word again, "disheartening," I've seen come up over and over again. But glad to have continued because after so many deaths they're at least starting to come to grips with the awful outcome.

“The classic that we often face is on the labor and delivery unit, this question about whether we should do drug testing [on a patient] or not,” she said. “It is very likely that in the past, I have kind of used my own biases to decide who I think may need drug testing.”

At UCSF, researchers are studying how stress can increase pregnancy risks, including the development of a new blood test that can detect who is at risk for pre-term birth, the main cause of infant death, and adjust a woman’s prenatal care for early clinical intervention.

Also, a collective of agencies and community members are pushing to provide black women access to doula care and stable housing, both of which come at a premium cost.

“We have all bought into this mythology around our progressive values so completely that it’s surprising to us that these bad birth outcomes could happen under our watch,” said Dr Zea Malawa, a city health department pediatrician, who is spearheading the new San Francisco pre-term birth collective impact initiative.