Cash During Pregnancy: A Promising Approach for Reducing Inequities in SF

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Interview with Michaela Taylor, Project Manager at Abundant Birth Project, on her work to pilot the first pregnancy income supplement program in the US.

 

By Gina Gorman, Natural Resources Board Member 


Welcome to the “Listen and Learn” Interview Series...part of our “It Takes a Village” Fundraising & Awareness Campaign


In San Francisco, a Black infant is almost twice as likely to be born prematurely compared to a White infant. Similarly, Pacific Islander infants have the second highest preterm birth rate.

Well-documented historical and recent discrimination underlie differences in wealth in Black and Pacific Islander communities. And this makes it difficult for these families to meet basic needs...ultimately resulting in higher stress, and an impact on physical health. 

The nonprofit organization, Expecting Justice, realized that pregnancy is a critical period of development for these families. And they’re using this untapped opportunity to generate long term health and financial improvements for mothers and families — by addressing income volatility.

Enter the Abundant Birth Project (ABP) — one of Expecting Justice’s core programs, and the first pregnancy income supplement program in the US. The Abundant Birth Project provides unconditional cash supplements to Black and Pacific Islander mothers. 

The goal of the project? To give women back their power to make decisions for themselves. To reduce preterm birth and improve economic outcomes for our communities. And ultimately — to transform San Francisco into a city where all children have a healthy start at life. 

We’re excited to learn more about this amazing initiative today from Michaela Taylor, Project Manager at Abundant Birth Project.


In this episode, we discuss: 

  • Michaela’s background and her interest in the ABP
  • Importance of supporting marginalized communities in pregnancy and childbirth.
  • Root causes of racial inequalities in birth outcomes.
  • How the Abundant Birth Project works.
  • Three things new and expecting families should know.
  • How You Can Support the ABP

Gina Gorman: Hi, everybody, we're ready. Hello and welcome to the Natural Resources, It Takes a Village interview series, where we're speaking to contributing members of the parenting and birthing community here in the San Francisco Bay Area. 

Thank you so much for joining us and for supporting Natural Resources as the community's nonprofit, supporting new and expecting families in the Bay Area and beyond. 

I'm Gina Gorman, I am a board member at Natural Resources and I am here today to speak with Michaela Taylor, who is program manager at the Abundant Birth Project in San Francisco. She's also a registered nurse and a student at the Berkeley School of Public Health. Michaela, thanks so much for being here.

Michaela Taylor: Thanks for having me Gina.


Michaela’s Background and Her Interest in the ABP

Gina Gorman: So, first of all, let's jump right into it. Why don't you tell a little bit about your background, what you do now and what inspired you about Expecting Justice and the Abundant Birth Project?

Michaela Taylor: Yeah. So, first I just want to say that I recently graduated from UC Berkeley.

Gina Gorman: Congrats.

Michaela Taylor: Thank you. So, that's great. A bit about my background. I am a public health nurse, like you mentioned, by training and I was practicing as a nurse before I came to Expected Justice and the Abundant Birth Project. 

And really what inspired me to get more involved in the systemic or social injustices is a variety of different experiences. So, starting with my clinical training and really being in the hospital and noticing that all the majority of the patients were people of color. 

And that was, really... it, kind of, alarmed me in my mind because... That was not reflective of the city that I was living in. So, I got really curious about that and that was, kind of, coupled with my experience of learning about people of color, specifically black people, who are more predisposed to so many different health conditions.

And so, when I learned what health disparities were, that's when I, kind of, knew that, for sure, I wanted to be involved in public health. So, I became a public health nurse and I was working specifically with the young people who were involved in foster care or the criminal legal system. 

And I think just from my practice and experience, it really exposed me to the different ways that systems, despite their best intentions, do not really provide the resources that folks need and sometimes they're actually separating or causing harm to families. 

So, that's really what brought me to my education at Berkeley and also with Expecting Justice, as an organization that really focuses on looking at systemic and root causes and how we can address those to change health outcomes.

Importance of Supporting Marginalized Communities in Pregnancy and Childbirth.

Gina Gorman: Great. And why do you think it is so important for organizations, like Expecting Justice and the Abundant Birth Project, to support marginalized communities and communities of color, especially in pregnancy and childbirth?

Michaela Taylor: Yeah. So, specifically with pregnancy and childbirth, we're looking at the health outcomes. There are some birth inequities, specifically around black women and PI women, in San Francisco that are persistent. 

So, all the existing programs have not done much to close that gap. And honestly, we know what it takes for people to have healthy births. People have healthy births every day but because of the systemic racism, it has blocked many folks and families out of the resources that they need in order to have healthy births. 

