NURSE FAMILY PARTNERSHIP
“They’re keeping food on table, roof over their head, and clothing on their back…”
- White woman, Nurse Family Partnership
“Kalamazoo is rich in resources, but there is a disconnect…”
- White woman, Nurse Family Partnership
“Do we communicate well with each other? And if people are aware of it [resources], do they access it?”
- White woman, Nurse Family Partnership
“Maternal factors, too. Chronic illness. Chronic disease. Diabetes. Drugs. Mothers using substances during pregnancy. Young moms who are still growing.”
- White woman, Nurse Family Partnership
“She was saying that she really believed that part of it was just that long-standing racism—like the stress of racism over a lifetime, no matter how well you are doing in your pregnancy–can still affect you”
- White woman, Nurse Family Partnership
“Well, you look at the Kalamazoo community, and the supports are there. And people are going to prenatal, well not all, but enough people are going to prenatal appointments that you wouldn’t think that we would have that significant of a disparity between racial groups. You know, the supports are there to help support these families. A lot of them seem to be connected. I don’t have numbers on how many of them are connected to the supports that they feel they need or would be ideal. But it seems like it’s there, yet we still have this huge disparity between ethnic and racial groups and that’s just—it’s hard to fathom why.”
- Nurse Family Partnership
“It’s that some young moms, or not just young, but some single—it’s the single mom being the sole caregiver and responsibility for these children, besides going to school or working, or both, and taking care of a child: worrying about daycare, worrying about money, all of those social cofactors.”
- Nurse Family Partnership
“It’s just so hard to do it alone. Even if they have some family support, it’s not the same as being the sole person responsible.”
- Nurse Family Partnership
“It’s hard, you know, how do you tell what factors lead up to why a child dies? I would say it’s got to be different in every one, and again it’s why does it seem to happen in this group so much more than in another? What’s different about them aside from the color of their skin? You know, and obviously there’s probably some cultural things, but it’s hard to pinpoint what a cultural factor would be that would cause this.”
- Nurse Family Partnership
“Why is it just the African American population that their infant mortality is so high?”
- Nurse Family Partnership
BRONSON LABOR AND DELIVERY NURSES
“And I think perhaps culturally, the visits seem so mundane. You come in, you see a practitioner. They don’t do anything to you or for you necessarily so the perception seems to be a lot that well, ‘Why do I have to go do that?’ There’s no understood value.”
- Labor and Delivery Nurse, Bronson
“Ethnically I can’t say, racially I can’t say that I’ve had any one experience be more consistent than another. I think each person brings something unique to it. That’s what makes it so challenging is because you can’t say ‘Oh, I can fix this and that will fix it.’”
- Labor and Delivery Nurse, Bronson
“I know there’s a birth center and clinic in Washington D.C. in the inner city part of town that has had really good luck just by providing patients care that is respectful, compassionate, and that makes the patients feel welcome and makes it feel like it’s a place that they want to be. […] So if patients are getting that level of special treatment and respect and compassion, where they feel like they are being listened to and they want to come back. And it’s not just put this on your tongue step on that scale, everything looks fine, see you next time.”
- Labor and Delivery Nurse, Bronson
“I have to assume, because I’m not in their community, but I don’t think that healthcare is a priority when they’re worrying about getting food on the table.”
- Labor and Delivery Nurse, Bronson
“Coming from unstable family lives is part of it. Lower socioeconomic status. Inadequate transportation. Not having a safe place to be pregnant and to turn into adults, so that their developmental status is sometimes stunted too.”
- Labor and Delivery Nurse, Bronson
“It would be interesting to know if there could be a tailoring of classes somehow. I don’t know how, because we have free childbirth classes, free parenting, free daddying boot camp. There’s a lot of options that Bronson itself provides, and then in the community there’s even way more. But it would be interesting to really look at what those services provide, how the respect is, how the diversity is.”
- Labor and Delivery Nurse, Bronson
“We’re women with a lot of experience, and pretty much Caucasian. That we just don’t connect, that our voices don’t have the authority or the value within the community”
- Labor and Delivery Nurse, Bronson
“It sometimes feels like as healthcare providers we’re missing something. It feels like there must be a way to do it better. Because the data is irrefutable.”
- Labor and Delivery Nurse, Bronson
“Or if I’m telling you how to put your baby back to sleep, and safe sleep, and sleeping this, but your culture and your community is telling you to do it a different way. How do we make those connections so that I’m giving you information that’s useful to you and not just this story that’s up over here”
- Labor and Delivery Nurse, Bronson
“Our African American mortality rate is awful for our county. But it doesn’t feel like it’s the African American culture. It doesn’t feel like when I’m talking to them that that patient because she’s African American I can say, ‘Oh, boom, this happens every time.”
- Labor and Delivery Nurse, Bronson
“Except when the statistics come out, we find out it’s four times the number of black babies that are dying than white babies. How is that happening?
What’s wrong? What are we missing?”
- Labor and Delivery Nurse, Bronson
“I think a lot of people care but it still feels like our whole community isn”t outraged; our whole community should be outraged”
- Labor and Delivery Nurse, Bronson
“That’s the hard part. That’s the puzzle, because we feel like we are giving the same level of care and the same chances and the additional resources and the programs. So why are we still failing? Where are we losing these babies?”
- Labor and Delivery Nurse, Bronson
“I mean, when a baby dies I don’t care if it’s purple polka-dotted. It’s a baby, it’s a future, it’s a hope.”
- Labor and Delivery Nurse, Bronson
HEALTHY BABIES HEALTHY START
“You know, if you have a mom who is depressed during pregnancy… she has stressors and when she has the baby usually she is depressed still and making that connection after she has the baby is so important.”
