Local organizations respond to a national health crisis.

“Black mamas matter.”

It was this phrase, in hashtag form, that popped up in April 2018 during the inaugural Black Maternal Health Week, a national campaign founded by the Black Mamas Matter Alliance. The goal was, in part, to raise awareness about black maternal health. Locally, it was personal for Jessica Roach, co-founder and executive director of Columbus reproductive justice organization ROOTT (Restoring Our Own Through Transformation).

Roach has been preparing for her role as a leader in reproductive justice since she was a little girl. Back then, in the tiny village of Irondale, Ohio, she would spend time with her great-grandmother, a healer who assisted Jefferson County women in childbirth.

“There were always women and their children around,” Roach says. “I didn’t understand what that meant until later, just understanding what role she played in the community.”

Roach went on to become a nurse and supported friends as they gave birth, terminated pregnancies and adopted children. But it wasn’t until after she had her third daughter, Julian Calderone, that she was compelled to become a doula and home-birth midwife.

“Seeing the differences in each one of my children and the differences in my experiences in those pregnancies, and those births, and the follow-up care ... [I thought], ‘There’s something not right about this,’” she says.

Roach had given birth to her first daughter, Jordan Roach, as a teenager. Though she was immediately told by medical professionals that she was at risk for a preterm baby (born before 37 weeks), high blood pressure and gestational diabetes because she was African-American, she had a healthy pregnancy. She credits her amazing experience to her support system, which included her great-grandmother, grandmother, father and uncles.

But seven years later, her second pregnancy was a different story. She was told she had an incompetent cervix, a condition that can lead to miscarriage or premature delivery. She developed preeclampsia, a pregnancy disorder characterized by high blood pressure, and delivered Jaden Calderone at 34 weeks. The only explanation given was, “You’re just at-risk because you’re African-American.”

“It just really didn’t make any sense to me,” Roach says. “I was really upset, and I was angry, and I had some issues with postpartum depression.”

“By the time I got pregnant with Julian, something clicked,” she continues. “I ended up having a home birth ... I had a midwife and I did prenatal yoga. I ate well. I went back to my roots.”

Julian Calderone was born at 42 weeks, weighing 8 pounds and 15 ounces, with no major health concerns.

“That’s when I became much more deeply involved [in reproductive work],” says Roach. “It was like waking up.”

Roach is not an anomaly. Black women are, indeed, at a higher risk for difficult pregnancies than their white counterparts—with often deadly results.

Circumstances are dire. According to the latest national data from the Centers for Disease Control and Prevention, black women are three to four times more likely to die from pregnancy-related causes than white women. And in 2016, the infant mortality rate—defined as the death of a child before it is 1 year old per 1,000 live births—for black women was 11.4, more than double as the rate for white women.

In Ohio, the infant mortality disparity is even worse. According to the Ohio Department of Health, in 2016 the infant mortality rate for black babies was 15.2—more than twice as high as the rate for white babies. And, according to preliminary data obtained by Columbus infant mortality initiative CelebrateOne, black babies were three times more likely to die in Franklin County in 2017.

“What we realize is we have fantastic programs and entities, [but] certain moms aren’t getting to [them],” CelebrateOne executive director Erika Clark Jones said at a panel on eviction and infant mortality at the Kirwan Institute for the Study of Race and Ethnicity earlier this year. “Or they’re not quite designed for our moms to succeed and thrive.”

Research has shown the reason for the disparity is not biological, but rather the result of health care, social and economic determinants. And at the root of those determinants is racism.

According to the Greater Columbus Infant Mortality Task Force Implementation Plan, “Studies show that health outcomes are influenced by a ‘neighborhood effect’ in which health outcomes vary based on where an individual lives. These inequities stem from a long history of racially biased policies and practices. Neighborhood factors include access to ‘life-enhancing’ resources such as health care, housing, education, employment, social relationships, transportation and food supply.”

CelebrateOne is focused on eliminating preventable, sleep-related infant deaths, reducing preterm births and connecting disconnected citizens to resources. But more assistance is needed.

To help fill those gaps in the city, Roach and doula Monique McCrystal founded ROOTT in July 2017. With a focus on addressing the impact of institutional racism on black maternal and infant health, the black women-led advocacy organization offers affordable doula services, health-care provider trainings and organizational consultation.

“There are many organizations out there that do great work,” McCrystal says. “[But] it’s not enough, because if it was, we would see a shift. And you cannot create a healthy family environment for a woman who is carrying blame and shame and fear and anxiety that she never gets permission to talk about.”

ROOTT also takes an active role in educating the community. Back in April, the organization hosted the events of Black Maternal Health Week, which strives to provide a “platform for black women-led entities.”

“The model works,” Roach says. “It’s for us, by us. Who better to dictate what it is that’s needed for our bodies than those of us that are actually living inside of them?”

Erica Thompson is a writer for Columbus Alive, where the original version of this story appeared.