A Community-Centered and Antiracist Model of Whole-Person Perinatal Care: Beloved Birth Black Centering

Abstract

Beloved Birth Black Centering (Beloved) is a community-centered and antiracist model of whole-person perinatal care, created by and for Black people in Alameda County, California. In 2019, a diverse group of birth equity advocates within Oakland's public safety net health care system and public health department came together to design Beloved, following the leadership of Black midwives, public health practitioners, physicians, and doulas. Beloved centers the expertise and vision of Black women and birthing people while working to redefine Black perinatal care and transform Black birthing experiences and outcomes. Growing evidence documents Black women and birthing peoples’ experiences, needs, and preferences for perinatal care. They seek to be respected, heard, believed, the autonomy to make informed decisions, and have access high quality care and supportive resources. Beloved aims to center these needs and preferences and provide whole-person perinatal care so Black women and birthing people not only survive—they thrive. Beloved bundles 5 evidence-informed strategies (referred to as the Gold-Package of Black Love) into its model of whole-person perinatal care: midwifery-led group perinatal care; racially-concordant care; wrap-around support; childbirth education; and doula services. Each evidence-informed strategy has been referenced as a need and preference by Black women and birthing people and has been found to protect against at least one pregnancy-related complication. The model aims to provide patients with holistic social support, high quality person-centered care, and antiracist approaches to care. The founders of Beloved took an asset-based approach and partnered with local community organizations and Black entrepreneurs to implement Beloved during the COVID-19 pandemic despite the inherent challenges of innovating new models in under-resourced, safety net health care systems. The model's development, implementation, theoretical underpinnings, and theory of change are described. Additionally, we discuss key lessons from implementation and future directions for research, quality improvement, sustainability, and community engagement.