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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.

Published

3 years ago

October 2, 2022

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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.

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MacKenzie Scott’s Billion-Dollar Defiance of America’s War on Diversity

BLACKPRESSUSA NEWSWIRE — Her most recent gifts to historically Black colleges and universities surpass $400 million this year alone. These are not gestures. They are declarations. They say that the education of Black students is not optional, not expendable and not dependent on the approval of those who fear what an educated Black citizenry represents.

Published

9 hours ago

November 16, 2025

Stacy M. Brown

By Stacy M. Brown
Black Press USA Senior National Correspondent

There are moments in American life when truth steps forward and refuses to be convenient. MacKenzie Scott has chosen such a moment. As political forces move to strip diversity from classrooms, silence Black scholarship, and erase equity from public life, she has gone in the opposite direction. She has invested her wealth in the communities this country has spent centuries trying to marginalize.

Her most recent gifts to historically Black colleges and universities have surpassed $400 million this year alone. These are not gestures. They are declarations. They say that the education of Black students is not optional, not expendable, and not dependent on the approval of those who fear what an educated Black citizenry represents.

And she is not the only woman doing what America’s institutions have refused to do. Melinda French Gates has invested billions in supporting women and girls worldwide, ensuring that those whose rights are most fragile receive the most assistance. At a time when this nation tries to erase Black history and restrict the rights of women, two white women, once married to two of the richest white men in the world, have made clear where they stand. They have said, through their giving, that marginalized people deserve not just acknowledgment but investment.

At Prairie View A and M University, Scott’s $63 million gift became the largest in the institution’s 149-year history. “This gift is more than generous. It is defining and affirming,” President Tomikia P. LeGrande said. “MacKenzie Scott’s investment amplifies the power and promise of Prairie View A and M University.” The university said it plans to strengthen scholarships, expand faculty research, and support critical programs in artificial intelligence, public health, agricultural sustainability, and cybersecurity.

Howard University received an $80 million donation that leaders described as transformative. “On behalf of the entire Howard University community, I want to extend my deepest gratitude to Ms. MacKenzie Scott for her extraordinary generosity and steadfast belief in Howard University’s mission,” Wayne A. I. Frederick said. The gift will support student aid, infrastructure, and key expansions in academic and medical research.

Elsewhere, the impact ripples outward. Voorhees University received the most significant gift in its 128-year history. Norfolk State, Morgan State, Spelman, Winston-Salem State, Virginia State, Alcorn State, and the University of Maryland Eastern Shore all confirmed contributions that will reshape their futures. Bowie State University received $50 million, also a historic mark. “We are profoundly grateful to MacKenzie Scott for her visionary commitment to education and equity,” President Aminta Breaux said. “The gift empowers us to expand access and uplift generations of students who will lead, serve, and innovate.”

These gifts arrive at a moment when America attempts to revise its own memory. Curriculum bans seek to remove Black history from classrooms. Political movements claim that diversity is dangerous. Women’s contributions are minimized. And institutions that have served Black communities for more than a century must withstand both political hostility and financial neglect.

Scott’s philanthropy does not simply counter these forces. It exposes them. It asserts that Black students, Black institutions, and Black futures deserve resources commensurate with their brilliance. It declares that women’s leadership is not marginal but central to the fight for justice.

This is where the mission of the Black Press becomes intertwined with the story unfolding. For nearly two centuries, the Black Press of America has chronicled the truth of Black life. It has told the stories that others refused to tell, preserved the history that others attempted to bury, and spoken truths that others feared. The National Newspaper Publishers Association, representing more than 200 Black and women-owned newspapers and media companies, continues that mission today despite financial threats that jeopardize independent Black journalism.

Like the HBCUs Scott uplifts, the Black Press has always been more than a collection of institutions. It is a safeguard. It is a mirror. It is the memory of a people whose presence in this nation has been met with both hostility and unimaginable strength. It survives not because it is funded but because it is essential.

