Sabrina Beavers and Shantay Davies - Balch

00:02 My name is Shante Renee Davis Balch. I'm 38. Today is May 3rd 2019. We are in a roll part of Fresno County in Sanger at the library. And Sabrina beavers is a friend and colleague. My name is Sabrina Michelle beavers 35 today's date is Friday, May 3rd, 2018 our location. We're here at Sanger library with in Fresno County. And my relationship to Shante is a friend and colleague. Also in the room is my little newborn daughter. Her name is Destiny, Serena code Johnson, and she's five weeks.

00:50 Sabrina I don't remember when we first met it was a few years ago.

00:59 And I remember that we met through work. I'm you work for black infant Health, which is a program in California that exists to improve birth outcomes for black women and at the time I was working as the regional breastfeeding liaison for California Department of Public Health.

01:21 And the first memory that I have of you.

01:26 Is you reminded?

01:29 Me of a younger version of myself and I was really inspired by how passionate and active you were to improve health outcomes for black women.

01:42 Yeah, I don't remember how we met either. I just I just know it was through work. I'm not for sure if I met you through Fanta which is the coordinator over the black infant health program or just buy happened chance that we met out in the field some kind of way. But I do remember you encouraging me within the field of maternal health and always being a supporter of black infant health and then also personally with me and my my daughter

02:21 So

02:23 Actually, I don't think we've ever talked about how you got to black infant health or what your story is, but so my story.

02:33 I'll share my story and then I actually would love to learn how you got to where you are cuz we've never talked about it. So.

02:44 I was born in Southern California and both of my parents were addicted to just various substances. And then we ended up in the Central Valley and I remember when I first came here I had just have this huge birthday party and then I came here to live with my grandparents and they worked in ad when I was turning 7 and we lived in these real places like Coalinga and Huron and just wherever there's migrant Farm Workers, you know, that's kind of where we lived.

03:24 And my mom was in the process of becoming clean and sober and then I went back with my mom and then unfortunately, I went into foster care and

03:38 What I remember very specifically is My Sanctuary at school was the library. So I would sort of go walk around and be really social with people and kind of a superficial way. But what I really wanted to do was go to the library. That's right. Go and one day and I had grown up like seeing babies like

04:02 Born really tiny. I didn't know there was a name for it. It kind of felt really normal to have babies born like small and really tiny or have them in the hospital for a long time.

04:15 And I remember growing up it was even normal to have black women die, like either during birth or soon after it was just normal and no one kind of talked about it and when I got to high school, I don't remember how but I was invited to join a group of students because Governor Gray Davis was on his campaign Trail and he stopped at Fresno high school where I was a student and he was the first person I've ever heard talk about preterm birth. That was the first time I heard the word preterm birth. I was in high school and it was the first time I heard someone formally talk about black moms dying and black babies like not surviving past their first birthday.

05:05 And

05:07 I became passionate about women in general, but also and also migrant women who tend to not have a voice and black women who tend to not have a voice and just health and our well-being and babies and breastfeeding and like everything that could possibly like help us Thrive. So that's my story of how I

05:30 Got here.

05:32 Well for me, I grew up in Kern County Bakersfield specifically was raised by a single mother. My father was kind of in the picture you listen to same city. We didn't develop a father more of a father-daughter relationship until I got to high school and it was kind of forced but at the same time it became natural and the reason why I was because my mom needed help. My mom has started working for the United States Postal Service, and she was working graveyard. So she would get off after I would have to be at school and I was a part of the marching band at Ridgeview High School in Bakersfield and we had zero. So it was like at 6 in the morning. Of course. She didn't take me so he my mom petition him to do.