- Healthy Babies Healthy Start
“It’s not just the co-sleeping there are a lot of different factors, mental health, domestic violence, smoking that contribute.”
- Healthy Babies Healthy Start
“We have to get more buy-in from the community that we’re dealing with we have to get more people within that community to believe in the cause for us to see an impact.”
- Healthy Babies Healthy Start
“I also believe that because it hasn”t happened to them or someone around them so they still are not really believing that this is happening”
- Healthy Babies Healthy Start
“I truly believe that it comes back to racism and the stress with racism. Waking up everyday and thinking that you”re a certain color and how that impacts you going into a place to receive services or how you”re treated or the trust for your doctor or the trust of the people giving services to your baby.”
- Healthy Babies Healthy Start
“The liquor stores are saying we accept EBT and WIC but, there’s not healthy food there and if there is supposedly fresh food there is not they’re rotting.”
- Healthy Babies Healthy Start
“It”s not only the choice of the mom making these bad choices and that she doesn”t want the adequates nutrients for her baby”
- Healthy Babies Healthy Start
“The monopoly and people who are interested in making money off of babies… they put out things that aren’t in agreement with safe sleep and the moms want it because it’s fuzzy and interesting.”
- Healthy Babies Healthy Start
“I think people as far as workers, that do some of the things like home visits forget about building a rapport first because if someone doesn”t really trust you it”s very unlikely that they are going to do what you say or use your advice.”
- Healthy Babies Healthy Start
“It sucks being poor, I”m just going to say it… you get asked different questions that people with money don”t get asked and then you’re supposed to tell them all this stuff and once you tell them maybe CPS gets involved…so it all gets turned around in a negative way.”
- Healthy Babies Healthy Start
“It”s been proven that people feel more comfortable when the people who come in can at least relate to them in some way, culturally, or whatever it may be.”
- Healthy Babies Healthy Start
“in our community if you take a look at the other programs they don”t really culturally represent the community that they’re trying to serve. Their heart is probably there but it’s not the diversity that is needed in the home visitation group to represent high-risk groups.”
- Healthy Babies Healthy Start
“If no one has time or resources it falls apart.”
- Healthy Babies Healthy Start
“They’re gonna always put me with a different provider if my schedule doesn’t match and if I don”t request my doctor.”
- Healthy Babies Healthy Start
“You get moms with a mental health issue who needs help and support… because the doctor wants them to take meds…instead of an alternative because are those meds healthy for the baby?”
- Healthy Babies Healthy Start
“There is a lack of support for people who are trying to manage their mental health.”
- Healthy Babies Healthy Start
“Once the family knows they can trust you they start to really believe what you say and see that you support and really want the best for them.”
- Healthy Babies Healthy Start
“Sometimes you have to bring yourself to their level to get them to understand.”
- Healthy Babies Healthy Start
“Sometimes they don’t feel comfortable talking to doctors one time a woman told me about an issue when the doctor left.. she didn’t feel comfortable telling the doctor.”
- Healthy Babies Healthy Start
“People need someone to believe in them and we have to believe that the seeds we’re planting we’ll see fruit from it one day.”
- Healthy Babies Healthy Start
YWCA
“If children are supposed to be our future, and there is no children, where is our future?”
- 40 year old black female, YWCA
“I honestly feel like it takes a village to raise a child. We need to come together as a community.”
- 30 year old black female, YWCA
But I had a stillborn in 1999. August 24, 1999. Quadralia Lashay Thompson may she rest in peace. But I was seventeen years old at that time. At that approximate time I was staying here at the Y. I was going through domestic assault and plus my age and stuff I think us young black people go through a lot more than the other races because of our lifestyle, how we live and how we have to survive, and how we have to cope with a lot of things. Some of us raised ourselves and some of our bodies were more mature than they were supposed to be before we started having intercourse–like me, I was raped, you know. It could have been come from abuse from the family, whatever.
-YWCA
“We [black people] have more challenges as far as where we come from, our parents have been some of them alcoholics, some of them drug users, some of them in the domestic violence program, which stresses out all of us and, you know, we try to protect ourselves cuz from us not wanting to be like our parents.”
-YWCA
“We”re [black people] actually tearing ourselves down, you know. Well, that”s just my opinion. And we need to learn how to focus on us and not actually what goes on with everybody else—focus on yourself, self preservation. And we should probably do that and not worry about what this man doing or what your momma did or what uncle raped you or, you know.”
-YWCA
“They said my placenta was not actually completed at, um, from being stressed out they said my baby, my cord had wrapped around her neck and from the stress she was going, it was going up and down so I didn”t know that my cord was strangling her but every time I was stressed out, and every time I raised my hand up over my head, I was taking life from her. And by me not being developed, it was like she, it got deeper so as far as you can go, like if you”re being hung, you can”t hang yourself unless you go so far. And so she hung herself and that was from me being seventeen years old, stressed out, and also going through domestic, domestic abuse.”
-YWCA
“We shut down as black women. We have an attitude that is not even an attitude; it”s called, um, we have this shell. No matter what is going on, I don”t care. We won”t cry easily; you cannot make us cry, you cannot break us down. We”re so hard on the outside, no matter what. When we get alone we”ll cry, but we don”t want the world to think anything is wrong.”
-YWCA
“Parents teach you. And a lot of black parents teach you: ‘I don’t want to see you cry. There’s no reason for you to be crying. You supposed to be like this, you supposed to act like this. Don’t you let nobody upset you. You don’t let nobody tell you what to do.’ You know? All that so we catch a shell no matter what’s going on we’re gonna—We’re just gonna hold it in until the last minute. We wait too long to fix the situation. And then by then it’s too late.”
