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Black Futures headline with Nugget logo

Editor’s Note: This blog is the third in our Black Futures series, which highlights the issue of Black maternal health. Our current Cover Club is raising funds for Equity Before Birth, with those funds ensuring Black Futures filled with play, joy, and potential.

Portrait of Joy Spencer, Executive Director of Equity Before Birth

Despite having the largest healthcare operations budget in the world, the US has poor maternal health outcomes when compared to similarly developed countries. These horrific outcomes, which exist across all education, career and income levels, include:

Compounding the problem, as of 2019, one in seven women of reproductive age in NC was uninsured. Lack of access to health insurance and paid leave creates barriers to accessing quality care. With no statewide or federal paid leave mandates, one in four American moms return to work within 14 days of giving birth, which does not allow time for adequate baby bonding, rest or healing.

Equity Before Birth is here to contribute solutions: increase access to healthcare services and support, promote financial security, improve health outcomes, and ultimately save lives.

Equity Before Birth’s model: providing leave and support services for those who need it  

Equity Before Birth is a public charity organization taking the unprecedented approach of improving maternal health by providing paid parental leave and sponsoring holistic support services. We promote birth equity by focusing on those disproportionately impacted: Black birthing people and their infants. 

In addition to supplementing income for those who do not have paid leave while on bedrest or recovering from a birth event, we sponsor doula services, childbirth education classes, breastfeeding classes, transportation to healthcare appointments, essential baby needs and more.  

When we remove financial barriers, we empower the entire family, giving them the opportunity to thrive.

Our model relies on relationship building, partnership and collaboration. We get to know the communities we serve, connecting with existing local organizations to provide services for families.  We constantly assess our approach by gathering feedback from the families we serve and using their input to inform our work. We center the voices and expertise of lived experience by making sure Black birthing people have decision-making roles within our organization.

Wages, financial support, and infant/maternal mortality

Providing financial security saves lives. And the research backs it up:

We also see lives being saved when employers offer comprehensive benefits such as health insurance and paid leave. Not only does paid time off reduce infant mortality, it supports childhood development, decreases maternal depression and helps parents remain in the workforce, strengthening overall family economic security.

Knowing that you have a way to provide what your family needs reduces stress and increases a caregiver’s ability to focus on creating a healthy and nurturing environment. We must address root causes such as financial insecurity when we work towards resolving systemic issues.

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It takes a village: our partnership model

We understand that we all have a role to play in making our community a better place.  We are delighted to partner with any organization who works alongside us to ensure communities are healthy and thriving. Our Community Partners address a variety of social determinants of health; we know the importance of taking care of the whole child and family.

We also know that culturally affirming care and representation matters. We serve our families through our Direct Service Partners, BIPOC-led grassroots organizations who already work with our target population. We see value in connecting birthing people with culturally competent service providers who look like them. We pay Black birth workers, therapists, movement specialists, and educators market rates for services, helping to amplify and sustain their work.  Together, we wrap critical support around families and create an ecosystem that is responsive to their needs.

The impact of Nugget Cover Club

Adverse experiences and trauma affects the way we perceive the world and impacts development in the womb, influencing a person for the rest of their lives.  When we support a caregiver or pregnant person, we are supporting entire families and future generations.  We may never be able to accurately measure the intergenerational impact of our work but we know the implications are huge.  

The funds raised through the Nugget Cover Club will exponentially increase our capacity to serve families. We will be able to significantly and positively change the lives of dozens of additional families in the NC Triangle. The stories we hear daily are both heartbreaking and motivating: families recovering from infant loss, avoiding eviction, struggling to secure baby formula. COVID is further complicating life for so many, including one pregnant mom we worked with who was sick with COVID, on bedrest, and had no paid sick leave. We provided her with supplemental income to ease the challenge of this time. We are connecting families to services that help them acquire nutritious food, diapers, breastfeeding support and more. We stand in the gap, offering resources regardless of socio-economic status. 

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We will continue our work, ensuring more families make a safe and healthy transition into parenthood. We will promote baby bonding, breastfeeding, and proper healing by providing paid leave; we will decrease the odds of developing perinatal mood disorders by providing access to therapeutic services. It truly takes a village to raise a child and give all infants an equitable start. 

Together we can create a community that nurtures everyone’s success. 


Joy Spencer is the Executive Director of Equity Before Birth, an organization providing financial support and holistic care for Black birthing people in the Durham, NC area.