So, Expecting Justice is really focused on looking at how systemic racism has shaped inequitable opportunities for people. And with the Abundant Birth Project, we're specifically looking at income disparities in the city and trying to address that with this program. To provide people with resources. Like your slogan, “it takes a village” says, in a village there's resource of people, but there's also resources of funds. This gives people freedom to take care of themselves the ways that they see fit and also to put resources into their own villages.

Gina Gorman: Right. Right. 

Root Causes of Racial Inequalities in Birth Outcomes.

Gina Gorman: I read this really amazing statistic on your website that, in San Francisco, a black infant is almost twice as likely to be born prematurely compared to a white infant. And Pacific Islander infants have the second highest preterm birth rate. What are some of the reasons for this? I know you just mentioned health disparities and income inequality but what are some of the reasons for this? And how can we support these communities in their childbirth journey?

Michaela Taylor: Yeah. So, thank you for asking. So, when we look at those health disparities, we know that they're not fully explained by a lot of the things that are supposed to be protective factors for people… Things like educational levels, socio-economic status, healthcare access. Those things don't fully explain why these health disparities still exist. 

So, when we look at the research we see that, really, it's exposure to racism, which causes some of these racial health disparities. With the Abundant Birth Project, we're trying to have that precise impact. We looked at those who are being precisely impacted and created a program that is for them. 

When we're looking at specific examples of how this came about — income inequality historically in the city — we see things such as redlining. And also looking at the urban development project, in the Fillmore district even... These are things that created or stopped the opportunities for generational wealth or success in black communities in the city.

And also to say, Pacific Islander people in the city face similar challenges but they also have their own unique challenges of being erased. By having a category that's often Asian and Pacific Islander, that kind of hides the disparities that they face. And then there's also the challenges that they may have in their communities with immigration or just being invisibilized, in general. 

So, these different challenges, they cause people to have different experiences, as far as with healthcare, as far as what opportunities they have available to them and really sitting at the root of much of that is racism.

Gina Gorman: Right. So, it sounds like there are a lot of historical reasons. This is something that's been happening for a long time and there are historical reasons for this racism and racism is really the reason for a lot of these inequities.

Michaela Taylor: Yeah. And actually, I wanted to add, because I know you had a call-to-action for how people can support. I just wanted to add that, of course, if you can support these causes financially, that goes a long way. Like I was mentioning, just for people to be able to have resources makes such a huge difference. 

And we want to provide cash, not just as a resource but also to communicate to people that all birthing people are deserving of abundance and to be celebrated in their births. 

Also, right now at the state level, we have the California Momnibus Bill that's happening. I don't know if you've heard about it but it's coming to the governor's desk soon.

We are encouraging people to call and to ask the governor to sign the bill. It will provide a guaranteed income pilot for pregnant Californians and it'll also cover doula access through Medicare. 

So, that is definitely a way that people can participate or they can contribute or support these communities. 

And then lastly, if you have privilege, in any type of way, leverage your privilege around how you may be able to change the system that you're in. Whether that's just a place where you're working and you're able to influence hiring practices to make sure that people have racially concordant care. Whatever ways you can bring the voices in the experiences of black and PI birthing people to the front center is also a way you can support these communities.

Gina Gorman: Those are great, great pieces of information, thank you for bringing that forward. Especially the California Momnibus bill, that's what it was called, correct? It's so important and I think that something that everybody can do is support the passage of that bill. And I actually didn't realize it had some of those features in it. So, thank you so much for bringing it up.

Michaela Taylor: Yeah. No problem. It's a big deal, so we're excited about it.

Gina Gorman: Yeah. Great. And that, kind of, leads me into the Abundant Birth Project and the work that you're doing there, with Expecting Justice and the Abundant Birth Project. I know that for Natural Resources members and supporters, the Abundant Birth Project is the partner for our most recent Play It Forward campaign. 

We're actually taking donations to purchase pregnancy bundles for Abundant Birth Project participants, which is very exciting, so that is another way that everybody can support. You can check it out and donate or learn more on our website, at naturalresources-sf.com

How the Abundant Birth Project Works

Gina Gorman: But why don't you tell me a little bit more about the Abundant Birth Project, specifically, how it works and what the goals are?

Michaela Taylor: Yeah. So, the Abundant Birth Project is a pilot income supplement for black and Pacific Islander pregnant people and women in San Francisco. And it's provided to them during their pregnancy and up to six months postpartum. 

We're trying to see how an income supplement can impact maternal stress and ultimately impact birthing outcomes, such as preterm birth. There are some studies that have already come out, specifically, one in Manitoba, Canada, that actually showed that, just providing a 10% increase in the income for folks, which came out to around 60 or $80, actually decreased preterm birth by 27%. So, that's pretty significant. 