-YWCA
“There’s not enough we’re listening too much to, ‘Well my grand mama did this like this. I don’t want my baby to be going to the hospital. They’re not gonna keep charging me on all these bills. I don’t want them taking my baby away saying I’m not taking care of my baby.’ Sorry. But you get this all the time, you know.
And then by then it’s too late and people want to call it SIDS—it’s not SIDS; it’s just the fact that the baby gon’—it’s unknown. But it could have been found out if we had took that time and we took that time, you know.”
-YWCA
“And instead of us taking that test to—I can’t check right—when you’re at the hospital: “Can you check my baby’s breathing rate?” All that stuff like that. We don’t do it. We don’t take that time now.”
-YWCA
“It’s just here. You scared to really find out what the doctor really has to say. You know, that’s even with me right now by myself. You know, when I go to take tests for diabetes, whatever, I’m scared to go take tests cuz I’m scared of what the doctor gonna tell me.”
-YWCA
“And, like, smokin’ cigarettes, or smokin’ weed, or drinkin’ or whatever, you know. We get to the place where we want to be around our friends and friends: ‘Oh, well, this ain’t gonna hurt ya; I did it with my baby.’ And, you know, they might have been alright with their baby but not alright with yours. I mean, you know, there’s a lot of things.”
-YWCA
“A lot of black people, we don’t track down our family history. There’s a lot, a lot of broken families. Back in the day like maybe the sixties and the seventies, I still have, I grew up with, well, I didn’t grow up with them. But my, my mother and father are still married to this day and I still, I couldn’t tell you who has passed my family tree. What’s going on with this. And that could be a big problem too; we don’t know nothing about our bloodline. We don’t know: Does this person carry sickle cell? Does this person, you know, um, have…This person had tuberculosis back and this auntie had tuberculosis and this auntie had this.”
-YWCA
“And there’s a lot of that—that, that unprotected sex, you know. Nobody’s married anymore. Everybody’s having babies without being married. ‘This is a one night stand, so I don’t know who the baby daddy is because…’ I don’t even like that word. ‘I don’t know who the father of my child is because I slept with Jimbob this day and I slept with Samuel this day and then two weeks later, because Samuel made me mad, I slept with this and this.’ So when you get pregnant and then you turn, you count down, trying to figure out which one. You ain’t gonna tell nobody that you don’t know who your child’s father is. You’re just gonna name one of them and then don’t tell nobody later down.”
-YWCA
“I had a miscarriage. And I didn’t know I was pregnant. And I had already had my son. But the person who I was pregnant by was stressing me out, just stressing me out. And, um, we had gotten into a fight on the side of the highway and something happened and I ended up at the emergency room and found out that I was miscarrying.”
-YWCA
“And that’s ‘cause, um, we put ourselves in stressful, stressful situations with, with these men. I mean, and like she said, we’re too busy thinking about this instead of thinking about ourself and our baby, we’re thinking about why we made him mad or trying to, trying to do something else instead of self-preservation. We need to learn self-preservation is number one, basically.”
-YWCA
[After asked about other common causes of infant death]: “Hematomas…It’s a blood clot, um, mine was, um on my placenta and I didn’t know it was under there. So I went to the hospital cuz my back was hurting. I was like seven and a half months and, um, I knew something was wrong because, you know, they didn’t give me any pictures or anything like that at the ultrasound. So they was taking a long time and, um, I went into the hallway and I seen like four doctors out there. And they looked at me like ‘Oh, wait we’ll be back in there.’ And then they, you know, took my kids out cuz I had two healthy kids before that. And then they told me, ‘Yeah, he wasn’t breathing. He’s gone.’ He had been—they said he died like a week before that and I didn’t know because I still felt him moving.”
-YWCA
“The stress comes from the wall. I mean, you’re forced to be relentless, right. You are forced to pretend like everything is okay.”
-YWCA
“After a while you can’t, um, show a sign of weakness because there are so many things, um, that are already built and designed to break you. So you can’t let things that you can control break you, you know. Um, the mental health thing—…When that was happening I couldn’t believe it at that moment, like ‘Seriously? Stress?’ But I knew that I was under a lot of stress because that was a valid situation, you know. Um, but I was also in school. I was working. I was dealing with the violence. So, it was compound stress; it wasn’t just that one thing—that violence.”
-YWCA
“And raised yourself since you was like ten or eleven basically. I mean, see that’s the life that we have been through. I know cuz of my best friend; she know what I’ve been through. But, yeah, we have been through.”
-YWCA
“They [hospital workers] just send you out the hospital and, [agreement from the group] and send you on your way—it’s nothing. Only, only help you got is the Y and the sexual assault program…And that’s why us African Americans go other places cuz there’s nothing out here for us. In Kalamazoo, Michigan we don’t have nothing. For us young black mothers who lost kids, we don’t have nothing. They don’t help you get over that. I mean, they, they, they don’t. It, it’s seems like they just don’t care.”
-YWCA
“I used to babysit, um, my nephew. He died at four and a half months, thank God my aunt took over cuz I was only about, I was about thirteen, you know, watching him and, um, and it’s crazy with him, um, and this, it’s so crazy because, um, his penis grew inside. So, he would have had to have, like several operations before he was one. Um, I don’t know, um, it, it was a lot going on. Um, I personally felt that the baby was being abused. Um, by his dad. The same man who abused me. Um, before he passed away, that day he was throwing up white stuff—figured out it was sperm and stuff like that. So, um, I, I guess this, you know, he was being abused and stuff.”
-YWCA
“And there’s a lot more abuse and, you know, sexual assaults and stuff happening in black families than you will find in the Caucasian families. A lot more.”
