Abundant Birth Project gives expecting mothers one less thing to worry about

Program aims to reduce Black, Pacific Islander preterm births with monthly payments, support

Breezy Powell is one of six children who were all born preterm due to high stress. In her mother’s last pregnancy, the child died in the womb from the same complications.

Now 33 weeks pregnant herself, Powell is a community researcher on the Abundant Birth Project, a program aimed at reducing preterm births like those in her family within the Black and Pacific Islander communities.

“I’m thinking… if my mom would have had something like the Abundant Birth Project during her pregnancy, it would have been [so much easier] for her. She’s a single parent,” she said.

For Powell, whose mother lacked support from the community or a partner, a healthy, full-term pregnancy is a way to rewrite her family’s history.

“Like I said that [was] my seventh sister and there’s six of us already,” she said. “It just would have alleviated so much stress for her and empowered her more. She would have felt more equipped [and] more in control of her life.”

The Abundant Birth Project is a pilot program that provides an unconditional monthly income supplement of $1,000 to 150 low-income pregnant Black and Pacific Islander women in San Francisco for the duration of their pregnancies and six months postpartum. It was announced earlier this month by Mayor London Breed.

The project, produced by Expecting Justice—a Black-led, cross-sector initiative of city agencies, community-based organizations and health providers—is a fully funded public-private partnership aimed at reducing high rates of Black and Pacific Islander preterm birth — when a baby is born before 37 weeks of pregnancy — and improve economic outcomes for those communities. The project will also work with local prenatal care providers and a network of pregnancy support services to identify and enroll eligible clients over the next two years. Enrollment for the program begins early 2021.

Breezy Powell and Ekland Abdiwahab, a graduate student at University of California, San Francisco, conduct a mock client interview. (Courtesy Breezy Powell)

Breezy Powell and Ekland Abdiwahab, a graduate student at University of California, San Francisco, conduct a mock client interview. (Courtesy Breezy Powell)

According to the San Francisco Department of Public Health, between 2012-16, Black infants were twice as likely to be born prematurely compared with white infants (13.8% versus 7.3%) with Pacific Islander infants having the second highest rate at 10.4%.

Anu Manchikanti Gomez, an asssociate professor at University of California, Berkeley’s School of Social Welfare who has studied reproductive and maternal health issues for nearly 20 years, is working alongside Expecting Justice as a co-leader in the evaluation process of the eventual participants in the program. What they’re looking for is changes in stress levels, financial well-being and racialized forms of stress.

“Black and Pacific Islander folks are small populations in San Francisco that are overrepresented in terms of adverse birth outcomes like preterm birth, and we know that these birth outcomes are linked to stress, but also structural racism and the legacy of decades of discrimination,” said Gomez. “Our hope is that this supplement is a way to reduce stress for these groups that are at risk. We know that we cannot change the system of structural racism with a supplement. But we hope for these groups that it will provide some relief and reduce stress, and by doing that that will improve their birth outcomes.”

In order to track this, the project will be surveying every participant during and after birth as well as when they finish the program. Other counties around San Francisco will also supply data from pregnant women not participating in the program to provide comparison points..

Because the supplement is unconditional, participants are able to spend the money without parameters. Gomez said that they aren’t interested in monitoring how people use the funds, but know that the benefits may extend beyond the pregnancy.

Powell has worked in collaboration with Black and Pacific Islander mothers within the community in an effort to learn their needs, birth experiences and experiences with social services in San Francisco. She and other community researchers helped design the structure of how expecting mothers can receive the income supplement.

“A lot of the moms reported just feeling unsupported by social services [and] also just having to deal with a lot of shame and stigma when you go to get social services. Also, just not having an adequate amount of [services],” she said. “[Social services] aren’t realistic in a way. They make them for robots instead of considering a real person and [their] needs and expenses.”

Powell said she hopes this program will provide mothers the agency that her mother didn’t have during her pregnancies. Whether it’s spent on a massage or diapers, she hopes the supplement helps mothers feel supported financially and mentally.

“I just want to see these moms feeling good and feeling in control of their life, not feeling like life is in control of them,” Powell said.


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