So, we can imagine what can happen in the city with $1,000, for these populations that have been having persistent preterm birth rates. So, we're excited to see the outcome of that. San Francisco is an extremely well resourced city. Yet many of its residents, specifically the black and Pacific Islander populations, which are always shrinking in the city, are suffering from extreme income inequalities and also significant disparities in birth.

And really, this project grew out of the need to address that. We wanted to design it with community, so this is a big part of our project. When we think about a lot of the traditional programs that are out there to help people, we can see that they haven't really gotten to these community and the ways to improve their health outcomes. 

And there's a lot of ways that these programs can actually be challenging or undignified or dehumanizing, even sometimes. Some of these programs have income brackets that are so low. Especially when we look at this city because it's so expensive to live here. So, a program that has an income requirement or threshold, that's $40,000 for a family of four, that's outrageous. It's not dignified in that way. 

These programs often have low purchasing power, so folks are not able to spend the money on what they need. They're being told what they can eat or how much they can spend on food.

So, really, with the Abundant Birth Project, we wanted the cash supplement to be unrestricted and no strings attached. We just want people to have it, spend it how you need it. Maybe you need to spend it to get your car fixed or extra diapers, for your other kids to go on field trips. Whatever you need for your family is how we wanted the money to be spent. 

We came up with all the different components of the Abundant Birth Project with the community. We actually had design sprints with black and PI mamas from the city to see how they wanted the money to be distributed, how much money they felt would actually be helpful and then also, what our eligibility criteria should be. 

A big part of the Abundant Birth Project is making sure we're actually accountable to the community and making sure that this is something that actually is helpful and what they need.

Gina Gorman: That's amazing, thanks for walking through that. And it's so great that it was really developed with input from the community and those who would be participating in it.

Michaela Taylor: Yeah.

3 Things New and Expecting Families Should Know

Gina Gorman: Well, I wanted to close out with a couple of questions for you. Based on your experience with the Abundant Birth Project and your experience in your career… What are three things that you would want to tell new and expecting families that maybe are... Or things that they may not know or resources they may not know about or what would, sort of, be three tips to someone who's looking for advice?

Michaela Taylor: Sure. I have something that I can offer. 

Well, first for resources, if you are an expecting black or PI mom in the city or if you know some expecting black or PI moms in the city, absolutely apply for the Abundant Birth Project. 

And for the communities who have been impacted by these different barriers...I just think that, often there's a lot of stories that can be challenging if we're looking at the numbers around birthing in the city. This can make it hard to be celebrated as a new parent or expecting mom in these communities. 

I want people to celebrate or to feel celebrated and happy and to surround themselves with positivity in their village. To use affirmations and to not be discouraged by these numbers of the disparities that we're seeing. That's what I want to offer families. I know that it can be hard, so just to encourage affirmation about their deservingness of abundance.

Gina Gorman: Yeah. That's great advice. 

How You Can Support the ABP

Gina Gorman: So, how can people find you and the Abundant Birth Project? If they want to learn more or they want to support, is there a website or you're on social media? How can people find you?

Michaela Taylor: Yeah. Well, I personally don't have any social media but you can definitely find me on our website, expectingjustice.org. And you can also find more about the Abundant Birth Project and Expecting Justice as an organization on Instagram, we are @ExpectingJustice and on Twitter, we are @ExpectingJusticeSF and you can also find us on Facebook

We are always sharing information about the Abundant Birth Project, the Momnibus Bill, doula projects, all kinds of resources and things that are happening in the community. So, definitely follow us on our social media and we'd love to connect with you.

Gina Gorman: Great, great. And like I mentioned also, the Abundant Birth Project is our partner for Natural Resources' Play It Forward campaign. So, if you'd like to donate a bundle there, you can do that at the Natural Resources' website too. 

Well, thank you Michaela so much for taking the time to speak with me today. It's been so great learning from you and having your insight.

Michaela Taylor: Yeah. Thank you for having me. And I just want to appreciate Natural Resources for this campaign and everyone who's contributing. I know that these gifts that we're going to be able to give out to these mamas actually are really important. And it’s important for us to be able to communicate to people that you're deserving to be celebrated. We’re honored to help support that abundant birth that we're imagining for folks. So, thank you.

Gina Gorman: Great, great. So, thank you everyone for attending this installment of our, It Takes a Village interview series by Natural Resources. You can find this interview as well as additional information on our website, at naturalresources-sf.com and we hope you'll check it out and learn more and support. We'll see you next time, thank you.

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Thanks for following along for our It Takes A Village Campaign. Please donate to support Natural Resources Today!
THANK YOU to our Campaign Sponsors. They are community leaders who value supporting families from pregnancy to early childhood! 
 
 
          

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