-YWCA
[When asked what does exist in Kalamazoo]: “You know the prenatal care. You know, the doctors and things like that. They wait for you and they have all that.”
-YWCA
“There’s nobody that you can really count to because if you, you know, you lose the baby now and they seen—you, you’re gone out the hospital within hours and, and then what is you to do? You go home and—and what? And what?”
-YWCA
“And then you have to—in the same, on the same unit as other mothers that just delivered so—And now your baby’s gone and then next door you have another baby crying.”
-YWCA
“I got a, a nephew now. His baby, um, how old is Isaa’s little baby? Five months old. Just turned five months. Um, they let him out the hospital with a feeding tube, told the mom, ‘Okay the baby was in the hospital a week because when he was eating the, um, milk was still going to his lungs, okay?’ So, there’s fluid on the baby’s lungs. They got it kind of cleared out, whatever. They allowed this baby to go home—now these are young parents. I’m sorry to say, they are young parents, okay? The girl’s about twenty years old.”
-YWCA
[In response to why the hospital workers would send home an African American baby before it seemed ready to go home] “That’s because we’re African Americans. I’m sorry to say, it’s African Americans that they let go because we only receiving Medicaid.”
-YWCA
[After being in the hospital and giving birth] “Throw you out in the street. Throw your babies out in the street like who gives a damn about you. A, a, another black person, black baby gone—Bye-bye. So we ain’t got to worry about that baby growing up, carrying no gun, or being a hoe on the corner. That’s just how I look at it. That’s my point. Because if it was a Caucasian baby, a middle-class baby, they, they would have been up in there, that baby would have been taken care of.”
-YWCA
Facilitator: So, so where, where are the services needed the most then, you know, prenatal, after losing a baby?
Response: “Everywhere, everywhere.”
-YWCA
“After losing a child. They need to get some type of grieving pro—or counseling, you know. Or some classes started.”
-YWCA
“I had my room upstairs and my mom had her room downstairs. My mom—and cousins—live in our home. My mom was living downstairs, my room upstairs. Two other rooms upstairs, and there’s men in her room. That’s how I begin getting molested.”
-YWCA
“My uncle had started raping his daughter, which was eight. He, that’s when he started raping me at the age of eight…I ran. And I ran and I ran and I didn’t stop till I got home. And I was crying when I got home but all my mother said to me—cuz he’s supposed to oh, oh, oh, pay me for babysitting but I’m not babysitting—he’s fucking me. Okay. So, I run all the way home, my mom, I’m crying, I got right in my room—a one-bedroom apartment, may I remind you—come out the room, she calls me out the room, she said she looked—“Did he give you the money?”—I’m crying. Not once did she say what’s wrong with me, this and that.”
-YWCA
“Do you know how it is on a black, young African child—this is why we don’t tell people nothing. Don’t nobody believe us. When we reach out: ‘Oh no, this couldn’t happen. They too close to this. They this, they that.’ Listen to your child.”
-YWCA
“I wanted to commit suicide. I wanted to do all type of stuff. You know? And that reflects me on in my life what that got me in, what that had got me in. I wanted that attention I never had got. And when I got that attention, the attention with the wine and dine, it was good so you ain’t care about the fighting—okay—okay, I got a busted lip today, or, you know what I’m saying? I’d just go to the Y for a while. And then all of a sudden, he’s gonna come ring that bell and guess where you’re gonna go—right back out.”
-YWCA
“I suffered from depression after my kids, and I didn’t even know I had depression at first.”
-YWCA
“And the psychiatrist is putting you on these other med—pills. But you can’t be on this medication when you got this baby because then you’re gonna have a neglect charge because you fell asleep on the baby. The baby could have choked—you don’t know how the baby died, now. Cuz you’re doped up on what they gave you.”
-YWCA
“There needs to be more postpartum care and definitely parenting support. Whether after you have a baby, or after you don’t. You still need support. It’s like, they don’t act like you’re having extreme trauma.”
-YWCA
“I lost my baby and I’m sitting in a room and all I hear are babies crying. That is traumatic. Because you’re trying to figure out: What would my baby’s cry sound like?”
-YWCA
Bronson Social Workers (White Women)
“These moms who did everything right, you know, who planned, who… you know who have either infertility that cannot get pregnant or have had multiple miscarriages or you know whatever their circumstances is but then they see so and so’s sister, or this other person, who doesn’t take care of their kids and shouldn’t have their children or is a horrible mom or horrible conditions for these kids and their children are alive and whatever level of thriving. My daughter works in the ERIC and has been there for 8 years almost now and, I’ll tell you, she said I’m not gonna have children. She said, I just… It drives me crazy to be in that ERIC and all these parents coming through there with these kids that… um, ya know, can’t take care of them, don’t have a clue… life is gonna be terrible. And they see these other ones who come in with miscarriages and things like that and it’s just not fair. It made her question her faith, it made her question everything, and when you start doing those kinds of things you see those high levels of burn out and compassion fatigue. And I hear that at my share table too. Why? Why me? Why did my child die and this person who just had their fifth child and didn’t want it. -social worker, Bronson
“Self-care is real important to do in this kind of work. It affects you. If it didn’t affect you… I cry with my families, you know, people have said to me I can’t do that, nurses especially, and I said the day I stop crying with these families that are going through stuff is the day that I need to stop doing this kind of work.”
-Social Worker, Bronson
“I think for our staff in terms of how it affects us, sometimes if we hear about a baby that we have discharged that then ends up on the news because of “shaken baby” or some unsafe sleep situation… there’s a lot of just anger, questioning. Why was this?… Maybe CPS must have been off? Why was this baby allowed to go home with these parents?… The system failed.”