06:32 So so that's kind of how I relationship develop because we will see each other every morning Monday through Friday throughout the fall and the rest of the school years cuz he would drop me off for my performances for band. But when I graduated from there, I was determined to leave Bakersfield because of Bakersfield kind of is kind of a similar Community to Fresno when you grow up there, it can be a

07:01 Like a huge hole that kind of draws you in and keeps you stagnant. You don't really progressed or grow. So I knew I didn't want to stay there if I didn't apply to any oncologists in Bakersfield all the colleges. I applied to either out of state or elsewhere in California, landed at Fresno State ended up getting my degree in health science or public health shortly after maybe a few years cuz it was also when I graduated was between it was around 2008. So that's when the housing market I kind of fell apart and so was hard to find a job finally around 2011. I got my foot in the door at the county through with social services and then once a job opened up as for health education specialist at Public Health

08:01 I applied and obviously got the job. I started working with the Fresno County Department of Public Health as a health educator. Was there a nutrition education and obesity prevention program or niat program? I was there for three years before I transferred over to block emails and I've been there since when I but my first exposure to Black maternal Health infant mortality preterm birth maternal Health in general was once I got was prior to me getting to the program cuz I partnered with them to come and do their educate their nutrition sessions. So I was familiar with black but I wasn't really getting into what it was at their services were until I actually became part of the program as a employee.

09:01 That's when I started, you know, getting more into realizing the prevalence of mothers dying during birth or shortly after are having.

09:18 Maternal incidents or injuries and then also the issue of babies dying before the first birthday being born too early or too small. So once that, and then I started thinking about my family, even though in my family, it wasn't something that happened to us directly at least that I knew of I knew a lot of friends and their families who have suffered with babies that were in the NICU for weeks or who didn't make it home. So I wanted to make sure that I was you know pushing because my I myself eventually was on her child, which I have now, I remember

10:05 It's funny that you mention family. It's only recently actually that I have found out that someone in my immediate family had a child that did not make it I was not even aware that she was pregnant or having a baby and I remember the time. But I just remember she kind of disappeared out of our lives for a little while and it took her

10:38 A really long time like

10:42 Over 10 years to acknowledge publicly, you know that she had experience and infant loss and

10:50 I think like in terms of thinking of my community one of the questions I always receive is well.

10:59 Why do black babies die at such a higher rate? Why do black women die at such a higher rate? You know, why is the rate so high and we don't have the the answer it's complex. But also there's a sensitive topic that's very real that comes up and I think it has to do with stress and racism and the structure of the Central Valley and it's really difficult to talk about that one because I love the Central Valley. I love Fresno. I love living here.

11:33 But we're a really small population and it's really weird to think that like I can go a whole week. For example without seeing anyone that looks like I do and when I think about the structure of my community, I think there's like key things that strike me. I can remember shopping in my early twenties like who goes to the grocery store now everything's just delivered but but I can remember going like to the grocery store. And the first thing I was told was separate your food from your non-food items cuz it's easier to process your EBT card and I was like, but wait a minute. I don't have an EBT card like I'm paying with cash or debit card or like going to the doctor. The first question I would be asked.

12:28 Was Ty. Do you have your medical card? No, cuz I have private insurance and it's so like walking in those shoes. I think a lot of people like don't understand the levels of stress that impact black women and so

12:48 It's sort of mind-boggling. That's the best phrase I can think of to think that you can be this educated black woman and still have a poor birth out. Even if you do everything right you can do yoga and have I do lie and, you know take your folic acid and go to the doctor early and go to classes and

13:11 Still you may not have the best outcome and you know, I have three kids Savannah Gigi and Kingston and both Gigi and Kingston were born early both of them and I did everything right? I was educated. I took my folic acid. I had a great doctor. I've had a midwife I had to do, you know, I did Sasha and I did exercise like I even had a spreadsheet where I tracked my vegetable and still, you know, I had two babies that were born preterm.

13:49 And I just don't understand what the answer is in. The one thing that I come back to is like the research on the body and stress and what happens to the body and like your experience of like carrying a child and being a black woman. I don't know what your experience has been but that was my experience. Well, I know coming from working as someone who implements a program to help prevent those things for black women.

