Birth Equity Initiative
Birth Equity Initiative
Background
Birth equity is a key initiative for CLC and began in Los Angeles County with Cherished Futures for Black Moms & Babies, a joint initiative of Communities Lifting Communities, the Public Health Alliance of Southern California, and the Hospital Association of Southern California from 2019-2023. The work of the joint initiative was completed as of 12/31/2023.
In 2023, CLC held focus groups and key informant interviews to assess the needs and challenges of Southern California birthing hospitals as they relate to birth equity and the care experience and birth outcomes for communities of color that have been marginalized by existing systems of care.
Co-developing a Birth Equity Initiative
In 2024 CLC hosted three roundtables addressing perinatal mental health, the Organizational Birth Equity Assessment, and highlighting Miller Children’s and Women’s Hospital.
- February 28 Perinatal mental health in the hospital setting
- April 24 Promoting birth equity at the hospital and in the community: Successes and Strategies at MemorialCare Miller Children’s and Women’s Hospital Long Beach
- June 26 Organizational Birth Equity Assessment enhancement and pilot opportunity with DoTank
2025 Activities Include:
- Hosting a Birth Equity Thought Partners meeting on May 28, 2025
- Evolving the Organizational Birth Equity Assessment (OBEA) tool and analytics and adapting it for ambulatory prenatal care clinics
- Building a collaborative learning curriculum/play-book for hospitals and ambulatory care clinics
Maternity Care in California: An Environmental Scan
Since 2014, 53 labor and delivery departments have closed in California. Prior to 2014, at least 250 hospitals in California delivered babies. The California Hospital Association (CHA) has prepared the Maternity Care in California: An Environment Scan for review and discussion. The CHA Report Finds Labor and Delivery Closures Driven by Three Factors:
Low delivery volumes, Workforce shortages, and Hospital financial instability. The report also finds that economically disadvantaged communities are disproportionately impacted, with fewer clinicians available and greater travel required to access care. Each California community is unique and requires an approach to maternal health services tailored to its needs, with priority given to mothers’ and babies’ safety and an emphasis on high-quality, equitable care.
Organizational Birth Equity Assessment (OBEA)
The Organizational Birth Equity Assessment, or OBEA, is a current state analysis tool for hospitals nationwide to assess their own strengths and weaknesses before ideating programming around birth equity improvement. The OBEA is a 60-question online assessment that is broken down into 4 domains, with each domain consisting of 3 sub-aims and each sub-aim consisting of 5 questions. This means there are 15 questions dedicated to each domain, culminating in the 60 questions total. From an analytical standpoint, all questions are weighted equally and therefore contribute to an organization’s score equally.
The OBEA was derived from Cherished Futures for Black Moms & Babies, a joint initiative of Communities Lifting Communities, the Public Health Alliance of Southern California, and the Hospital Association of Southern California from 2019-2023. The work of the joint initiative was completed as of 12/31/2023.
The Four Domains of the OBEA
Data
Collection, review, and reporting of their organization's birth equity data to assess if their data-gathering and data-use practices are equitable.
Workforce
Encompasses provider availability, reimbursed doula and midwifery services, diversity, provider and c-suite buy-in, and training.
Clinical
Clinical practices used by providers. It focuses on the practices integrated into patient care and measures whether best practices are in use.
Structural
Reflect on the institutional, political, and community structures that affect birth equity and maternal health care in their community.
