are largely connected and the work of doulas is often left out of the conversation about increasing breastfeeding rates. The limitations of some doulas to provide adequate breastfeeding support stem from a lack of continuing education, professional development, and mentorship to pursue lactation instruction as a means to improve infant health. I would like to highlight how going beyond the typical “serve one-parent/family at a time” model of birth work can benefit the doula and the community when it comes to breastfeeding.

METHOD: Surveys from local birth workers and Metro Mommy Agency (MMA)’s previous clients will be completed to understand the role of the doula to increase breastfeeding outcomes. Questions will center doulas and client understanding of community breastfeeding resources, community involvement, professional development resources utilized to care for families, stories of successes, lessons learned, and awareness of local community initiatives.

RESULTS: Pending case-study of MMA clients and doula survey results. Current data from MMA show that more than 75% breastfeed beyond 6 months with high exclusivity.

CONCLUSION: We can increase breastfeeding rates by diversifying birth work amongst doulas. Integration into the maternal-child-health initiatives in South Florida through networking and diversifying birth work increased the org’s reach and experience in supporting families. Through attendance at community meetings, MMA had been able to stay in step with community initiatives, offering a unique insight to breastfeeding advocates and stakeholders to increase community education. MMA has been able to guide the conversation and create new means of support for mentees, increasing their skills at identifying breastfeeding issues, sharing resources, and outsourcing/referring out when necessary.

Learning Objectives:

Identify 3 ways in which community-based doulas can increase breastfeeding within their community.
State 3 actionable steps that community-based doulas can do to improve breastfeeding in the first 2 weeks of postpartum.
Describe 3 ways that partnership and collaboration advance the goals of increasing breastfeeding in any community.