Zea Malawa is a Black mother and a paediatrician working in San Francisco, California. She runs the Abundant Birth Project, a guaranteed income pilot project for Black pregnant people experiencing marginalisation. We caught up with Zea at the22nd Basic Income Guarantee Conference in San Francisco, California to discuss the racism inside America’s health disparities and what monetary support can do to narrow the gap.
Neil Howard (BTS): What does a guaranteed income mean for pregnant people of colour?
Zea Malawa: On a technical level, a guaranteed income means providing cash in an ongoing, predictable and regular way for folks to use however they see fit. It’s about recognising that poverty is not a monolith and that low-income folks have a variety of different needs. This includes the most basic needs, such as shelter, food and health care.
They should be able to meet their needs and those of their kids on their own terms, and with dignity and flexibility, so they have what they need to thrive.
Underpinning our project, is the recognition that Black women in the US die at a significantly higher rate than anybody else during pregnancy because of racism. And Black babies are born smaller and earlier, again, because of racism.
We can’t fix racism with a magic wand, but we can try to protect and buffer Black mamas against stress during this critical period in their and their babies’ lives. We hope that we can give the next generation a healthier start, and we can give these families a new way to interact in our economic world.
Neil: Could you tell us more about the project?
Zea: We launched in June 2021 in San Francisco, with an initial feasibility pilot of 150 mums. And we continued from there. Now, we want to generate statistically significant evidence around whether providing mamas with cash during pregnancy can actually improve outcomes.
We’re reaching 1,000 mums across California with the same intervention, along with a robust research plan to really understand what it will take to turn the corner on health disparity in the US.
Our programme provides other types of support apart from cash, because we recognise that cash isn’t the entire solution. A huge part of what we also do is called ‘abundance coaching’. It’s optional coaching provided to the mamas to help them identify and achieve their goals. And that’s actually been one of the things our recipients have been the most positive about.
We aim to make sure all our coaches are also doulas, and we train them in lactation education so they can serve as an important, multi-faceted resource for mamas during this critical moment in their lives.
Neil: Can you tell us about the involvement of community members in the planning stages?
Zea: One of the things I am most excited about with the Abundant Birth Project is the way that community members – the very people who will be using the programme – were involved in designing it.
So often in the US, politicians, policy makers and programme directors don’t represent the communities they’re serving. They’re pretty disconnected from the real needs of families as a result. We’re really trying to heal that relationship with government by turning the keys over to the mamas in our community, so that they can tell us how they want this to go.
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