-Social Worker, Bronson
“There’s a lot of frustration and a lot of anger as to, you know, we’ve done everything we can to educate these parents, put in as many resources as we need, the CPS… We flag this one because we really didn’t feel like this was a safe situation for the baby to go home in. But your hands are tied and the courts say you can’t parent… and then you hear about it on the news. So, I think for our staff sometimes its been kind of a sense of anger, but a sense of why do we keep doing this? What’s the utility of it all? And just the frustration within our system… We feel like sometimes there could be more prevention and I feel like our system is very reactive. We are gonna focus on after-the-fact, after this baby has already been harmed, and so there’s a lot more of what could we do? Could the parents get their act together first, and then have the opportunity to parent rather than the other way around.”
-Social Worker, Bronson
“I at any given time, in the ICU, I have 15-20% of the babies up there are child protective service involved to some level. That may not mean that they are not leaving with their parents, but a large percentage, maybe half of those, will be going into temporary placement out of the hospital. They are not parents. So that’s a pretty big chunk of those patients that I am managing up there just making sure that whatever reasons CPS has gotten involved and they are staying involved and will dictate the discharge position based on their investigation.”
-Social Worker, Bronson
“But when you have like a first time mom, like who hasn’t had any kids before, and doesn’t have a history of any type of CPS involvement, and isn’t gonna be hanging out with us at the hospital long enough for us to kind of let them fail, I guess, is the best way to put it. And we honestly have to like… I have to sell my soul to get a judge in this county, in Kalamazoo in particular, to remove a first time baby. And I’m not all about taking away patients rights… I’m not. But we are real relative in our thinking. If we think there is something significant enough that we all are begging a judge to remove a child, there’s probably something to be looked at. But with first time moms we’ve sent babies that you just know it”s not going to work out.”
–Social Worker, Bronson
“A very sick feeling to send a baby home with someone who has not demonstrated either the bonding, the preparedness, the interest, the… comes in with a really hostile attitude and is not receptive to any kind of teaching or any sort of… you know, those kind of people they are coming and going, or are very questionable in their presentation and how they are treating… It’s like we don’t feel good that this little fragile baby that can’t hold their head up.”
-Social Worker, Bronson
“I think one of the huge improvements… With all of our wealth of knowledge and experience, ya know, here at Bronson have really put in a strong alert system on our electronic records for these socially high-risk equations.”
-Social Worker, Bronson
“Two infant deaths that came into the ER in the last month both, in reviewing their charts, both has CPS investigations at the time that they were infants here… newborns… that allowed them to go home with parents. And that’s a sick feeling…”
-Social Worker, Bronson
“But I think that when you look at the research and you look across the board it is… it’s higher within that population not just… I mean if you took the socioeconomic out it would be a different percentage, but it’s still there. So is it that chronic sense of racism? Is it that chronic sense of stress? I don’t know…I think it was more of that community and just that trusting more of what grandma and auntie said no matter what that social worker is telling me… no matter what that baby shower is telling me… that was great that they gave me that bed and that car seat but… and grandma said I raised all my babies with this crib like this and sleeping them on their bellies and… they put them on their backs and they spit up and throw up they’re gonna aspirate… they are gonna swallow that stuff and die. There’s a lot of that kind of stuff… oh you gotta put a pillow under there… raise that head up a little bit. I mean there’s all those urban legend kinds of things that they trust that person that’s like them that lives two houses down that has the five kids running around. But you don’t know how many miscarriages she had because people don’t talk about those things in those communities. That’s greater trust for their information and their knowledge then there is from those who come from professional standpoints.”
-Social Worker, Bronson
“As a staff, we have primarily white nurses working on the floors giving them the education. With some of my African American families I have pulled in our Safe Kids Coalition employee who is African American. Sometimes I feel like she can get the message through better than I can. But I think sometimes it comes better… the message comes better and I wish we had more African American diversity with our staff but also with the case workers in the community too. That’s kind of an issue we have as a county.”
-Social Worker, Bronson
“There are a lot of resources in Kalamazoo for pregnant women. I mean, compared to the greater population… I don’t want to imply that this is a hopeless situation. There are a number of programs in place in the community to help women get the stuff they need for the babies, to provide education for them. I honestly could make countless referrals during the pregnancy and it’s still not working.”
-Social Worker, Bronson
“And I don’t know that it”s what we are doing during pregnancy that’s helping out. I feel like there needs to be something in place earlier… in the schools… that do something more preventative so that there is more people involved in doing and helping these guys get prepared.”
-Social Worker, Bronson
“It’s not after you know you are pregnant that really matters with a lot of these problems that these babies have.”
-Social Worker, Bronson
“Kalamazoo has the Kalamazoo Promise. I mean, it”s like the place where dreams are made… where every child that graduates from a Kalamazoo school, no matter what school it is, is guaranteed a college education. You have something like that in place and we still have this kind of infant mortality and we still have all these kinds of problems.”
-Social Worker, Bronson
“I mean its systemic. I think inculturated. Racism is real. It’s there and everything whether we want to admit it or not.”
-Social Worker, Bronson
“I’m not sure what those answers are but I think it’s getting in those zip codes where we are having them and getting in there with those people and getting people. We went to these communities and we said who do you guys listen to? And we found those community leaders that weren’t necessarily what we saw as community leaders but who they were listening to and sometimes they were the people with money. They were the people that might be the drug dealer in that community that had peoples ear. We went in there and we said to them “Listen, your babies in this neighborhood that are dying. Do you care? How can you help support us in doing that?” And when you got those people to the table people listened, people came. But was that sustainable? No. It was grant based and it was not sustainable. It’s kind of scary sometimes too…”
-Social Worker, Bronson
“I’m overwhelmed by not just my population of patients but the teenagers in general… how many of them have sex very randomly whenever they feel like it. Who tells them not to do that?… It’s like what is this doing to you as a person?”
