Community Organizing for Health Justice: Reproductive Justice Activism and the Coalition to Fight Infant Mortality

Bridget Cuadra

An enduring struggle for communities of color, infant mortality is a major issue especially for pregnant Black women and their newborns. Deliver Birth Justice—a public health initiative in Santa Clara, California—aims to dismantle such racist and sexist structures in medicine. According to Deliver Birth Justice, Black babies are two to three times more likely than white babies to die before their first year of life and are often born prematurely.^[1] Black mothers also face grave disparities in childbirth; Deliver Birth Justice notes that Black mothers are three to four times likely to die in pregnancy and childbirth. This essay focuses on the historical activist work of the Coalition to Fight Infant Mortality (CFIM), an organization that preceded Deliver Birth Justice by over 40 years, as they advocated for Black women and their babies during the 1970s and early 1980s in the East Bay Area. Black women and babies face similar inequities regarding reproductive health even today; this essay suggests that fighting for reproductive justice, as Deliver Birth Justice does, continues to be imperative.

Like Deliver Birth Justice, the CFIM focused on lowering infant mortality and maternal mortality rates for the Black community.The Third World Women’s Alliance and Black Panther Party leader Erika Huggins formed the CFIM in 1979. The CFIM sat at the center of women of color feminism in the Bay Area, particularly East Oakland, and was active until 1984. Through efforts like its Community Based Investigating Team (ITEAM) the CFIM served as an important precursor to the reproductive justice movement. It demonstrated intersectional activism, mobilized the community, and emphasized the right to have children and the right to parent children in a safe environment, two core principles of reproductive justice activism.^[2]

In 1980, the CFIM formed ITEAM to gather information from the community regarding infant mortality at Highland Hospital. Highland Hospital was the only public hospital in Alameda County to deliver babies, and it was notorious for its disparities in healthcare for Black infants and mothers. ITEAM consisted of a “racial cross-section of community members and health care providers in Alameda County–including members from Highland Hospital.”^[3] It included the “people’s physician” Vicki Alexander, MD and TWWA member Melanie Daumont.^[4] The CFIM opposed Highland Hospital and the Alameda Board of Supervisors (BOS) in addressing the situation at the hospital. The activists argued that the hospital and the BOS were both complicit in the suffering of the patients at the hospital.^[5] They showed that structural racism and sexism in medicine played a key role in the treatment of Black women at Highland.

Participants who took part in the ITEAM investigation included community members, health care providers, hospital workers, patients, doctors, nurses, receptionists, clerks, physicians assistants, and Highland workers in inpatient and outpatient units.^[6] The investigation committee gave the local people the opportunity to discuss their experiences at Highland and to work toward change and healthier mothers and infants. The ITEAM sent out four questionnaires to currently pregnant women. They sent another one to women who received reproductive healthcare at Highland in the past, one to Highland Hospital staff in both inpatient and outpatient settings, and one to local health professionals outside of Highland Hospital. The CFIM and ITEAM chose open-ended questions so that the participants could fully express themselves and their thoughts regarding Highland Hospital.

The ITEAM investigation noted that Highland Hospital fell short in their care for poor women of color, leading to infant and maternal deaths. The hospital had a plethora of issues, including a lack of translators for their Latinx patients. In a newsletter, some of the complaints included the high cost of prenatal care, which the activists noted as the “most important barrier” to medical care.^[7] Women had to travel to get prenatal care, and they experienced slow and expensive public transportation and poor attitudes from providers. Black mothers experienced racism from the providers, and they noted that women of color felt rushed, with doctors not spending enough time with the women in their care.

During the ITEAM meetings, the BOS demonstrated racist attitudes towards the patients at Highland. For instance, Chairperson Fred Cooper made disparaging remarks comparing Highland to Piedmont, a predominantly white neighborhood.

Piedmont does not have drug addicts getting pregnant. Piedmont does not have alcoholics getting pregnant. Some women think you can be a drug addict or an alcoholic and get pregnant without it affecting the baby.^[8]

Like the ITEAM hearings, the local newspapers elaborated on how poor women of color received subpar care at Highland Hospital. The San Francisco Chronicle’s first article on the topic, “East Oakland’s Shocking Rate of Infant Deaths,” noted that East Oakland had the second highest infant mortality rate in the country. Black Panther for Self Defense member Erika Huggins compared the situation to low income, developing countries.^[9] Another article in the Oakland Tribune covered the experience of a woman named Charlene, who ended up having a stillbirth due to lack of access to prenatal care and the racist attitude of the doctor at Highland Hospital when she went for her appointment.

Rather than considering the ITEAM findings, the BOS decided to address the issue themselves through the Alameda Grand Jury. The ITEAM argued that the Grand Jury, being made up of white, middle class men, did not represent the East Oakland community. The Grand Jury suggested that Highland get a Neonatal Intensive Care unit in the form of a Level Two nursery. While this suggestion was a step in the right direction for the women and babies delivered at Highland, the ITEAM called for a more comprehensive approach, including translators for the Latinx population.^[10]

The ITEAM completed their investigation in 1980.^[11] The CFIM charged the BOS with neglect of mothers and infants, and argued that the wealthier areas, particularly neighboring Piedmont, received better care and experienced lower infant and maternal mortality. CFIM activists requested a sliding scale for payments. Additionally, they noted that several doctors had private practices outside of Highland. The activists claimed that Highland doctors should only practice medicine at the hospital. They warned that working at Highland and having their own practices led to overworked doctors. The hospital also lacked funding and translators for its high population of Latinx patients. Alice Jones, a medical resident working at Highland Hospital and medical professional who supported the ITEAM, explained the inadequate care poor women of color received at the hospital. For example, she witnessed nurses delivering babies without a doctor present.^[12] She recalled a doctor leaving the room before a delivery was over, which resulted in a stillbirth.^[13] To address these issues, the CFIM gathered the opinions of the residents of East Oakland regarding Highland Hospital and infant mortality rates.

The ITEAM report remains an important document in the history of reproductive justice and women of color activism in the United States. Considering the fight for women’s reproductive rights and the continual injustices faced by women of color while pregnant and giving birth, the ITEAM document provides perspective on these reproductive experiences and influences activist efforts today. Therefore, the ITEAM and CFIM continue to be central to reproductive justice activism–in large part by creating the foundation for present-day activist organizations, such as Deliver Birth Justice. The organization works to ensure that each birthing person feels empowered and has the right to deliver their baby in a safe environment with supportive healthcare providers. Additionally, Deliver Birth Justice allows for mothers to give birth in and provide a safe environment following the birth, with emphasizing a reproductive justice and intersectional perspective. Overall, the CFIM, ITEAM, and Deliver Birth Justice emphasized that sexism and racism intersected to create deadly consequences for women of color while giving birth.

Bridget Cuadra

Bridget Cuadra is a Professor of History at Oklahoma City Community College in Oklahoma City Oklahoma. Her research interests include the history of medicine and gender, social movements during the 1960s-1980s, and African American history. In her spare time she enjoys spending time with her family.