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A reporter finds new ways to tell stories of black infant mortality amid newsroom layoffs

A reporter finds new ways to tell stories of black infant mortality amid newsroom layoffs

Picture of Alejandra Molina
Black Infant Health program leader, Lesha Porter, right, gives a high five.
Black Infant Health program leader, Lesha Porter, right, gives a high five.
Photo: Cindy Yamanaka/The Press-Enterprise/SCN

I had been working in Riverside County for about two months, writing about race, immigration, and culture for The Press-Enterprise, when my editor suggested I look into the new Black Infant Health program that was being reinstated.

This was back in 2015. The program, which addresses the disparities in black infant mortality, was active in Riverside County until state funding ran out in 2009-10. Public health officials revamped the program with a group-based approach.

I began the story with that angle but soon realized there was much more to dive into: infant mortality data, research showing racism as a contributing factor to early infant deaths, and a lot of sourcing.

In smaller newsrooms, we’re not often afforded a whole lot of time to work on a single story. Outside a breaking news event — which involves us writing a number of articles a day — we’re used to turning around a feature over a one- or two-day span. Reporting on a community that you are not a part of requires a deep sense of responsibility, nuance and time to get it right. So I was glad I was able to work on this piece for more than a week while juggling other stories.

The story presented the disparities in infant mortality with state data. It highlighted the Black Infant Health program and gave insight into the group meetings. It noted the research showing how racist incidents can increase stress levels, which can in turn impact birth weight.

It was a good start, but I wanted to dig deeper.

Three years later, I had the chance to do so through the help of the 2018 California Fellowship.

I began with a big idea — a three-part series explaining the disparities in infant mortality in Southern California and how the state, counties, and local communities were addressing the problem. The Press-Enterprise in Riverside is part of the Southern California News Group, which includes papers such as The Daily Breeze in Torrance, The Los Angeles Daily News, and The San Bernardino Sun, and I wanted to incorporate the other counties in my coverage.

I planned to look into how infant mortality varies across Southern California, when factoring in race and ZIP codes. I wanted to see if there were major disparities between Los Angeles, Riverside, San Bernardino, and Orange counties. Were infants in Moreno Valley in Riverside County more likely to die than in certain L.A. County neighborhoods? If so, I wanted to explore possible reasons. I also wanted to build my own data sets.

I also aimed to look into the origins of the state-funded Black Infant Health program and how it has changed throughout the years.

Lastly, I wanted to explore how the community was addressing the issue by interviewing women of color who were forming networks to teach each other how to become doulas in their communities.

I sat in on a Black Infant Health session over the summer in Moreno Valley. I introduced myself to the women in the group and interviewed those who were willing to take part in the story. I followed up with phone calls to make sure I was interpreting their experience accurately. I reached out to a local birth-workers-of-color collective and attended a doula training session they hosted last fall. I researched and contacted mainstream nonprofits like DONA International that specialize in certifying doulas. I scoured a number of data sets and requested loads of data from Riverside, San Bernardino and Los Angeles counties.

Although the project did not result in the three-part series I envisioned, I did produce two stories that explain how the state, Riverside County, and local communities are addressing the issue.

Here are some of the lessons I learned:

Be open to scaling back or changing your angle. Soon after I applied for the fellowship, our newsroom went through layoffs. Although I remained on staff, I was removed from my beat to fill gaps in breaking news and cops coverage. I was also no longer based in Riverside. The daily cop grind was a change of pace and although editors did make time for me to work on this piece, it was challenging to fully focus on this health story.

It was clear that I would not have the time to build a data set that would include ZIP code data and infant mortality statistics across three counties.

Additionally, the issue of black infant mortality was being covered more by other major news sites. The New York Times Magazine in April published a comprehensive look at how racism was impacting black mothers and babies. I was glad the issue was getting attention, but I had to tell my story differently.

My efforts resulted in two stories.

The first article detailed how the Black Infant Health program has changed over the last two decades, with a focus in Riverside County. The other, explored how women of color are forming networks to train one another to become doulas — a relevant issue as state public agencies across the nation are starting to subsidize doula care through Medicaid.

These are two stories on the same topic, but they offer new takes on the issue.

Embrace the direction the story takes you. Analyzing the data, I realized Riverside County had the lowest black infant mortality rate in Southern California, and was among the lowest in the entire state. So I decided to focus on the Black Infant Health program there.

By talking to Monica McLemore, a nurse and professor at UC San Francisco, I learned of the value in Black Infant Health programs, despite data showing black infant mortality disparities persist.

“At the very local level, they’re very impactful in terms of improving patients’ experience as well as improving their perceived confidence and competence in being able to parent well,” McLemore said.

For Black Infant Health programs to be properly evaluated, she said, public health officials should look beyond the data.

“We haven’t looked at the participants’ experiences,” she said. “We have not qualitatively really understood what it has meant to them and whether or not they believe they have higher confidence or competence in order to be able to be a good parent.”

Here is a link to that story.

The doula angle was also very relevant. The profession is not legislated or regulated in any way in the U.S. Doulas are not required to be certified. As more states are including birth doula services in Medicaid coverage, certification is expected to become more common. Doulas who qualify for reimbursements must be certified.

If California embraces this program, it could leave out the birth workers of color collectives that train, but do not certify doulas.

The way these collectives see it, the mainstream certification process is misguided and unnecessary because doulas do not provide medical procedures or intervention. Additionally, many doula practices are rooted in culture and tradition.

I’m in the process of finding a different outlet to publish this story that explores how this certification process can impact doulas of color who serve communities that need it the most.

Comb through multiple data sets. I started off by requesting ZIP code and infant mortality data broken down by race from San Bernardino, Riverside, and Los Angeles counties. Orange County didn’t have a large enough black population to explore the issue there. Even though I didn’t have the capacity to build a data set from scratch, it was helpful to compare the data I had requested with data that was already available. It helped me understand the issue better and write with authority.

I also found there are a lot of nonprofits who publish data on infant mortality. I relied on state data compiled by the Lucile Packard Foundation for Children’s Health. Their databases were easy to play with and I was able to break down how the mortality rates looked across the state and counties.

Keen in touch with sources. The connections I made reporting on the 2015 story really helped me in my fellowship reporting. They directed me to new sources and experts and welcomed me to attend another Black Infant Health group session.

Follow up! It’s crucial to follow up with sources to fact-check and to make sure you are interpreting their stories correctly, especially if you are reporting on a community you are not a part of. When I attended the Black Infant Health group meeting, I took notes as I listened in on certain conversations. Then I followed up. I took down names and contact information of women who were interested in being featured in the story. A big topic of discussion during the group session was how women internalized unrealistic beauty standards that can pit light- and dark-skinned black women against one another. To write with more authority on this issue, I made sure to call back and talk in length about their experiences.


The Center for Health Journalism’s 2023 National Fellowship will provide $2,000 to $10,000 reporting grants, five months of mentoring from a veteran journalist, and a week of intensive training at USC Annenberg in Los Angeles from July 16-20. Click here for more information and the application form, due May 5.


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