By Dianne Anderson

What happened to young parents Charles and Kira is anybody’s nightmare, but it is the nightmare that keeps on happening.

Decades later, federal data shows that Black women still die around the time of childbirth at roughly 3.5 times the rate of White women.

Kira Dixon Johnson was an accomplished Black woman. She was young and athletic, a mother to a healthy 19-month-old at the time. She was also a pilot, a marathon runner, and race car driver. Her new baby, Langston, was born healthy.

Ten hours later, she was dead.

The father, Charles Johnson, had begged doctors to help his wife as she lied bleeding internally after giving birth.

Devastated by his wife’s death after what was supposed to be a routine 2016 C-section, Johnson founded 4Kira4Moms in 2017 to push for systemic change.

From the start, he said his top priority is getting the Black Maternal Health Momnibus Act, including the Kira Johnson Act, across the finish line. In regions like the inland empire, the fight is about hospital accountability, transparent maternal outcomes data, and closing the gaps that leave Black birthing families invisible in their own care.

Expanded Medi-Cal doula coverage is the kind of policy win that turns advocacy into infrastructure, making continuous, culturally congruent support a standard of care rather than a luxury, he said.

Combined with community-rooted programs like those being built in the inland empire, he said it creates a layered protection that Kira didn’t have.

“The tragedies we’re trying to prevent almost always happen in the gap between what a patient is saying and what the system is hearing. Doulas close that gap. Legislation like expanded Medi-Cal coverage keeps the gap closed,” he said. “Both are essential. Neither is sufficient alone. That’s the movement.”

Through 4Kira4Moms, Johnson keeps pushing policy that would fund community-based organizations to fight racial inequities in maternal healthcare, but he said policy alone won’t save lives. Every clinician who cares for a pregnant patient should be trained to recognize implicit bias, he said.

“Kira didn’t die because we lacked the medical knowledge to save her. She died because the people around her didn’t listen,” said Johnson.

Because these tragedies happen in the gap between what patients say and what the system hears, he wants to see more connections with local programs.

“When a Black birthing family walks into a hospital with a trusted advocate at their side, someone who speaks their language, understands their culture, and knows how to navigate a system that too often dismisses their pain, outcomes change. That’s not opinion. That’s evidence,” he said.

But he stressed that local advocates should know their voices are not small because of the size of the county. Some of the nation’s most powerful accountability wins have come from underestimated communities.

He also emphasized that families should request everything in writing, and bring an advocate to every appointment.

“And trust what your body is telling you. If a provider dismisses you, that is data, document it and escalate. You are not being difficult. You are being diligent,” he said.

Johnson recommends that local advocates build coalitions before they need them.

“Then demand three things, publicly reported maternal outcomes data, an implicit bias education requirement with real accountability, and a formal patient advocacy pathway inside every birthing facility. And use the tools that are already out there. 4Kira4Moms, the Perinatal Safe Spot network, Chamber of Mothers, our partners in the RMC Collaborative, we’ve built this so you don’t have to build it from scratch. Reach out. Plug in. We are stronger together,” he said.

In Moreno Valley, a new set of postpartum support services is rolling out at the Towngate Community Center, targeting an often overlooked time for moms and babies in the weeks and months after childbirth.

That critical time is when complications are most likely to occur and support systems often fall away.

Local providers say closing the gap between hospital discharge and outpatient care requires automated check-ins and multidisciplinary referrals to connect families with support. At Riverside University Health System-Medical Center (RUHS-MC), health officials are working to ensure new mothers are not left to navigate the postpartum period alone.

Shana Fujimoto said support continues after delivery, through follow-up care, automated check-ins, and individualized referrals. Newborns receive follow-up visits within 48 hours of discharge, while mothers are scheduled for postpartum care within two to six weeks.

“Following delivery, patients receive comprehensive postpartum assessments and referrals, including substance use disorder referrals, WIC services, newborn Medi-Cal enrollment, lactation nurse consultation and postpartum depression screening,” said Fujimoto, Executive Director of Nursing at Riverside University Health System-Medical Center.

Before discharge, the hospital also uses electronic screening tools, case management, and social workers to flag high-risk conditions and social barriers.

Beyond hospital walls, RUHS-Public Health is addressing gaps that leave maternal mental health needs unseen and untreated, said Curley Palmer, Program Coordinator for Maternal, Child, and Adolescent Health.

Data from California Department of Public Health dashboards show that between 2019 and 2021, prenatal depressive symptoms among Black individuals in Riverside County stood at 17.8%, while postpartum depressive symptoms reached 16.9%.

“Perinatal mental health disorders often remain underdiagnosed, untreated, or undertreated,” Palmer said. “For many populations, especially Black, Indigenous, and People of Color (BIPOC), underdiagnosis and undertreatment represent an even greater disparity.”

Palmer said one of the biggest barriers is not only access to care, but whether mothers can find culturally responsive support, including mental health professionals trained in perinatal mental health disorders.

To help moms get the care they need, RUHS-Public Health used a Kaiser Permanente grant to host a three-part Black Maternal Mental Health Matters workshop series in Moreno Valley. The RUHS Perinatal Equity program also connects new mothers to home visiting programs and community-based services through partnerships with Public Health Nursing, the Medical Center, and local outpatient clinics.

After a successful kickoff in the Coachella Valley in March, the next workshop is set for Aug. 13 at Crestmore Manor in Jurupa Valley, with another planned for October. Palmer said organizers hope to bring the series back in 2027 to continue reaching new mothers across the region.

Black mothers and babies in San Bernardino County continue to face higher rates of severe pregnancy complications and infant deaths despite similar rates of early prenatal care.

In response, the county’s Black Infant Health program is expanding culturally centered support through weekend services, Black Breastfeeding Week events and a locally developed Fourth Trimester Toolkit.

“While women understand the importance of identifying the maternal warning signs while pregnant, the 4th Trimester Toolkit will increase the birthing persons’ knowledge of the risks of injury and/or death in the 12 months following a birth,” said Francis Delapaz, Communications Officer for the San Bernardino County Department of Public Health.

In fiscal year 2025-26, the BIH program served 549 unique birthing individuals, reaching 88.3% of eligible individuals and exceeding the state benchmark.

Delapaz said those efforts are part of a broader push to build community connections and identify long-term solutions.

“Through the Department of Public Health’s Perinatal Equity Initiative (PEI) and Black Infant Health (BIH) programs, healthcare providers and community members work together to identify systems and policy changes that can improve infant and maternal health in the Black community,” Delapaz said.

For more information on Black Maternal Health, see:

Clinical Courage Academy https://www.clinicalcourageacademy.com/

4Kira4Moms at https://www.facebook.com/4kira4moms/

Perinatal Equity Initiative (PEI) Community Advisory Board at https://dph.sbcounty.gov/bih/pei

MCAH / Fetal Infant Mortality Review Community Action Team: https://dph.sbcounty.gov/programs/fhs/mcah/

San Bernardino Maternal Health Network:https://www.maternalhealthnetworksb.com/contact-us

San Bernardino County MCAH Dashboard (maternal/infant indicators)
https://indicators.sbcounty.gov/wellness/prenatal-care/