#DignityinBirthCA: Free Implicit Bias and Reproductive Justice Training for Perinatal Providers

It’s a startling fact: Black birthing people are four to six times as likely to die from pregnancy and birth-related causes, and twice as likely to suffer a maternal morbidity — such as hemorrhage and infection — than those of other racial and ethnic groups. These variations cannot be explained away by factors such as age, income, educational level, and health insurance status.

Evidence points to implicit bias and racism, not race, as key causes of disparities in maternity care and maternal outcomes for Black birthing people. Research has shown that implicit biases affect the way we see other people, even if we don’t believe the stereotype and it goes against our personal values.

In January 2020, the California Dignity in Pregnancy and Childbirth Act (Senate Bill 464) took effect. This law aims to reduce pregnancy-related preventable deaths, severe illnesses, and associated health disparities that prevent Black birthing people from receiving equitable care. It requires perinatal service providers at hospitals and alternative birth centers in California to undergo evidence-based implicit bias training, with Attorney General Rob Bonta’s office tracking compliance.

To help perinatal providers learn more about reproductive justice and implicit bias — while meeting the requirements of the law — the California Health Care Foundation (CHCF) supported the development of a free, evidence-based e-learning course called Dignity in Pregnancy and Childbirth. It is available for anyone to take.

In addition, the Joint Commission is implementing new requirements to reduce health care disparities, effective January 1, 2023. CHCF’s training will be a useful tool as hospitals implement these requirements — and specifically for hospitals focusing on reducing disparities in maternal mortality.

Details on the training and complying with Senate Bill 464 include:

• Individuals can take the course on their own and organizations can add it to their Learning Management System (LMS). This way, staff can easily access it and organizations can track completion rates. CME and CEU options are available.
• The course takes one hour to complete. It is split into three modules, each using real-life, composite stories to illustrate the way racial bias, however unintended, can undermine perinatal care. Each module provides specific, concrete, evidence-based strategies for interrupting racial bias. 
• Attorney General Rob Bonta’s office is tracking compliance to ensure that healthcare providers involved in perinatal care in hospitals, freestanding birth centers, and clinics have taken this or a similar training. Their “request for information” and submission details are outlined at the end of this letter. Staff who provide care outside of those three settings are not required by law to take this training — but it is a step they can take to help advance Black maternal health outcomes in California and beyond.

Have questions? Need technical support? Want ideas on how to share this within your organization? Please email Beccah Rothschild, consultant to the California Health Care Foundation. Have you already used this training? Does your organization or hospital plan to? Please send her an update so that CHCF is aware of your efforts. Thank you!

(Related: Download CHCF’s Dignity in Pregnancy and Childbirth Communications Outreach Toolkit, and spread the word about this helpful resource!)