Black Infant Health (BIH)
Black Infant Health (BIH) is a health equity program that offers individual and group support to pregnant and post-partum Black mothers and birthing people. BIH was created in recognition that anti-Black racism, social and economic stressors, and neighborhood conditions contribute to poor birth outcomes for Black mothers, birthing people, and infants. In California, and across the United States, Black mothers and birthing people experience some of the highest rates of life-threatening childbirth complications, deaths from pregnancy-related causes, and babies born too early or too small. The BIH program structure and strategies help participants enhance life skills within a culturally affirming and supportive environment that honors the unique history of Black women and birthing people. BIH seeks to impact not only participants themselves, but future generations of Black women, infants, and families.
Program Profile
Our Goal: To advance CDPH’s long-term goal of achieving healthy pregnancy and birthing outcomes for Black infants, women, and birthing people.
We Serve: Black women and birthing people who are 16 years or older, pregnant, or up to six months postpartum at the time of enrollment, regardless of income.
Service Delivery: Services are free and provided by Family Health Advocates, Group Facilitators, Public Health Nurses, and Social Workers.
Outcomes: Evaluations show BIH’s empowerment-focused, group model is a promising strategy for improving Black women’s birth outcomes. BIH participants report:
- Enhanced life skills and reduced stress
- Greater feelings of personal empowerment, leading to healthy behavior changes
- Strong social support, including positive connections to their heritage and the Black women in their community
Funding: Federal Title V MCH Block Grant Funds, Federal Title XIX (Medicaid) Funds and State General Funds.
Culturally Appropriate Services that Respect the Participant’s Values and Beliefs. The program includes empowerment-focused group and one-on-one (1:1) support services to improve the health and social conditions for Black women and their families. Activities draw from promising practices and are based on the findings of a comprehensive assessment of the BIH model..
Group Sessions: BIH provides 10 prenatal and 10 postpartum sessions designed to empower and support participants. Group sessions are led by culturally supportive staff who reflect the target population served and provide attendees with the opportunity to bond and support other pregnant women. These group sessions are available to participants 18 years and older. Sessions cover many topics, including:
- Cultural heritage as a source of pride
- Healthy pregnancy, labor & delivery
- Nurturing ourselves & our babies
- Prenatal, postnatal & newborn care
- Stress management
- Healthy relationships
One-on-One Support: Participants also have 1:1 sessions, which are intended to support participants in making healthy choices. Topics covered include:
- Referrals for identified services (e.g., medical, dental, social)
- Guidance on family planning
- Identification of strengths and problem-solving skills
- Assistance with setting short and long-term goals
1:1 support is available to 16- and 17-year-old participants and those who are unable to attend group sessions.
BIH uses a group model, which offers participants 18 years and older 10 prenatal and 10 postpartum sessions. The group sessions are complemented by 1:1 support. The group sessions and 1:1 support help pregnant and parenting Black birthing people develop life skills, set and attain goals, learn strategies for managing stress, build social support, and reduce isolation. The group model helps guide long term life planning that promotes continued progress after the program.
Each group session includes activities designed to address internalized racism. For example, sessions include a discussion of a "Black icon,” which is a Black person who has made significant contributions to society. Participating in a group with other Black birthing people, with opportunities to appreciate each other's thoughts and feelings and form friendships, may also be an antidote to internalized racism and promote self-esteem.
The 2015-2018 BIH Program evaluation focused primarily on implementation of the prenatal group model. The BIH prenatal group model is achieving its intended outcomes. Data for a sample of participants that attended an average of 7.2 prenatal groups and 5.1 one-on-one support meetings showed significant positive change in 13 of the 18 health and health-related outcomes examined.
The largest improvements were observed in seven outcomes:
- 60% decrease in no practical and emotional support
- 51% decrease in smoking within the last month
- 45% decrease in food insecurity
- 38% increase in the use of yoga, deep breathing, and/or meditation to manage stress
- 35% decrease in depressive symptoms
- 33% increase in intention to put baby to sleep on their back
Most participants that filled out a satisfaction survey had a positive experience with the program, with 99.2% of them saying they would refer a friend, colleague, or relative to BIH.
One participant said: "BIH gave me a place to connect with other Black mothers that are at the same state in their lives/pregnancy as I am. BIH provided me with women who look like me that can provide me with information/advice."
Results support BIH as a promising strategy to improve the health of Black birthing people and their families.
Services are provided in communities where over 90% of Black births occur: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Long Beach, and Pasadena.