ChiByDesign co-created a Maternal Success Kit to eliminate the disproportionate removal of Black and Brown babies from their families and reduce the Black Maternal Morbidity rate in New Jersey. Black and Brown mothers who have experience in the child welfare system in New Jersey led the co-design of the Maternal Success Kit. The kit is a preventative system of services to reduce the likelihood of child welfare involvement and, more importantly, support mothers during their pregnancy journey, therefore increasing maternal health outcomes for mothers of color. Black and Brown mothers who have experience in the child welfare system in New Jersey led the co-design of the Maternal Success Kit.
Our kit aims to provide mothers with the specific resources needed to meet the unique challenges they experience due to structural racism during pregnancy and postpartum. The statistics regarding the adverse health outcomes for Black and Brown mothers in New Jersey are alarming. Black women are 3 times more likely to die during and after childbirth than White people. Similarly, Black babies are twice as likely to die as White babies (Greenwood, B. N., et al., PNAS, Vol. 117, No. 35, 2020). The kit emphasizes mothers' well-being and ensures they're in the best possible position to seek the support they need to overcome systemic and structural challenges and care for their newborn's needs once they arrive. The system of services through the kit is available to mothers in 3 parts:
First trimester: Welcome and introduction to the kit
Second trimester: Pre-birth kit (focused on essentials and resources for the mother's health and well-being)
Third trimester: Post-birth kit (focused primarily on the baby's essentials along with resources for the mother)
The co-designed anti-racist infrastructure centered around the kit begins to address critical structural challenges Black and Brown mothers face in New Jersey. The components of the new infrastructure are:
1. Criteria for developing the kit- a collection of themes and goals that lay the foundation for the kit's development. The themes are as follows:
1a. Safety and Well-being. E.g., compression socks, therapy support service subscription.
1b. Financial Support. E.g., coupons and vouchers for transportation, childcare, laundry.
1c. Basic Essentials. E.g., overnight pads, baby first aid kit.
1d. Building Communities. E.g, cooking workshops, count-on-me network.
1e. Education and Awareness. E.g., resources for traumatic events such as domestic abuse and pregnancy loss, educational material on what to expect during childbirth.
1f. Easy Access to Resources. E.g., QR code leading to a resource hub, analog copies for resources accessible to parents.
1g. Advocacy. E.g., List of pro-bono law services, parents bill of rights, etc.
2. Concept Recommendation: 'Count on Me' network- A social network to repair civic connections and provide informal support mothers need during pregnancy and after childbirth (see image named Count on Me).
3. Policy recommendations- Structural recommendations to address long-term systemic challenges to support the success of expecting mothers and the kit. E.g., providing connected transportation, access to healthy food, and establishing free childcare.
To further advance the idea for a maternal success kit and take a step towards reducing disparities for Black and Brown families and communities, the NJ DCF partnered with ChiByDesign to bring our anti-racist design process to identify and challenge oppressive systems. Based on this, we sought to develop a system of services that support expectant mothers during their pregnancy journey, but more importantly, an intervention that shields Black and Brown mothers from the structural racism found in the child welfare and healthcare systems.
We hired biological mothers with child welfare involvement as co-designers onto our team. Their lived experience and insight were critical in defining the project's direction and outcome. The team designed prototypes to initiate discussions with lived experts and system workers to create criteria for the successful development and implementation of the kit. To achieve this purpose, we conducted two week-long sprints.
On our first trip to New Jersey, we met with our co-designer teammates to plan and begin building the prototype for Sprint 1, and we learned a significant lesson. During one of our team meetings in the dining room of our co-designer's home, another co-designer reflected on her experience while dealing with the child welfare system. She shared, "I remember when I needed help for me and my kids, I couldn't even ask for it until my mind was right. I needed to be in a good space to receive support." We had been thinking about the kit as an all-in-one kit for baby care, but after she highlighted the importance of supporting the mother's well-being, the game plan changed. Our shopping trip to Target that afternoon looked very different. We added affirmation cards and wrote messages of encouragement, candles, heated memory foam slippers, and nipple cream to our shopping list of baby bottles, diapers, and formula.
The feedback we got in Sprint 2 from mothers and other stakeholders affirmed the importance of this pivot. They built on this and encouraged us to design the kit to embody the affordances of a "gift" when expectant mothers receive it. These changes help the kit communicate to Black and Brown mothers that they aren't the problem but, in fact, the protagonists of their own story.
Additionally, we learned from sprint participants that the kit needs to facilitate relationship-building amongst mothers and within the community. They shared a need to make the kit an interactive experience when distributed, where mothers can ask questions and build a relationship with the distributor intimately and intentionally.
Over-policing and over-surveillance in Black and Brown communities lead to disproportionate involvement in the children's services system, fraying family and civic support networks and creating a reliance on system support for Black and Brown mothers. The Count on Me network, a part of the kit infrastructure, is a concept recommendation to facilitate relationship-building between mothers and other women in their community who want to be a listening ear, receive knowledge, and get connected to needed tools and resources. The network consists of community members with experience overcoming adversities (domestic violence, substance abuse, etc.) and interacting with various systems to support mothers in accessing the resources they need. Professionals will also be available to help mothers work through trauma. Different engagement opportunities, such as workshops, will allow support systems to emerge organically as the community grows and participants build relationships.
We do not imagine this kit to be THE solution for removing disparities for Black and Brown mothers and families, but a step toward preventing child welfare involvement for Black and Brown mothers and families. There evidently needs to be a deeper systemic transformation by creating new policies, practices, and infrastructures that reduce disparities and advance the well-being of Black and Brown families.
The project's success is evident through testimonials shared by the following project stakeholders:
"I was extremely honored to be a part of this project because it gave me the chance to potentially help someone else. I know the feeling of being unsure, alone and over all defeated so giving others support like I wished I had during my journey was very important to me. I honestly think the kit will make an extreme impact in the community because not only does the kit supply things for mom and baby throughout each trimester but it really restores hope in rebuilding a "tribe like" mentality. So many people involved in child welfare have lost hope and trust and the kit of course can't change that overnight but it can definitely be a starting point." - Biological mother and co-designer
"This deep work with community has resulted in the development of a Maternal Success Kit that promotes social networks, provides concrete resources, and diversifies the supports that are deployed in communities. For DCF, the recommendations reflect a desire to change the ways that we interact with community to build trust and equip stakeholders with assets that are not connected to the child protective parts of our system. We will also use the accompanying report, prepared by ChiByDesign, to help guide our transformational efforts in this regard. While there is more to be done, we are proud of the ways in which community willingly engaged with us to develop recommendations that promote family preservation." - Commissioner, NJ Department of Children and Families