-Social Worker, Bronson
“We still are in our own silos and we are not getting into those homes and into those heads where we need to be getting. And I don’t know if anybody that sits at these tables that you interview is gonna have answers.”
-Social Worker, Bronson
“It’s just like the housing issue itself. I mean MSHDA has been working for how many years now to end homelessness. It’s so systemic. I don’t know if its something we’re ever gonna do… and even if you have a home, is it a safe home? Is it a safe environment? You talk about these zip codes we are talking about and you go walk down the street in one of those.”
-Social Worker, Bronson
“My patients don’t feel safe there. Like their answer to a standard question “do you feel safe at home?” We are asking that looking for domestic violence and they are like “no”… “Well is someone hurting you?” Well no… it’s just not safe. People… there’s guns all over the place, there’s drugs all over the place, I can’t let my kids go outside in the yard and play, and that’s where they have to live because they don’t have any other options.”
-Social Worker, Bronson
“I mean we talked… The wealth of this community with the… there’s just so much… the community foundation is one of the wealthiest community foundations per capita for Kalamazoo. The head of that foundation has said if I could write a check to fix this problem, these problems, then she would do that. They do spend lots of money, lots of resources, and we still are at these… lots of programs that, you know, kind of get into the reactive or prevention kind of pieces that we are talking about but yea, if the check writing can do it we have check writers in this community that could and it”s not gonna fix it.”
-Social Worker, Bronson
“It always makes me think of a young man one time that said “write me the check, and that will change my life. Forget about sending these people in telling them to figure out how to do it, write me a check so my life is changed.” It’s like… we are spending all this money trying to do this, what can we do different?”
-Social Worker, Bronson
“It needs a champion to keep things moving forward and keep those collaborations from building and growing and all of those things because it really is the collaborative piece within the community that can put those resources out there and make a difference.”
-Social Worker, Bronson
“I just think it”s eye opening when you really look into the statistics. It’s almost like how we kept trying to pull up out of the swirling cycle there… its almost daunting just to think about it because it”s not about one factor or another it is so huge and systemic.”
-Social Worker, Bronson
“Their stress is chronic, chronic, toxic stress, and it just is their lifestyle. The chaotic lifestyle which they live, their inability to set goals beyond the day in which they live, to kind of you know, help you know keep some sanity in their world, and so it is just constant moving around, just lack of being ready or anticipating their needs for the next situation whatever it is, and so that in and of itself fuels a lot of this exhaustion that comes into play long before they are pregnant, and tired, and have a newborn and that just compounds a lot of these situations.”
-Social Worker, Bronson
“and because of that chronic stress, I mean just getting to prenatal appointments is just such a low priority. If you’re searching for housing for the next night or you don’t know where your next meal is going to come from, getting to the doctors office is not going to be a priority. And getting transportation I think is a big issue for a lot of pregnant women, housing and transportation is huge, so then if they aren’t making it to the prenatal appointments they aren’t getting a lot of the education and sometimes do have poor pregnancy outcomes as a result of that, unfortunately.”
-Social Worker, Bronson
“I remember talking one time to a quite large African American male who had just experienced, and they weren’t sure if it was him or his wife, they were both in bed together but the infant had died from suffocation. I came in and I said to him, you know, I was talking to him about trauma, you know just the symptoms of trauma and the experience, and he said “trauma? You’re talking to me about trauma? My whole life has been nothing but trauma. For me, I’m used to trauma, that’s my norm.”
-Social Worker, Bronson
“I remember one time we had a young woman who was not African American, I don’t know her ethnicity for sure, but she was Middle Eastern, and she had a job here at the hospital and she had had a death. There were things about the birth that she felt didn’t go right and she was starting to talk about it and her partner put his hand on her leg like that (gesture to person next to her) and she said “oh I don’t, I don’t want to lose my job.” It was that sense of oh everything is fine, I can’t complain about it, I don’t have a right to speak up because you know, we all have sources here, we talk to people. And she was like “Oh no, no, no”. So its almost like that sense of protection, you know, we have to protect ourselves, we have to protect our own, we have to ride the waves, that sort of thing. It’s hard.”
-Social Worker, Bronson
“You know, I think if you come right back down to it all, we all know about self medication, and you know, sex is basically in a lot of ways for a lot of these people, it is their only release or pleasure, you know. It’s the release of that serotonin, that serotonin uptake, that’s their antidepressant in life, so when you look at those kinds of things and you hear from these 13, 14, I remember one in Allegan County when I was working there that was 11 years old, that are pregnant and they act like there’s nothing wrong with that, like ‘well I just want a baby, I just want to have something to love, and to love me.’”
-Social Worker, Bronson
“Almost without fail, they have been abused as children, um, sexually, emotionally, and physically. And it’s just constant. But it’s not always sexual, sometimes it will be emotional, and “well I got hit so ill go here” and it just goes on and on and on. It’s the only interactions they have had with men and how their moms have interacted with me their entire lives, and it’s just what they are used to, and I think that plays a huge piece of what we see with our patients here at the hospital.”
-Social Worker, Bronson
“There have been individuals that I have encountered that I think would categorize their feelings that time as relief. I think that, you know, it’s not always a grief response and a devastating loss, there are those situations for which in their mind this is the best outcome. And it’s tough to be a support person, you know the decision was made for them, that they aren’t having to be burdened with this in a sense.”