14:21 A lot of the women that would come to our program with Express certain micro aggressions them going to the doctor's office. They have an appointment and I have to wait 3 hours before they're seen by a doctor and these are women that are on medical and receive other government assistance or going to the WIC office and having a week or not getting their needs met not getting their questions answered having to get the run-around when it comes to getting the services that they need in that of course and do some stress and of itself and then you think of their personal lives and there's a lot of toxicity when it comes to their relationships with their family, they're significant other husband, and there's a lot of dysfunction because oftentimes they come from families that don't know how to love

15:20 They're doing the best that they can but then X the support they received this what's causing their stress because they don't know how to engage in self-care they take on that strong black woman Persona of having to take care of everybody. But no one's there to take care of them. Even while pregnant even though and then of course fighting against what we're telling them as far as implementing the program like you need to you can't take care of everybody. If you're not taking care of yourself what happens if you fall dead then what I mean, you hear stories of women taking care of their grandparents or being a very takers or dealing with their grandparents who should know how to deal with life as an adult. So, of course that's hard and they're young and experiencing all these things on top of having to deal with

16:20 Health Care System having to do with social services and

16:26 Was it difficult for you? When you were pregnant would like navigate the system if you will the healthcare system for me because I know more than the average person so it wasn't like they can't treat me any kind of way. I knew how to speak up for myself fortunate fortunately. I didn't have any.

16:55 Bad experiences nothing but support even from my doctor now, but I could use a little bit more for my doctor. There were some things about my care. I did have questions about but because of the fact that my prayer my pregnancy was progressing. Normally they didn't raise any red flags and I thinking about it in retrospect after I delivered at 35 weeks and 2 days gestation on my last day of work, ironically what happened on your last day of work. So my last day of work preparing to go on maternity leave cuz I was taking advantage of the 30 days prior to my due date.

18:17 If we could tell the story again if your last day of work, okay, so my last day of work I Was preparing to leave to go on maternity leave to take advantage of the 30 days prior to delivery so I can rest nest and you don't prepare for my impending birth. And while I was sitting at my desk, I wasn't doing anything stressful. I was sitting there relaxing. I was actually waiting for my co-workers to finish ups setting up for my quote-unquote surprise baby shower already knew about it, but I was waiting for them to get

18:59 Everything together. So it was around 11:20. And then I had this what I thought was a Braxton Hicks contraction, but it was really really tight and it was causing pressure against my Buckle. So I just kind of sit sad up to you know, get more comfortable in an ad to get to the point spread unbuckle my pants to kind of give it rude and when I did that over sudden I felt this.

19:30 Like a gush like a pop and then a good shower and then I'm sitting there and I'm thinking it is because I'm only 35 years. So I'm like well, maybe I just have to go to the bathroom. So I went to the bathroom to check and see what was going on. I did have to go but then after that was over where they were still liquid coming out and I'm thinking okay. Well if this is what your water breaking it supposed to be like that this probably is what it is and tell your water broke when you're 35 weeks. So I walked back by walk outside to go call Labor and Delivery at Kaiser to tell him what had happened. They were like, it sounds like your water broke. So we're going to need you to come in so we can evaluate.

20:20 So the clothes out whatever you need to do and make your way over here and then they ask why you ain't paying the first I said no and then of course the contraction came and was it that answer change by wait a minute then she was like actually don't go wherever you need to go just come here immediately. So I'll go back inside and talk with my boss fans and one of my other colleagues Meghan and I let him know. Okay, so I might have to leave early and I will see you later. Where you going? I'm pretty sure my water broke and she was like, I remember when I heard that your water broke I felt sad.

21:09 I felt sad because

21:13 I just thought about people like you and me and just people across the state who are working really hard to prevent preterm birth and to prevent black women from having their babies in the NICU to prevent low birth weight babies early babies just poor birth outcomes, and I just thought to myself. Okay, I don't understand. I'm educated Sabrina's educated. We have all the information in the world. We can be self advocates for self. We understand what questions to ask.

21:45 So

21:48 Why am I doing the work that I'm doing? What am I sharing with other black women? Am I even telling the truth? Like I kind of question my own self.

21:58 Like why am I telling black women that it's helpful to like do yoga and have a reduce your stress level?

22:07 Because it feels like even if you have all the information and you do everything right and you have all the education in the world and you know how to Advocate and ask questions and you take folic acid and go to the doctor that you still have a poor birth outcome. So that's how come I felt sad when I heard that Destiny was

22:29 Was early

22:32 And then I thought about all the other women who actually don't have all the education and they don't know how to advocate for themselves or they don't know what questions to ask or maybe they

22:47 Had to sit for four hours at the doctor every time they go or maybe they missed appointments because in the Central Valley, we have a huge shortage of doctors. It takes 3 hours or 4 hours. Sometimes just to see a doctor. I remember just through the course of work. I was talking to a pediatrician and he told me he saw 81 patients that day 81 in one day and then I think okay, so that means that

23:16 This is a good guy who really wants to take care of babies. Like he wants to see babies Thrive and be healthy and he has 3 minutes.

