Danesha “Dani” Wallace knew something was wrong.
Her pregnant self vomited all day. Hunger, but then also nausea, warred within the longtime Bakersfield resident. She had never felt so ill during her previous two pregnancies.
“You are vomiting in your sleep,” said Wallace, who was 19 at the time. “You are basically … withering away.”
She sought help from a place designated to provide care: a doctor’s office. But her physician dismissed all concerns — it’s just morning sickness, Wallace recalled being told. She watched the doctor try to allay her concerns without making eye contact and shuffling out within minutes.
Months ticked by and she never saw the same doctor twice. Her pleas for someone to listen went unheard.
Wallace gave birth to a baby boy in April 2009. He was a calm and happy baby.
“He had these eyes like they were staring into your soul,” she said.
The mother of three began to breastfeed newborn Jeremiah. But he couldn’t keep his food down and would projectile vomit. He started losing weight and she switched to formula based on a doctor’s recommendation. The next few months blurred into a routine of taking her baby to the hospital, working three jobs and caring for her two other children.
Amid the flurry, she had taken Jeremiah to a physician referred by her pediatrician. The new doctor accused her of withholding food from Jeremiah and went to alert Child Protective Services.
Wallace frantically called her pediatrician.
“How dare you?” she recalls her pediatrician saying to the referred doctor. “She’s a great mother. I see all her kids. … I sent the baby to you to find out a reason and you are just judging her without looking at the whole case.”
Wallace’s experience as a now 33-year-old Black woman navigating the maternal health care system turned her into an advocate for other mothers. She offered her knowledge to the Kern County Public Health Services Department to create their new program, the Black Infant Maternal Health Initiative, to combat the high mortality rates seen among Black mothers and their babies.
Brynn Carrigan, the director of the county’s public health agency, said for the first time community groups and other health organizations pooled their knowledge, aiming for equitable health care by forming the Black Infant Maternal Health Initiative.
The actionable goals became effective Friday after the Kern County Board of Supervisors approved its enactment during its June 21 meeting.
“I remain extremely hopeful that they’ll have a positive impact on the mortality rates that we’re seeing in this community,” Carrigan told The Californian.
Black women are nearly four times more likely to die from maternal complications, which surpasses any other race locally, according to public health’s data. Kern’s rate of maternal deaths is 1.5 times higher than the state’s average, the data shows.
These disparities may arise from health care workers being uneducated about Black cultural practices and instead treating them as a monolith rather than individual humans, said Phela Batiste, supervising public health nurse of the Black Infant Health program. This organization partnered with Kern Public Health in the Black Infant Maternal Health Initiative.
So “strong, passionate” people met for about 18 months — along with Black mothers like Wallace who shared their stories — to explain challenges and experiences facing Black people, said Anastasia Lester, a program officer with First 5 Kern, an organization that is also involved. Lester initially told Carrigan about the need for a task force.
The finished product included initiatives such as a public awareness campaign, educational pathways and teaching health care providers about disparities in Black maternal health.
“If 5.3 percent of the population (who are Black are) doubling (in maternal deaths compared to) any other race in your county, that’s an epidemic,” Lester said. “That’s no longer just an issue.”
Hope bloomed in Wallace after her ill-fated appointment with the referred doctor.
Her baby boy — now about seven months old — was barely throwing up in November 2009, his mom said.
Wallace woke up very early one morning, and didn’t disturb Jeremiah as she got ready for her job. She recalls going to work, making a mistake and her boss “chewing her out” when her phone rang. And kept ringing.
When she answered, it was her then-husband saying Jeremiah was not waking up. He was taken away in an ambulance.
Wallace rushed to the hospital, and spoke to a nurse who said they were resuscitating her baby.
“I tried to hold onto hope,” Wallace said.
Hospital staff walked her to a room with Jeremiah. She saw her baby on a metal slab, a red onesie cut down the middle.
A scream sounded.
Knees buckling, Wallace realized the scream had escaped from her.
“There wasn’t any hope,” she said.
Statistics from the Kern County Public Health Services Department show that Black infants are born underweight two times more often than any other race and are 1.5 times more likely to die than infants of other backgrounds.
“There should be no reason why these Black infants and Black mothers are dying in a developed country,” Wallace said.
Lester has watched others dismiss this issue in years past, and heard people say politically correct words. The Black Infant Maternal Health Initiative is different, she said.
Many people participated on a voluntary basis, and are now committed to the three-year program, she said. Members have broken into subcommittees and are working on plans such as creating an educational pathway between Kern Community College District and California State University, Bakersfield targeting African American and Black students in high schools, and creating a minimum two-year internship for African American and Black students. The idea is to increase the number of Black people entering health care professions.
Others are working on conducting focus groups to pinpoint barriers to mental health services, and creating peer support groups for African American and Black women. They also seek to create a dinner for OB/GYNs to share data about Black maternal and infant health in addition to providing education regarding their care, with training at subsequent offices.
Aldene Zeno, an assistant professor in obstetrics and gynecology at the University of Southern California, who has researched health disparities in medicine, said these public health initiatives are a step in the right direction. But physicians must also ensure health care is offered to birthing parents at preconception to improve outcomes. Doctors should be aware of different programs in their county, such as a mental health support group, and refer these parents to them.
Having pap smears and cervical cancer screenings, or even an annual physical, can significantly impact birthing parents’ ability to have a healthy pregnancy, she added.
Lester hopes achieving these goals results in measurable change, and the program keeps going after three years. But change is already afoot for some.
She recalls Wallace crying and approaching her after one Black Infant Maternal Health Initiative meeting. After hugging, Wallace thanked Lester for her work.
“I’m going to go to the cemetery now,” Lester recalls Wallace saying. “I’m going to tell my son that his life is not in vain.”
A life’s purpose
Wallace doesn’t know how she pieced herself together after Jeremiah’s death.
“For me, life has never been easy, unfortunately,” Wallace said. “But that almost broke me.”
Her other babies, brimming with joy, filled her with purpose. But she always wonders if Jeremiah would have been like his siblings.
“You know there’s always something missing,” Wallace said. “(On) holidays, you try to be joyous but you know you should be buying gifts for somebody else.”
Wallace has ensured Jeremiah’s legacy never dies by becoming a doula and educating other parents. She teaches them to advocate for themselves with doctors and learn. For example, everyone should know why a medication is offered, she said.
But it shouldn’t take trauma to bring progress, she added. People shouldn’t have to lose their lives for others to care. Mothers shouldn’t lose their babies.
It’s taken generations for these problems to persist, Wallace said. They will take time to fix.
Positive Cases Among Kern Residents: 251,888
Recovered and Presumed Recovered Residents: 243,766
Percentage of all cases that are unvaccinated: 75.13
Percentage of all hospitalizations that are unvaccinated: 83.35