Scott’s giving suggests an understanding of this. She has aligned herself with institutions that protect truth, expand opportunity, and preserve the stories this country tries to erase. She has chosen the side of history that refuses to be silent.

“When Bowie State thrives,” declared Brent Swinton, the university’s vice president of Philanthropic Engagement, “our tight-knit community of alumni, families, and partners across the region and beyond thrives with us.”

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The Perfumed Hand of Hypocrisy: Trump Hosted Former Terror Suspect While America Condemns a Muslim Mayor

BLACKPRESSUSA NEWSWIRE — They had the audacity, the gall, the hypocrisy to condemn Zohran Mamdani, the newly elected mayor of New York City, while opening the White House to a man their own government once called a terrorist.

Published

11 hours ago

November 16, 2025

Oakland Post

By Stacy M. Brown
Black Press USA Senior National Correspondent

They had the audacity, the gall, the hypocrisy to condemn Zohran Mamdani, the newly elected mayor of New York City, while opening the White House to a man their own government once called a terrorist. It was not long ago that the U.S. Embassy in Syria published a “Rewards for Justice” notice for Muhammad al-Jawlani, offering ten million dollars for his capture. His face, his name, and his crimes were displayed for the world to see. That poster remains online even now, an unaltered monument to America’s selective memory.

Yet this month, that same man, now known as Ahmad al-Sharaa, was greeted in the Oval Office as a partner and friend. The president who bans Muslims, mocks immigrants, and threatens to deport an elected official of color, smiled warmly for the cameras beside a man once sworn to jihad. He called their meeting “friendly and forward-looking” and praised al-Sharaa’s “vision for peace.” The irony was suffocating.

Al-Sharaa, who once commanded al-Qaeda’s branch in Syria, now leads the very nation he once helped destroy. His journey from fugitive to head of state may astonish the world, but America’s acceptance of him reveals something far more telling. Trump’s government, which once condemned Syria’s militants as the scourge of civilization, now celebrates their leader as an ally. Perfume was sprayed, hands were clasped, and jokes about wives filled the air where solemnity should have stood.

Meanwhile, in the same breath, the same government seeks to strip Zohran Mamdani of his citizenship. They accuse him of deceit, of sympathizing with terrorists, of bringing danger into America’s heart. His only crime is being Muslim and refusing to bow. Born in Uganda, raised in New York, and dedicated to serving its people, Mamdani ran a campaign focused on housing and affordability. For that, he was branded a threat. His opponents called him a “communist,” a “jihadist,” and worse. They moved to bar him from office, claiming he lied on his citizenship papers, though no such proof exists.

To his supporters, Mamdani stands for the very ideals this nation claims to defend. Yet the same leaders who cheer for a man with blood on his hands work tirelessly to silence a man with none. When Mamdani spoke of the cruel normalcy of Islamophobia, he described not just prejudice, but policy. It has become acceptable, even expected, for power in this nation to punish the devout and uplift the dangerous, to vilify the righteous and sanctify the reformed militant.

How easily the American conscience bends when profit, politics, or spectacle call. They will weep for victims of terror while shaking hands with its architects. They will warn of radicalism while applauding those who once preached it. And they will condemn the faithful who dare to lead in peace, because their peace threatens the myth of superiority.

A nation that once vowed to bring terrorists to justice now protects them in the halls of its highest office. The president who vowed to protect America from Islam now embraces a man who once led its enemies in battle. Yet a Muslim mayor, chosen by the people, is told he does not belong.

Such contradictions do not mark strength, but moral decay. A country that rewards violence and punishes virtue stands stripped of its own credibility. This is not the land of freedom it claims to be. It is a land that kneels before its own hypocrisy.

“To be Muslim in New York is to expect indignity. But indignity does not make us distinct; there are many New Yorkers who face it,” Mamdani stated. “It is the tolerance of that indignity that does. No more will New York be a city where you can traffic in Islamophobia and win an election.”