-Social Worker, Bronson
I think from the staff standpoint there is relief from this standpoint, that this fetus did not survive and have to live a life of chronic physical handicaps, challenges, and just the limits of the quality of life issues, that the parents might not appreciate. I would say that in some of those situations where I have a sense of relief is when the patient is not having to go forward with a quality of life issue, I would never say that to the family obviously in those terms, but there is that reality, like if the patient is on mechanical ventilation and can’t breathe on their own, and the parents won’t accept that that’s how it is.”
-Social Worker, Bronson
Female Community Members
“Well they wait about 20 weeks or sometimes, I see, they wait till they get 6 months pregnant and go to their first doctor appointment. Because they smoking weed and all that stuff and they don’t know they’re pregnant”
—- ????
“Yeah and like, Now days, parents don’t have patience with kids, it’s so different now than back in the day. And that goes back on the parents now. Kids are so different. (Everyone joins in-(they’re so bad, so indiscipline…etc…)”
—- ????
“A lot of them don’t put themselves out for help, you gotta hear it through the grapevine, some programs I just find out about them like where did that program come from, I never heard of it, it’s like sometime you gotta hear it through the grape vine”
—- ????
“I think the family has changed, everyone used to chip in but now everyone is for themselves.”
-Woman at YWCA
“-Sex education has to start early because younger and younger girls are getting pregnant and they don’t get any support. Majority of the time they say it is “accidental”.”
-Woman at YWCA
“It used to be part of our science classes but now I think you need a pass slip from your parents for you to have sex education.We started in middle school; it was all part of our education. You gotta start early.”
-Female Community Member
“theres a lot of resources, but no one is taking them. They just don’t take the initiative to come to it. Because I know, working thorough head start, we do a lot. We do a lot for the parents, and they still don’t come out and do what they need to do. Like when the kids need to go to the dentist and doctor, we even take them to the doctor. That’s the only way I guess, so we gonna have to ….”
-Female Community Member
“A lot of it got to do with being last too you know, Black people are more – I hate to say it – but black people are more lazy! When it comes to taking care of babies! You know? Let the baby just lay there, the baby better get up and get its own bottle, you know?”
– Female Community Member
“BIM won’t change until society changes itself. You’ve got SIDS and IM and all of these other problems that are going on in the world, you keep doing studies, you keep doing this but, until people want to change, it won’t change”
-Female Community Member
“I wouldn’t say that they’re all unplanned but it’s the lack of responsibility on the person who is actually having sex because you can go and get condoms that’s for free, I mean they are right there for you to get. That is planned to me. If you don’t try and prevent it, its planned”
-Female Community Member
“the dad is not a part of their lives. Most of them is not, they hit it and quit it”
-Female Community Member
Male Community Members
“More people in the community have to get involved, that’s all it is”
– Male Community Member
“Some of these programs are biased towards men, it”s frustrating at times because it’s at times like I’m taking care of a daughter all by myself and I’m doing all this and at times I do need help, but its times where certain times where I call places and they be like “we only help women”
-Male Community Member
“if you are not part of the solution, you are part of the problem, I do little things that I feel good about at the end of the day, I don’t know we just don’t care if it don’t happen to us, I’m just being real honest about it, it wasn’t my problem, it was their problem, but it should be all of our problems”
-Male Community Member
“It’s not that…. Its not that there’s not a lot of opportunity for learning, when you have a child, theres only so much that somebody can tell you. If you don’t try to go over there and listen, because there’s a lot of things you can do, In the hospital they tell you don’t sleep with your child, don’t do this, don’t do that. They tell you what you’re not supposed to do before you take that baby home, but if you don’t listen, then what can somebody say? … The first person, that their baby died it was my friend, had a friend in my apartment and I told her, I used to tell her every night, I used to tell her every time I saw her, yo you can’t sleep with that child! What happens if you drinking or something or you smoking or something and you in deep sleep and you got your child next to you and you roll over? Then what happens? Don’t do it. And two weeks after we have that conversation… Bam? She rolled over her baby and killed her baby.
-Male Community Member
“always that option, when people say they can”t buy cribs, I say that’s a lie. There’s a lot of resources here. Theres a lot of places helping women with kids, but not a lot of single dads going to these places. But if you keep calling and stay consistent. If you want to change you got to do it yourself. You can go to events and read everything, but if you don’t apply it, it’s not important.”
-Male Community Member
“Most of the pregnancies that are going on these days are unplanned a lot of pregnancies and are fueled by alcohol and drugs and violence going to come about because drugs and alcohol are involved. I mean you have to understand when you have Kids out here who are 12 and 13 , and 14 drinking and smoking, and kicking it. A lot of that has to deal with parenting because a lot of these parents don’t parent. They trying to be their friend. Cause I know growing up we had curfews and respect and if you did something down the street and lady woman saw you do it, you got beat and she would call your house and you would get double. But now a days you don’t have that anymore, you don’t have no sense of humility anymore, you don’t have no sense of respect of parenting, you don’t have no sense of nothing cause now a days you can see a child doing something in the room, you go tell that child’s parent, that child parent going to want to argue with you and if you tell a parent these days that parent will fight with you”
-Male Community Member
“substance abuse, you know? I think a lot of it has to with substance abuse man, cause where I be at, I see a lot of man, I came out of the store and he’s like 11 or 12 and he talking about how many pills he had popped last night. Its crazy and that’s where I think it should start at, you want to have that title of being baby daddy, but they don’t even be in the house to take care of the child. Lets see how many girls I can knock off and get pregnant, they are treating their kids like trophy’s. Then the girls don’t know nothing, don’t know how to take care of them.”