23:27 That doesn't even make sense. And then I think about the women for example, who

23:34 Maybe couldn't get to the doctor. So you called Kaiser and they're like, okay drop what you're doing and come to the hospital and then you're like, okay great. I'm going to let my team know I'm leaving getting your car and you drive. What about someone who lives role they don't have a car or they have to wait for a ride or there's no bus and then by the time they can get to the hospital things have progressed and then maybe complications and then there's meconium in the fluid and there are maybe they are some adverse outcome happens because there's you can't get to the doctor or the hospital fast enough. And so I felt grateful that I knew that you could advocate for yourself and that you would know what questions to ask in the NICU but then I also felt sad like thinking of all the other women and particularly black women because that's where our biggest

24:28 Album is in the Central Valley so then I felt really sad for them.

24:34 Well me considering that was going through it. I feel very calm even though I knew that it wasn't the right time because of my knowledge as a in the program. Of course. I was a participant in my own program, even though I work for the program cuz I knew the importance of

24:57 Having a place to go to meet with other women to talk about things that are going on in your life as a was a black woman as a woman and as the pregnant black women, I'd always come I always had empathy and try to

25:18 Connect with the women in our program, but I couldn't really because I hadn't experienced being pregnant or motherhood. So it was an eye-opening experience to actually be a part of my own program and get the experience from the other side. So when I when they told me I had to be admitted course because my water broke and there's no point of return at that time. So my body was getting ready to deliver this baby. Oh fortunately and unfortunately, I delivered in 4 hours for our labors right and that there were some concerns because with each contraction of her heart rate cat varying and my blood pressure keep going up, but the medical team that was there was on top of everything, but I can imagine so

26:18 One who's in that situation and they're telling patients who are on Medi-Cal that we need to do an emergency C-section and it's like, okay, no, not necessarily baby's heart rate is still within normal is just that every time moms in pain, but pressure varies, that's normal. You just got to reposition spring for it can keep baby's heart rate from dropping give Mom oxygen right do whatever you can to keep from having to do make this major surgery on top of gel top of delivering a preterm baby in you thinking about having to be cut open and incision and recovery time and then what happens when baby comes home if they spend time in the NICU they have to come back and forth to the hospital. So I had to experience that even though it was only for a week and I didn't

27:18 I felt very overwhelmed why even talkin about it now, I still feel overwhelmed about it because it wasn't something that I was prepared for.

27:29 Um parte overwhelmed you was it

27:32 The fact that

27:36 I felt kind of cheated out of the last part of my pregnancy.

27:39 People talk about their pregnancy glow and being able to deliver full term. I didn't get that experience here. I am here. I am driving back and forth to the hospital two times a day with whatever I could cuz that's gas going back and forth to our money and our hospital at the NICU is kind of far. Yes. So I was green. I was grateful that she was still at Kaiser so she was still in Fresno, but I felt for the moms whose babies had to be transferred to Valley Children's witches in Madera that's like 45 minutes from here, right? So if there's not a shuttle for moms who don't have a car then how they going to get to see their baby every day.

28:26 And work talk about work taking time off of work. Yeah, so about that prior to delivery that's taken away. There are no Provisions for women who deliver early and you think there would be how we don't have that and considering the rates that we have here in general when it comes to our nation for preterm birth and even just the state of California for preterm birth. You think that they would make Provisions for that? What do you do for a woman who delivers a baby at 23 weeks?

29:02 Of course, she's going to take time off of work, but after she heals and her disability runs out and she doesn't have any more time on her books for paid time off her baby still in the make you

29:18 And you're going to want to spend every waking moment or as much of your time. There is possible especially if you're trying to breastfeed right or provide breast milk, you want to make sure that you're providing they provide them the best available and for them to know that you're there so they can continue to thrive they can't Thrive just sitting off in an incubator and be dealing with nurses all day night. They need their match mother's cash. Do you feel supported so I know you said that you felt overwhelmed, but did you feel

29:52 Supported by your Healthcare team. Did you feel supported by the NICU team? Like did you feel like you?

