In California, as in much of the US, Black birthing people* experience the highest rates of maternal morbidity and mortality of any racial/ethnic group. Evidence points to implicit bias and racism, not race, as key causes of disparities in maternity care and maternal outcomes for Black birthing people.

The California Dignity in Pregnancy and Childbirth Act (SB 464), authored by State Senator Holly Mitchell, took effect in January 2020. It aims to reduce pregnancy-related preventable deaths, severe illnesses, and associated health disparities. It requires perinatal service providers at hospitals and alternative birth centers to undergo evidence-based implicit bias training, with the Office of California Attorney General Rob Bonta ensuring compliance.

To help perinatal care providers comply with SB 464, the California Health Care Foundation (CHCF) supported the development of Dignity in Pregnancy and Childbirth, a free e-learning course that explicitly addresses the requirements of the law. CHCF worked with Rachel Hardeman, PhD, MPH, a leading national reproductive health equity researcher, and Diversity Science, a training organization focused on diversity, equity, and inclusion, to develop a course that empowers clinicians and providers to provide the high-quality and equitable care essential for the health and well-being of Black birthing people.

The hour-long Dignity in Pregnancy and Childbirth course is composed of three animated video modules presenting annotated, real-life delivery room scenarios, as well as primers on brain science. The course is accredited for one hour of CME or CEU credits. Links to the course, supporting communications materials, and details about obtaining course credits are below.

Dignity in Pregnancy and Childbirth Resources

• Dignity in Pregnancy and Childbirth course: Register for the free training course as an individual or for your organization, get help adding the training modules to your LMS, learn how to track course completion for staff within your organization, and access all accompanying educational resources.
• Dignity in Pregnancy and Childbirth refresher course: Register for the free refresher course to reinforce your knowledge from the original Dignity in Pregnancy and Childbirth course that you and your staff completed when SB 464 first took effect.
• Communications outreach toolkit (ZIP): We welcome health care researchers, educators, state policymakers, and birth justice advocates to spread the word about these educational resources throughout their networks and encourage perinatal service providers to take the course. Our toolkit contains a background document with top-level messaging, and sample newsletter and social media posts, as well as graphics and images for you to use.
• Course information flyer (PDF): Use this one-page course summary to share information about Dignity in Pregnancy and Childbirth learning resources within your networks.
• Launch webinar: This webinar was broadcast in April 2021 at the official launch of the Dignity in Pregnancy and Childbirth course by Diversity Science.
• Challenging Providers to Look Within Themselves: In this article on the CHCF Blog, the foundation’s director of learning and impact provides additional insight into how the Dignity in Pregnancy and Childbirth course is a critical step toward achieving better maternal health outcomes for all.

Find more suggested social media posts in the communications outreach toolkit.

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Partner Organizations

The following organizations support using the Dignity in Pregnancy and Childbirth course to educate perinatal providers on implicit bias and reproductive justice while meeting the requirements of California SB 464. Use the left and right arrows to view all the organizations.

Learn More

For more information, please contact Beccah Rothschild, consultant to CHCF.

* CHCF uses the term “birthing people” to recognize that not all people who become pregnant and give birth identify as a woman or a mother. Diversity Science uses the term “birthing women” in the Dignity in Pregnancy and Childbirth course to specifically highlight the experiences of Black women who have historically been and continue to be marginalized and deprioritized.