-Male Community Member
“I’m telling you you, I looked outside the window, I woke up because my daughter woke up and I was changing her diaper and then I look out my window, it was like 35 people outside, just doing nothing, drinking, talking loud and smoking weed. It’s like you, Don’t you have anything else to do with your life? It is more to life and I talk to a lot of the young kids, because I live out there, that’s where I live at, when they told me that me and my daughter could not stay with her mom, I had to find me somewhere to go, I’m just doing what I had to do, I get a crib and I like my neighborhood b/c they do a lot for the kids out there, but I try to talk to the teenagers because they like 17-22 and I tell them, there’s more to life then just Drinking, Smoking, Kicking it with girls. When you do not have a high school diploma and you can’t get a job because all you thinking about is some drugs, where you going to end up? (Jail, Dead, or institution somewhere, that’s what is yo, its one of those three options yo and if you don’t change you are not going to be able to see your kids raised up to get a high school diploma, you need to break the cycle cause if you don’t change, your kids might be 10,11,12 doing the same thing you did because you didn’t break the cycle”
-Male Community Member
“You can’t use that as a question no more, a lot of people was using poverty, race, saying that I can’t do this because of where I live, you can’t do this because of color of my skin, you can’t do that no more yo, its 2015 yo, they got all this technology out here yo, all this education out here yo, all this money out here, you get money to go to school, get all these degrees out here and you can’t use that as no question no more, ain’t no excuses on why you can’t get an education, no excuses on why you can’t find a job, ain’t no excuses on that, there’s jobs out here, JVS hiring everyday, every week,”
– Male Community Member
“to be honest with you man, let me be straight honest with you, it didn’t even bother me, because it didn’t affect me, you know what I’m saying, when it happened to my friend, it hurt for a minute, but it didn’t happen to me, my life just kept going and going and I didn’t even think about it, what they said you aren’t part of the solution, you are part of the problem, I do sorta feel bad now, I do know a lot of young people that I go talk to, everyday man when I do be out there, I do try to talk to people , young kids because I’m a big believer, if you are not part of the solution, you are part of the problem, I do little things that I feel good about at the end of the day, I don’t know we just don’t care if it don’t happen to us, I’m just being real honest about it, it wasn’t my problem, it was their problem, but it should be all of our problems”
-Male Community Member
Medical Social Worker (White Women)
“We need to talk about it. Get support from each other as we go through things different things that are difficult. And it does help burn out in the field to be able to have resources that you can draw from and I always tell staff that nobody really understands that it is what we do and we have to support each other because most people don”t understand the depth and the breadth of everything we do. And it can be very very difficult. You could work with a family for a year or two, they could be in foster care, it could have a really good outcome, it could have a tragic outcome, and you”re with a family no matter which way it turns. So it”s not like when it gets hard you can opt out.”
-Medical Social Worker
“I think that when an infant has passed away you think back to when it happened and could that have been prevented… it”s that education piece. Educating moms that they”re going to be completely exhausted, and that you can fall asleep in the chair with the baby and when you get that tired, you know, you need to put the baby down, because even without intention you can become an unsafe sleep.”
-Medical Social Worker
“Everybody just has these moments and they don”t know how to cope with the stress, the crying all night long, or they leave the baby with the neighbor because they”re so desperate for the break, and that neighbor doesn”t know what to do with that infant, and the baby cries and they get frustrated and they end up shaking the baby, those kinds of things are definitely contribute just because there”s not, they don”t have that kind of support system.”
-Medical Social Worker
“I assume that they just don”t know. I don”t say, “I know you”ve been told this.” I say “I don”t know if you”re aware that they actually don”t recommend using these things.” And they”re like “oh, okay.”
-Medical Social Worker
“I was just talking to a couple of our staff and she was saying this was an eight year old girl who her mother, I”m not sure if it was the dad or the boyfriend, but any way they moved out of town but it was her responsibility to fix the roof and get rid of the cockroaches. Those were her responsibilities. And she would talk about just how big these cockroaches were. And most of us would just be like “Pow!” you know really mind-blowing, but that is their reality, and then we ask why they don”t do better in school. It”s like you have no idea what they”re going through… and a lot of times you don”t even want to know. And that”s why I say we need to support each other. Because the will not to believe is very powerful and most people don”t really want to hear how bad bad is, you know what I mean?”
-Medical Social Worker
“This has to do with education, being poor, and the things that automatically go along with that put folks at a real disadvantage… you know, they”re homeless, can”t keep housing, they can”t keep jobs… so they”re… just in this perpetual flux of instability. And that crosses you know, all colors, and I know we”re really looking at why is it 4x what it is for black infants than it is for white/other ethnicities… um, you know, I don”t have a real good answer.”
-Medical Social Worker
“…What we know now that we didn”t know before, is that if babies don”t get their social/emotional needs met they”re never making it to academics. They”re just not. And we didn”t think social/emotional stuff was that big of a deal, that that was sort of extra if they got it, but it isn”t, it”s the whole enchilada actually.”
-Medical Social Worker
“We socialize our babies through eye contact and be animated and so if you have a flat mom, you can”t do that, then the baby”s flat. And then it takes about two-three months and then the baby can be diagnosed with depression. We”re not going to give the baby meds, but we”re going to talk to the parent about how to better meet those needs and get her the help that she needs, so that”s why we do what we do, so what we do is work with the parent and the child. What”s very different about infant mental health is that we don”t identify the child nor the parent as our client, but their relationship is our client, so it”s an equal, you know, one is one half and the other is the other half, and so if there”s something wrong on one end or another, we need to get assistance to help that, you know, relationship heal, get off on the right foot, you know, whatever the case may be.”
-Medical Social Worker
“I love having people come at the work from all different places. We all learn from each other. I think of it as cross-pollination. And so we can learn so much from each other. I always say come the day I don”t learn something new I won”t be here anymore. To me, that”s exciting and I don”t think I”ll ever arrive, I hope I never arrive.”
-Medical Social Worker