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“Shameful” Cal DOJ Report: Hospitals Ignored Racial Bias Training Mandated to Address Black Women’s High Maternal Death Rate

Four years ago this month, Senate Bill (SB) 464, also known as the California’s Dignity in Pregnancy and Childbirth Act, was signed into law by Gov. Gavin Newsom. The law, authored by Los Angeles County Supervisor Holly Mitchell, when she served in the State Senate, mandated that health care facilities implement training to address unconscious racial bias toward expectant mothers relative to California’s high maternal death rate among Black women.

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From Left to Right) U.S. Rep. Sydney Kamlager-Dove (D-CA-37), Assemblymember Akilah Weber (D-La Mesa), Sen. Lola Smallwood-Cuevas (D-Ladera Heights), L.A. County Supervisor Holly Mitchell, California Attorney General Rob Bonta and Gabrielle Brown, Black Women for Wellness Maternal and Infant Health Program Coordinator at a California Department of Justice press conference. Photo courtesy of the Office of the Attorney General, State of California.
From Left to Right) U.S. Rep. Sydney Kamlager-Dove (D-CA-37), Assemblymember Akilah Weber (D-La Mesa), Sen. Lola Smallwood-Cuevas (D-Ladera Heights), L.A. County Supervisor Holly Mitchell, California Attorney General Rob Bonta and Gabrielle Brown, Black Women for Wellness Maternal and Infant Health Program Coordinator at a California Department of Justice press conference. Photo courtesy of the Office of the Attorney General, State of California.

By California Black Media

Four years ago this month, Senate Bill (SB) 464, also known as the California’s Dignity in Pregnancy and Childbirth Act, was signed into law by Gov. Gavin Newsom.

The law, authored by Los Angeles County Supervisor Holly Mitchell, when she served in the State Senate, mandated that health care facilities implement training to address unconscious racial bias toward expectant mothers relative to California’s high maternal death rate among Black women.

However, a report released by the California Department of Justice on Oct. 27 found that most hospitals and clinics either failed to implement the training or instituted it late.

“The disparity in maternal death rates in California reflects the deep and shameful racial inequities in our healthcare system,” said Attorney General Rob Bonta in a statement the DOJ released on Oct. 27.

“In California, people of color, particularly Black women, continue to die at three to four times the rate of white women,” Bonta continued. “This is unacceptable. With today’s report, the California Department of Justice has taken an important step forward in addressing this issue by successfully building upon the California Dignity in Pregnancy and Childbirth Act.”

According to Bonta, the United States has the highest maternal death rate in the developed world. He disclosed that one year into the program, less than 17% of health facilities in the state had initiated the mandated staff training, as reported to the DOJ.

It was only after Bonta wrote a letter in 2021 threatening state intervention for non-compliance, that the percentage began to rise.

“As a Black woman, a mother, a legislator, and as a board-certified OBYGN, this topic of implicit bias and Black maternal mortality is both personally and professionally important to me,” said Assemblymember Akilah Weber (D-La Mesa), a member of the California Legislative Black Caucus (CLBC), in a statement.

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Oakland Post: Week of May 28 – June 30, 2025

The printed Weekly Edition of the Oakland Post: Week of May 28 – June 3, 2025

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Oakland Post: Week of May 21 – 27, 2025

The printed Weekly Edition of the Oakland Post: Week of May 21 – 27, 2025

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OPINION: Your Voice and Vote Impact the Quality of Your Health Care

One of the most dangerous developments we’re seeing now? Deep federal cuts are being proposed to Medicaid, the life-saving health insurance program that covers nearly 80 million lower-income individuals nationwide. That is approximately 15 million Californians and about 1 million of the state’s nearly 3 million Black Californians who are at risk of losing their healthcare. 

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Rhonda M. Smith.
Rhonda M. Smith.

By Rhonda M. Smith, Special to California Black Media Partners

Shortly after last year’s election, I hopped into a Lyft and struck up a conversation with the driver. As we talked, the topic inevitably turned to politics. He confidently told me that he didn’t vote — not because he supported Donald Trump, but because he didn’t like Kamala Harris’ résumé. When I asked what exactly he didn’t like, he couldn’t specifically articulate his dislike or point to anything specific. In his words, he “just didn’t like her résumé.”

That moment really hit hard for me. As a Black woman, I’ve lived through enough election cycles to recognize how often uncertainty, misinformation, or political apathy keep people from voting, especially Black voters whose voices are historically left out of the conversation and whose health, economic security, and opportunities are directly impacted by the individual elected to office, and the legislative branches and political parties that push forth their agenda.

That conversation with the Lyft driver reflects a troubling surge in fear-driven politics across our country. We’ve seen White House executive orders gut federal programs meant to help our most vulnerable populations and policies that systematically exclude or harm Black and underserved communities.

One of the most dangerous developments we’re seeing now? Deep federal cuts are being proposed to Medicaid, the life-saving health insurance program that covers nearly 80 million lower-income individuals nationwide. That is approximately 15 million Californians and about 1 million of the state’s nearly 3 million Black Californians who are at risk of losing their healthcare.

Medicaid, called Medi-Cal in California, doesn’t just cover care. It protects individuals and families from medical debt, keeps rural hospitals open, creates jobs, and helps our communities thrive. Simply put; Medicaid is a lifeline for 1 in 5 Black Americans. For many, it’s the only thing standing between them and a medical emergency they can’t afford, especially with the skyrocketing costs of health care. The proposed cuts mean up to 7.2 million Black Americans could lose their healthcare coverage, making it harder for them to receive timely, life-saving care. Cuts to Medicaid would also result in fewer prenatal visits, delayed cancer screenings, unfilled prescriptions, and closures of community clinics. When healthcare is inaccessible or unaffordable, it doesn’t just harm individuals, it weakens entire communities and widens inequities.

The reality is Black Americans already face disproportionately higher rates of poorer health outcomes. Our life expectancy is nearly five years shorter in comparison to White Americans. Black pregnant people are 3.6 times more likely to die during pregnancy or postpartum than their white counterparts.

These policies don’t happen in a vacuum. They are determined by who holds power and who shows up to vote. Showing up amplifies our voices. Taking action and exercising our right to vote is how we express our power.

I urge you to start today. Call your representatives, on both sides of the aisle, and demand they protect Medicaid (Medi-Cal), the Affordable Care Act (Covered CA), and access to food assistance programs, maternal health resources, mental health services, and protect our basic freedoms and human rights. Stay informed, talk to your neighbors and register to vote.

About the Author

Rhonda M. Smith is the Executive Director of the California Black Health Network, a statewide nonprofit dedicated to advancing health equity for all Black Californians.

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