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OP-ED: The 50-Year Mortgage Is a Trap, not a Path to Black Wealth

BLACKPRESSUSA NEWSWIRE – For Black families already fighting a manufactured wealth gap, this isn’t a path to ownership. It is a debt trap that drains equity, delays retirement, and repeats the same housing discrimination that locked us out generations ago.

Published

20 hours ago

November 15, 2025

Oakland Post

By Constance Carter
Wealth Advocate

Einstein called compound interest the eighth wonder of the world. Those who understand it earn it. Those who do not pay it. That is why the Trump administration is floating a 50-year mortgage. They are betting that we will not see the true cost.

He, him, and they are framing this as a path to affordability. But let me show you what it really is.

Let’s look at the math for a $420,000 home at 7 percent interest.

30-year mortgage:
Payment: $2,792 per month
Total interest: $586,332

50-year mortgage:
Payment: $2,527 per month
Total interest: $1,095,029

You save about $265 a month but pay an extra $508,697 in interest.
Half a million dollars.

That’s not a discount. It is a trap. Stretching a loan across five decades hands banks hundreds of thousands of dollars that will never circulate through our families or build our wealth.

The numbers don’t lie.

The median age of a first-time homebuyer in 2025 is 40, according to the National Association of Realtors. If a 40-year-old signs a 50-year mortgage, they will not own their home until they are 90.

Ninety years old.

You will be renting from a bank for half a century. This is not what the 30-year mortgage was designed to do.

When the 30-year mortgage gained popularity in the 1950s, the average home was priced around $7,354, and the typical interest rate was about 4 percent. One income could support a family and pay a mortgage. The mortgage system we are being asked to trust today was never designed with our interests in mind.

From 1934 to the 1960s, the Federal Housing Administration refused to insure mortgages for Black families, calling it an “economically sound” policy. This helped establish the red lines on maps that labeled Black neighborhoods as “too risky.” Even Black veterans who served in World War II were denied access to GI Bill home loans that helped white families build generational wealth.

Black families were just as qualified to buy those affordable homes but were denied access.

White families purchased homes for $7,000 in the 1950s that are now worth $300,000 to $400,000. That appreciation built the white middle class. Black families were locked out by design.

If they move forward with the 50-year mortgage plan, working-class Black families in particular will feel the impact first, depleting the wealth we have accumulated despite all the barriers we’ve faced.

Prices are high. Rates are high. Affordability is at its lowest point in decades. We need two incomes, side hustles, credit stacking, and divine intervention to compete with institutional investors and inflated housing prices.

A 50-year mortgage does not solve this. It expands the burden by creating the illusion of affordability and traps people in a cycle of debt for life.

Think about retirement.

The average Social Security check is about $1,900 a month. Even if the program still exists in its current form by the time today’s buyers reach retirement age, how will they manage a $2,500 to $3,000 mortgage and still afford food, medicine, and basic living costs?

A 50-year mortgage pushes Black homeowners into a future where retirement is impossible, which is its own form of bondage. Bondage is debt you cannot escape. Bondage is owing a bank money until the day you die.

The data on Black wealth is already alarming. A report from Prosperity Now and the Institute for Policy Studies predicts that by 2053, the median wealth of Black Americans will fall to zero if trends do not change. A 50-year mortgage moves us closer to that outcome.

The legacy of housing discrimination still shapes today’s wealth divide. What we need is access, not more years added to a loan.

The real solutions are clear:

Affordable housing construction.
Lower interest rates.
Higher wages.
Down payment assistance.
Regulation on hedge funds buying entire neighborhoods.
Stronger consumer protections against products disguised as opportunities.

A 50-year mortgage solves none of this. It solves one thing for banks. Profit.

Family, do not make decisions today that will bankrupt your future. Before you sign a 50-year mortgage, ask yourself:

Will I still be paying this when I am supposed to be retired?
Will this help me build equity or delay it?
Will this protect or drain my family’s wealth?

A mortgage should be a path to ownership.
We cannot build generational wealth on a foundation of generational debt.