Veranda Rodgers got pregnant at age 16. At the time, her parents were very disappointed. “My father didn’t speak to me for two months,” she said. Nonetheless, they supported her so she could finish high school and graduate from Cleveland State University. She is now married to the father of her child.
“Pregnant at 16, that could have been the story that derailed my life,” Rodgers said. “It could have taken me down a path of being in poverty, of being stuck. I’m pleased to say that is not where my life ended.”
These life experiences shaped Rodgers’ desire to provide culturally competent care for Black women. In 2014, she founded Pregnant with Possibilities (PwP), a nonprofit organization dedicated to teen pregnancy prevention, positive birth outcomes for Black women, and preventing subsequent births to non-equipped women and teenage girls in urban communities.
PwP is one of the emerging “Black-led and Black-serving” social service and healthcare organizations in Cleveland that is confronting the racial disparities in Black women’s maternal health.
“Our services are created by African American women for African American women, but we do not exclude anyone,” Rodgers said.
Cultural competency is increasingly recognized as a barrier to ending racism in healthcare. For example, the Covid-19 Ohio Minority Health Strike Force Blueprint recommended that Ohio mandate cross-sector cultural and linguistic competency and implicit bias training for all professional licensing boards for hospitals, health systems and service providers.
People of color account for 24% of all healthcare workers, but only 8% of the decision-making senior management positions in Northeast Ohio, according to the Diversity & Inclusion Assessment Report published by Greater Cleveland Partnership in January 2021.
Over the past three years, Cuyahoga County has shown substantial improvements in Black Infant mortality. Per 1,000 births, Black infant mortality was 15.49 in 2018, 16.34 in 2019 and 13.26 in 2020, according to data provided by the Cuyahoga County Department of Health.
However, the racial disparity for infant mortality between non-Hispanic Black women and white women remains stubborn. Despite improvements, non-Hispanic Black babies born in Cuyahoga County remained approximately 4x more likely to die before their first birthday than white infants in 2018 (4.1x), 2019 (4.2x), and 2020 (3.9x).
Black women are leading the charge in this improvement.
Improving Black maternal health
Rodgers addresses cultural competence through her curated list of service providers. She partners with other organizations led by African-Americans, such as Nakeisha Wells at Cleveland Diaper Bank, Yvonka Hall at Northeast Ohio Black Health Coalition, Marie Jones at Neighborhood Leadership Institute, Danielle Graham at Rooted Blossoms and Tenisha Gaines at Village Of Healing.
Rodgers tapped Delta Sigma Theta – a national, historically Black sorority with notable members, such as former Congresswomen Marcia Fudge, Shirley Chisholm, and Barbara Jordan – to mentor her clients on a weekly basis.
As a provider of educational services to pregnant women, PwP also coaches its clients on the preventable risk factors for infant death. These risk factors include sleep-related deaths leading to sudden infant death (SIDS) and teenage pregnancy.
Rodgers also focuses on the prevention of teen pregnancy. Her own son weighed just four pounds when she gave birth to him at 17 years old.
According to the World Health Organization, “Adolescent mothers (ages 10–19 years) face higher risks of eclampsia, puerperal endometritis, and systemic infections than women aged 20 to 24 years, and babies of adolescent mothers face higher risks of low birth weight, preterm delivery and severe neonatal conditions.”
In Maple Heights, where PwP is located, the teen pregnancy rate is 48.35 girls out of 1,000. Maple Heights has the second highest rate of teen pregnancy of any city in Cuyahoga County. In Ohio, about one in 10 infants are born to a teenage mother.
PwP has a 10-week program called “Sexual Health” aimed at schools. Cleveland Metropolitan School District and other urban schools have contracted with PwP for pregnancy prevention services. Although the Maple Heights School District has never contracted with PwP, Rodgers has answered the call to provide ad hoc services to its residents.
“I had a mother call me because she had a son in eighth grade who was sexually active,” Rodgers said. “She begged me to provide educational support for him.”
Marie Jones, Director of Community Health Initiatives at Neighborhood Leadership Institute, contracts with PwP for its Equity in Birth Outcomes program, combating infant mortality.
“There is a lot of work to do because we have all internalized the perceptions of African-American inferiority, that we should not have a voice,” Jones said. “All health providers should be educated. Even the Black doctors who made it out don’t understand the water we are swimming in.”
A new network of Black providers
Collaboration between grassroots organizations has resulted in targeted solutions to improve the number of Black women who receive prenatal care, a key indicator of maternal health. In December 2020, the Regional Transit Authority (RTA) received $400,000 from the Ohio Department of Transportation to transport expectant mothers in Collinwood, East Cleveland and Glenville to their prenatal appointments.
The RTA received the grant based upon the data and advocacy initiated by Community Health Initiatives and PwP. The two organizations identified a preponderance of expectant mothers in those specific neighborhoods who opted out of prenatal visits because of lack of transportation. Their clients bemoaned how Provide-A-Ride required them to arrive two hours early for an appointment and kept them waiting two hours to go home.
RTA’s Baby on Board program began on January 22, 2021. Women and families within zip codes 44108, 44110, and 44112 will receive transit passes so they can reduce the cost burden of going to all medical appointments necessary for a healthy baby and healthy mother. In addition, a portion of the funds will be used to improve bus stop amenities – targeting stops near medical and family facilities, such as daycares, libraries, and grocery stores.
PwP also holds the unique position of being both an educational service provider and an official navigator for pregnant women and mothers in Cuyahoga County. Navigators connect pregnant women in Cuyahoga County to supportive healthcare and social services. There are more than 30 contractors in Cleveland working with pregnant women.
PwP educates its client base – which is 89% Black – in personal development and preventable risk factors in poor maternal outcomes while also referring their clients to culturally sensitive organizations for housing, food and transportation resources.
They are part of a new network of Black women helping Black women.
“I can see organizations that are African-American owned coming together and building synergies around the families we serve,” Rodgers said. “So often a lot of decisions are made by individuals who don’t look like us without polling the population they serve. Decisions are made by organizations without grassroots or the cultural competency to address what families deal with. We have so many stigmas and traumas around healthcare.”
Miesha Headen is a freelance journalist and Executive Director of AACE, a non profit transportation company. She was a recipient of the CLE AKR Informed Communities grant to write about Black women’s maternal health through collaborative journalism.
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