29:59 Tigers going back to you and me working in public health. I can remember when I delivered my babies early. I felt like I had someone there to help support me and ask questions. Did you feel alone or did you feel like you had someone that could help advocate for you? The weird thing about it? I felt both. I did have a lot of support from the NICU team. That was there giving me helpful tips letting letting me know when our feelings were so I can come and make sure that fed heard encouraging skin-to-skin like kangaroo. We are humping for make sure she gets breast milk. So they communicated with me. Well, they're very nice each nurse snooze for the most part she was in there by herself. So they got to know her very well considering that there's usually a break-in. Where there aren't any babies that are in the inner.

30:59 Mediary NICU, neither babies that have cases that aren't severe enough to where they have to be transferred for Advance. Can they can manage them on sight on site. So these are babies that might have issues with sucking and swallowing them. So they might have to have a feeding tube. They have jaundice and they going to need to be under the ultraviolet light things that can be managed therap Hospital bearnaise breathing issues where they have to be put on a ventilator right or they need major surgery and they need to be in a hospital that specializes in Peds for 4. I mean you're talking about

31:42 Micro preemies in premature babies about her side. She was born at 4 pounds and I ain't so how much does she weigh now? She's almost 7 rounds into breastfeeding earlier. So, you know, I'm a breastfeeding educator. Also that's in my other world. I was really that was actually one of the concerns I had was breastfeeding. It's really hard to breastfeed and maintain your milk supply when you're in the NICU. It's like when you have a baby in the NICU they're so much going on as a parent you have so many things that you have to worry about yourself your baby.

32:27 Just helping your babies Thrive and on top of all that.

32:36 I feel

32:38 As someone that works in public health

32:41 I feel I have empathy and I have sympathy and then also sometimes I feel upset and I feel upset because

32:52 Do babies who are born early? Like one of the best things that we can do for them is to make sure that their breastfed like it's one of the best ways that we can help them Thrive and I feel like black women across the nation and in the Central Valley have very low breastfeeding rates, very low. We have the lowest rates of I think all Races and ethnicities.

33:15 But then when you have a black woman who?

33:20 Understands the value of breastfeeding and she wants to breastfeed. I feel frustrated because I feel like I've heard too many stories of black women who did want to breastfeed but felt like they didn't have the support from either the doctor or the nurse or from NICU staff to support them and their desire to breastfeed to increase their milk supply to establish their milk supply and it's not bad. If you can't breastfeed. Sometimes you just can't you know, there's lots of reasons you might want to

33:54 But I feel like we

33:58 Need to do a better job of the porting moms who want to breastfeed and then helping them like every step of the way.

34:08 I'm really proud of you. I'm really proud of you. I know it was really hard with Destiny. I'm with breastfeeding and you guys have made lots of progress and I just feel like however many times you were able to get her to breast. She's that her own Champion. Just coming out of the NICU and not even having that time with you. She lost, you know a whole week of doing something that's really natural and then

34:34 At this young age 5 weeks to re-establish and reach herself, you know like how to feed in and what to do. So I really proud of both of you. I remember when I said, okay, so what's her name? And you said Destiny I said, yep Destiny cuz she's destined to do something and I hope that Destiny continues. I actually hope that Destiny continues and our path that she will be concerned about black women and black babies and making sure that there are more babies that make it past the first birthday and that more babies are born at term.

35:16 And that her work will contribute to Mom's not feeling like they were cheated.

35:25 That's interesting that you say that I think now that I think about it. I think I felt a little cheated too because I developed I had gestational diabetes and preeclampsia and I like had to be delivered for my own health and well-being like right away and I remember feeling depressed because I was like, like I had my hospital bag packed and I was excited like I wanted labor to happen sort of like how you reading the book of you're going to wake up and it's time to go and I didn't get to experience that so

36:06 Is there so that's those are my thoughts for for Destiny. Do you have any like thoughts about people who are doing this work like?

