Teaja Watts faced one of the most daunting challenges of her life when she became a mother.
Her pregnancy was complicated from the start, marred by a heartbreaking miscarriage at 11 weeks as she initially expected twins.
After a long struggle, she went into labor at just over 25 weeks.
The birth of her daughter, Kaori, was a moment filled with uncertainty.
At just 1 pound, 10.8 ounces, Kaori was so tiny that she could fit in her mother’s hand and was unable to breathe on her own.
Watts vividly recalls, “I just remember seeing her so small. I just didn’t know if she was going to live or not.”
Unfortunately, Watts’ experience is not an isolated case but part of a disturbing trend affecting Black mothers in San Francisco, facing higher rates of preterm births and alarming health outcomes for both mothers and infants.
Recent statistics highlight that the rate of pre-term births among Black mothers in San Francisco stands at 16%, a significant spike since the state began recording this data in 2007.
This rate contrasts sharply with the 8.5% overall preterm birth rate in the city, which is lower than the California average of 9.1%.
To put this disparity into perspective, 1 in 6 Black babies is born prematurely in San Francisco, compared to just 1 in 17 white babies.
The gap in early birth rates between Black and white mothers continues to widen, with outcomes improving for white mothers while deteriorating for their Black counterparts.
This alarming situation has drawn attention to the San Francisco Department of Public Health, which appears to have underfunded initiatives aimed at combating these maternal health inequities.
An investigation by The San Francisco Standard revealed that the city has underspent its budget to address these issues by at least $8 million since 2021.
In fact, critical positions within a program meant to improve Black maternal health have remained unfilled.
Women’s health advocates emphasize that addressing disparities in maternal health requires dedicated race- and gender-based funding, especially as opposition grows against diversity, equity, and inclusion policies.
Dr. Zea Malawa, a pediatrician and founder of the nonprofit Expecting Justice, expressed concern, stating, “If 1 in every 6 Black births is early, that is more kids with health conditions who need better healthcare and more medical bills for the parents.”
California has made strides in addressing racial disparities in maternal health through legislative measures like the 2019 Dignity in Pregnancy and Childbirth Act, which mandated training on implicit bias for healthcare providers.
The response to California’s dire statistics—where Black women account for a staggering 21% of maternal deaths—has involved further investigations and new legislative actions to ensure compliance with these mandates.
Despite these efforts, the statewide preterm birth rate among Black women in California has barely changed since the initiation of the Dignity Act.
In San Francisco, however, the Black preterm birth rate has unfortunately risen, which raises serious questions about the city’s commitment to fully staff and invest in state-designed maternal health initiatives.
The Black Infant Health Initiative (BIH), a program launched in the city to support Black mothers, has struggled with chronic understaffing since its inception in 2021.
State Department of Public Health records indicate that the program has operated without a director for four years and faced critical personnel shortages at various times throughout its operations.
The BIH provides essential services like support groups and breastfeeding programs but has significantly underspent its budget allocation, totaling $7.3 million over the years from 2021 through 2024, with further underspending projected for fiscal 2025.
City health officials have defended their performance, asserting that the program has continued to meet its requirements despite the budget inconsistencies.
Equally concerning, the Perinatal Equity Initiative (PEI), set up to fund various maternal health resources, also suffered from poor financial management as the city failed to account for the funds appropriately.
In the 2025-26 budget discussions, essential details surrounding that funding were inadequately addressed, leaving many advocates alarmed and questioning.
Dr. Malawa reacted with shock upon realizing that substantial amounts of PEI money had gone unspent, leading to concerns that the city was neglecting a pressing public health issue.
From 2021 to 2024, San Francisco returned a staggering 43% of its allocated PEI funds back to the state, undermining efforts to support Black maternal health as racial disparities continued to grow.
While the state government remains committed to addressing these inequities, the rise of anti-diversity activism has hindered municipalities and nonprofits from engaging in vital race- and gender-specific initiatives.
The Abundant Birth Project, which began around the same time as the statewide BIH, focused on providing financial assistance to Black and Pacific Islander mothers carefully designed to alleviate financial stress during pregnancy.
Participants in the program received $1,000 per month for their last six months of pregnancy and the first six postpartum.
Sabrina Hall, a participant, described the positive impact it had on her life, saying, “It gave me the ability to provide for my kids.”
She attributed her success in returning to school and securing employment as a medical assistant to the financial relief she received from the program.
Despite its success, the Abundant Birth Project faced legal challenges when a conservative legal advocacy group, the Californians for Equal Rights Foundation, lodged lawsuits against similar initiatives that offered support based on race or gender.
Citing the 14th Amendment, the group successfully challenged programs like Abundant Birth in Sacramento County and has set its sights on San Francisco, arguing against race-based assistance.
These legal battles cast a shadow over critical programs aimed at improving conditions for marginalized communities, preventing necessary expansions and support.
Malawa has expressed her frustrations following the emergence of this lawsuit, stating that negotiations to continue the program with the city have stalled amid these challenges.
In the meantime, the Abundant Birth Project has pivoted to launch pilots in other counties, while concerned health professionals continue to monitor the troubling conditions for Black mothers and infants.
Ranesha Mims, another Black mother, reflected on the inadequate care she received while laboring at Zuckerberg General Hospital during a COVID wave.
She observed that she received less attention compared to non-Black patients in similar circumstances.
Feeling overwhelmed and neglected, Mims experienced both fear and isolation during what should have been a supportive time.
Despite her previous birthing experience, she remains hopeful and plans to take an active role in advocating for herself in her upcoming pregnancy.
Watts, for her part, eagerly anticipates the day when Kaori, who has spent over six months in the NICU, will finally come home.
While the political and health landscape continues to evolve, advocates like Malawa remain vigilant for the futures of Black mothers and their babies.
“As racism will take generations to heal,” Malawa asserts, “babies are born every day.”
image source from：sfstandard
