“Empowered Beginnings” report calls for stronger protections in Black maternal health

For Alana Dillette, an associate professor in the Payne School of Hospitality and Tourism Management at San Diego State University, getting out into the community and “seeing what’s really happening on the ground” was at the core of her report “Empowered Beginnings,” which studies Black maternal health in San Diego and recommends policy action to improve it.

San Diego’s Black population represents less than 6% of the county; the report elevates their stories and voices. A break from her usual hospitality and tourism management research, the study deals with important topics of equality and equity.

“Even though my experience was different than the crux of the project, I was just looking for something to take me out of my comfort zone, something that I personally identified with as well, and that’s really what inspired me to pursue the work,” Dillette said.

Prepared in collaboration with the San Diego Black Worker Center, the study highlights maternal health challenges reported by participants, including inadequate paid leave, lactation and breastfeeding barriers, knowledge gaps about access to maternity leave, high-risk pregnancies, as identified in the report, and the exclusion of gig and self-employed workers.

The report also examines potential policy actions, recommending measures such as mandating six to 12 months of fully paid, job-protected leave, requiring paid pumping breaks, funding culturally competent “Maternity Rights Advocacy Hubs,” and creating dedicated leave programs for medical complications.

The report points out for Black workers, who often face intersecting racial and gender discrimination in the workplace, equitable policies are essential for safe pregnancies and recovery stages, as well as positive outcomes in the long term for parents and infants.

“Because a lot of women, especially Black mothers, have to work to survive, the workplace is a really big part of your pregnancy and maternity leave experience,” Dillette said.

With a strong background in both qualitative and quantitative research, Dillette approached the project with professional rigor. The topic also resonated with her personally, as a Black mother, adding another layer of connection to the work.

As part of the qualitative research for the study, Dillette conducted interviews with 12 focus groups about their experiences with maternity care access.

“Across those groups I got to talk to 70 different Black mothers and birthgivers and hear their stories, and I would say that that has been the most meaningful and the most enjoyable part of the work,” Dillette said.

“Sometimes when we see a lot of data, we tend to sort of disassociate from the data,” Dillette said. “Actually sitting down for hours all together hearing the stories of each individual Black mother and birth giver really helped me to understand the story and bring it to life.”

Dillette reflected on how, even though the project stretched her to learn about a different field and see how her experience intersected with it, she was grateful for the ability to go outside her usual area of study.

“It was a roller coaster of a ride, learning all that I did, but I'm really glad that I decided to go forward,” Dillette said.

Dillette also said the process of working on the report helped her to think about workers’ rights within the hospitality and tourism industry as a whole.

According to Dillette, the industry is prone to issues of workers’ rights, but the project helped her expand her viewpoint and look at more areas for which she could research solutions.

Above all, Dillette hopes to create a world where pregnant people know their rights as navigating policy for pregnancy leave can often be convoluted and hard to access. She hopes “Empowered Beginnings” will be an example for the rest of California and eventually the rest of the U.S. to increase the care that is given to all mothers.

The full Empowered Beginnings report can be found online.