
Expecting Justice is a Black-led collaborative, mobilizing leaders from across San Francisco to take action to improve maternal and infant health in Black and Pacific Islander Communities. In San Francisco, racism and birth outcomes are intertwined. Black and Pacific Islander (PI) families experience adverse birth outcomes at significantly higher rates than other communities. Before a Black or PI child sets foot in the world, he or she is affected by historical and ongoing discrimination in housing, employment, and care.
The enduring legacy of racism continues to shape our city’s interactions with Black and Pacific Islander women. We need a transformational approach that values and includes African-American and Pacific Islander women throughout their lives in order to improve birth outcomes.
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of Black women in SF give birth prematurely each year. The highest rate in the county.
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Pacific Islander infants have the second highest preterm birth rates in San Francisco at 10 percent.
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of Black women live below the poverty level; 13% have have moved due to high rents.

We are aligning our knowledge, resources, and efforts to name and repair the impact of racism on the health of mothers, families, and children in our city. We envision that every birth among Black and Pacific Islander communities will be healthy and full-term by the year 2030 and that systems and services will coordinate efforts to reduce stress and the impact of systemic racism on Black and Pacific Islander parents across San Francisco and beyond.
Our initiative envisions that every birth among these communities will be healthy and full-term by the year 2030 and that systems and services will coordinate efforts to reduce stress and the impact of systemic racism on Black and Pacific Islander parents across San Francisco.

Our work is driven by three strategic focus areas: Anti-Racism Promotion, Doula Access, and the Abundant Birth Project. Our focus areas complement one another to address key dimensions of vulnerability faced by Black and PI women and people during pregnancy and childbirth: interpersonal and institutional racism in the healthcare and public health systems, plus structural racism manifested as the racial wealth gap. Based on deep engagement with community members and other stakeholders, we believe this combined approach is imperative to ensure safe and healthy childbirth for Black and PI mothers in our city.

Anti-Racism Promotion

Through training, seminars, and skill-building workshops, Expecting Justice helps participants develop awareness to recognize the impact of racism.

Doula Access

Our Doula program provides culturally congruent Doula support to all Black and PI mothers through prenatal, birth, and postnatal periods.

Abundant Birth Project

The first pregnancy income supplement program in the U.S. open to Black and/or Pacific Islander San Francisco residents.

The Abundant Birth Project
In the United States, racial disparities in birth outcomes continue to persist with income inequality being one of the key contributors. Structural interventions that reduce the racial-wealth gap are urgently needed and have the promise to narrow longstanding inequities. In a community-academic partnership, Expecting Justice piloted the first pregnancy income supplement program in the US called the Abundant Birth Project (ABP).
ABP presents an opportunity to transform San Francisco into a city where all children have a healthy start at life.

In San Francisco today, far too many Black and Pacific Islander women and are shut out of the resources and opportunities they need—such as housing, respectful and quality healthcare, nourishing food, good jobs and livable wages—to have healthy pregnancies or births. We believe that no single individual or organization alone can stop this urgent issue. By rallying together as a community, we can transform San Francisco into a city where every child can be healthy, thrive and take part in our city’s vibrant future—not just now, but for generations to come.

Resources for Black and Pacific Islander Birthing People
We recognize that healthy pregnancies and births are deeply connected to our lived experiences and opportunities.
We’ve compiled a list of resources that include articles, toolkits, and organizations working to improve outcomes for Black & Pacific Islander birthing people.




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