Multi-Stakeholder Engagement with State Policies to Advance Antiracism in Maternal Health (MEND)

California has passed a new law (SB464) that requires perinatal clinicians to undergo implicit bias training, with the goal of improving care and outcomes for Black birthing people in particular. This project will engage Black birthing people, perinatal clinicians, and socio-legal scholars to produce evidence-based guidance for these trainings.

Black mother and child at postnatal visit

Principal Investigator:
Sarah Garrett, PhD | UCSF Philip R. Lee Institute for Health Policy Studies


Black women and birthing people experience maternal mortality, morbidity, and preterm birth at higher rates than most other groups in the US. Researchers and policy-makers increasingly understand that racism and other biases within the healthcare system are important causes of these inequities. In 2019, California passed laws meant to reduce racial bias among healthcare providers (Senate Bill 464, Assembly Bill 241). This represents a historic opportunity to improve care for Black women and birthing people.


MEND is a cross-disciplinary project that has, under the guidance of and in collaboration with a community advisory panel: (1) Worked with legal scholars to interpret the history and content of the new laws. (2) Engaged Black women and birthing people and perinatal clinicians in the San Francisco Bay Area to learn how the laws can be implemented to fit their realities and priorities. And (3), with legal and community input, drafted evidence-based guidance for local and state implementation of the new laws.

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Peer-reviewed publications

Challenges and Opportunities for Clinician Implicit Bias Training: Insights from Perinatal Care Stakeholders

Click here to read the full publication.

Antibias Efforts in United States Maternity Care: A Scoping Review of the Publicly Funded Health Equity Intervention Pipeline

Click here to read the full publication.

Additional birth equity resources for patients, providers, and health system leaders


Facility IBT Planning Guide


Healthcare Provider Implicit Bias Training  - Proposed State Legislation 2019-2022

Click here to read the report.


MEND Policy Report: Legal analysis, stakeholder insights, & policy recommendations for healthcare provider implicit bias training in California

Read the report


MEND Study Executive Summary

Click here to read.


Preliminary Survey Research on Support for Stakeholder-generated IRB Recommendations Outside of MEND Bay Area Study Region

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“Always more moving and always more memorable”: The potential of patient stories to advance birth equity

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“Get to know me”: The role of patient stories in reducing bias in perinatal care

Click here to read the full abstract.

Challenges & opportunities for clinician implicit bias training: Insights from perinatal care

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“Shifting the culture and the way that we practice": Perinatal clinicians' cognitive, behavioral, and collaborative changes in response to antiracism and antibias interventions

Click here to read the full abstract.