36:18 What do you want other women to hear that have experienced preterm birth, and like what do you want people who are the decision makers at the hospital's at the foundation to impact preterm birth and maternal Health. Like what do you want us to know? We're here. I want this to not be normal.

36:43 It's so normal to the point to where we're not cuz I'm the community outreach liaison for black infant Health when I go out to tell women about the program that like will why why is it important that I participate?

36:57 And I I get frustrated but at the same time I'm like, you know what that's kind of the perfect way to come at this because you don't know that it's a problem.

37:09 I wish that as a black women as a black community we talk more about these types of things just like we talked about heart disease stroke diabetes and how it runs in the family. Same thing when it comes to preterm birth when it comes to infant mortality nine times out of 10 when a woman has a miscarriage or a fetal demise or they deliver early it's usually because there was somebody else in the family. Usually someone really close immediate that had the same thing but you don't find out about it until after the family and it's like well, why don't we talk about these things prior to why are these normal conversations and partly because it's not it's normalized. We think it's okay to do that are Beyond at 23 weeks and go back and forth to the hospital. We think it's

38:09 I've had women who told me that if I could just make it to 36 weeks. I'm okay it.

38:14 Right, and there's which is not normal person's right at that time and I'm thinking no 35 weeks and 2 days and I wish I had delivered at 36 weeks right or at 40 weeks. Like I would have appreciated having that extra time with her and uteral to build that bond for her to come out as healthy as possible cuz she's more protected than the moon that she's out, but I want

38:44 Are policymakers to see tonight ignore and downplay?

38:51 The the impact the impact of the episode. I feel like it's a crisis so

38:59 I have three questions for you.

39:05 So I feel a sense of responsibility. I'm the Maternal Child Health director for March of Dimes for the entire Central Valley and when situations like yours come up, especially when their personal when we have a fetal demise when we have a preterm birth, and we have low birth weight and very low birth weight when we have a mom. That doesn't make it I ask myself. Am I doing my job? What else was I supposed to do or how did I fail this Mom?

39:42 Do you have an Ask of

39:47 Folks like me like, is there something that I could have done or others that we need to do differently?

39:59 To be honest, I don't know as far as I was concerned everything that was provided to me that I could have taken advantage of I did.

40:10 Support from colleagues. I mean I work for a program that works with African-American pregnant women and all the women that work for the program or African American that happens and this program is across the state of California and a lot of jurisdictions can't say that right. They might have a director who's not African-American. They might understand the issue and be an advocate and they might not they might be the problem. So

40:44 I mean, the only ask that I have is that we continue not only supporting those who are in the field but making sure we support those were out and I think by being in the field we take it a little more personally because we know this person we worked with this person named but also taking that energy and making sure that my girlfriend knows that which is fortunately my sorority sister was in the program as well and she delivered her baby free full term and she was

41:21 Most likely going to deliver her baby preterm because she had an incompetent cervix, but her baby was born put full term and me but making sure that we have that same energy for people that are outside. I was more concerned about her and her delivery because mine was going normally right to the pay was picture book. Perfect. I remember so

41:50 I'm really happy to have had this conversation with you.

41:54 And I'm really happy that we have a healthy Destiny in front of us.

42:01 And my closing words to Destiny is

42:08 Destiny as you grow and Thrive and when you become an adult

42:15 I hope and pray that you will not have the same experience that your mom had and I hope that by the time you decide or not decide to have a family of your own that your experience will be much different and that we won't be having the same conversation about preterm birth.

42:39 And the disparity of preterm births that exist among black women that we've been having for decades.

42:47 My clothes are remarks are for my daughters sake and for the sake of any black woman here now or destined to be that they don't have to experience some of these things that we

43:07 Figure out how to keep prevent this from happening and then

43:13 We don't have to worry about things such as preterm birth infant mortality that these things become eradicated if can be just like we have done with so many other.

43:26 Like polio. Yeah, sorry, but I want to make sure that this world is a lot better than it is presently. I'm really happy that you're here. I love working with you and I'm honored and really excited to continue to work with you and really honored to be your friend and I just want to remind you to engage also and self-care as you're going through your journey with Destiny and I will see you back at work. Probably another 6 weeks.