Diapers, Food and Cash: San Francisco Group Helps Black Families, One Delivery at a Time

This story contains clarifications.

In a storage room behind an old dance studio in San Francisco’s Bayview neighborhood, four volunteers busily pack diapers, wipes, fresh produce and other household essentials into cardboard boxes.

Asmara Gebre, a nurse-midwife and founder of One Love Black Community, a local group dedicated to improving Black people’s access to reproductive health care, shuffles through notes. She calls a client who gave birth a month earlier to find out what she needs.

“Do you already have a hand pump or just an electric pump?” Gebre asks. “Are you exclusively breastfeeding or formula feeding, too?”

Once the boxes are filled and crammed into car trunks and back seats, the volunteers caravan across San Francisco to make deliveries to expectant and new Black parents.

The “Sunday Show Ups” began at the start of the pandemic when Gebre noticed that few of the Black patients at her Zuckerberg San Francisco General Hospital clinic were taking advantage of a pantry a doctor had set up for pregnant patients. Concerned about insufficient outreach to a vulnerable population during an uncertain time, Gebre sought donations on social media for her Black patients, and the grassroots effort took off.

“There were disparities in access to masks, access to education and factual information around the pandemic,” Gebre says. “Out of this hard period, we created a space where we can engage in conversations and give back to the community in a positive way.”

The focus on Black families is personal and purposeful: Gebre, 34, was living in a home for pregnant people more than 15 years ago. She relates to the multitude of challenges her patients face. As a medical professional, she has seen Black birthing people suffer from higher rates of pregnancy-related complications and preterm births even as the city’s Black population dwindles.

In San Francisco, Black birthing people make up half of the city’s pregnancy-related deaths, and Black children make up 15% of infant deaths (PDF) despite representing just 4% of all births. City data also shows nearly 14% of Black infants are born prematurely compared with 7.3% of white infants. It’s a cause for alarm because preterm babies are more likely to experience chronic disease, not to mention learning and behavioral difficulties in school.

At first, the donations included masks, hand sanitizer, diapers, children’s books, produce and money. The cash donations allowed Gebre to distribute $200 per household — no strings attached.

As her network of volunteers grew, so did her reach.

With the help of her most dedicated volunteer, Cassandra Perkins — an outreach coordinator for the San Francisco Department of Public Health — they expanded their deliveries to new parents participating in the California Black Infant Health program and to pregnant people who are unhoused. They also aligned with several Bay Area initiatives that are trying to address racial inequalities to improve Black maternal health.

Perkins has spent the last 23 years working in HIV and family planning clinics in the city’s Black neighborhoods. She has an easy smile and is the kind of person who gives away books, socks and toiletries stashed in her car to people she meets on the street.

She calls the Sunday Show-Ups her church.

“I look like them, so it’s easier for them to relate to me … just to inform, educate and be of service and always treat people with dignity and respect and you get it back tenfold,” Perkins says.

She said after birthing patients leave the hospital and recover at home, many of them miss out on information about services focused on Black people’s health. The home visits are filling a crucial gap in postpartum care and establishes One Love Black Community as a reliable source of information to a community wary of outsiders after experiencing decades of poverty, environmental injustice and racial discrimination.

Bayview-Hunters Point became a Black neighborhood in the 1940s as African Americans from the Gulf Coast migrated to the Bay Area to work at the nearby Navy shipyard. After World War II ended, jobs evaporated. Black people, who were limited in where they could live in San Francisco due to racist housing policy, were left languishing in the area, surrounded by pollution left over from the shipyard.

“If they show initiative in how much they care to help you, then that’s the most helpful because they make you want to put more initiative into yourself,” says Charise Haley, who met Perkins when she was living on the streets and pregnant with her now 10-month-old son.

Haley, who continues to cope with losing her partner to suicide, says she’s close to receiving a subsidized apartment.

“Cassandra is one of my favorite people because if it wasn’t for her actually believing in what I can do, I probably wouldn’t be where I am right now,” she says about Perkins.

Haley was among seven women who received deliveries on one Sunday last month.

I ride with Gebre in her SUV that’s cluttered with baby supplies in the back and her half-eaten breakfast in the front. A tireless multitasker, she also finds time to lead Black Centering, a program at SF General where she organizes nature walks, CPR classes and other community-building activities for expectant Black parents.

Perkins and Katiana Carey-Simms, a midwifery student, follow in two other cars filled with supplies. Meanwhile, Gebre’s son Devin comes along to pack and haul boxes.

We go uphill to an apartment complex overlooking the bay and meet Crystal Hill, who is receiving her first delivery from One Love Black Community. Inside her unit, football plays on the TV while Hill’s 2-month-old boy lies in a baby swing.

Big pots of stew simmer in the kitchen, and the aroma prompts Gebre to offer to sign Hill up for six weeks of meals delivered by Postpartum Justice, an organization that recruits Bay Area restaurants to cook nourishing meals for Black people healing from childbirth.

“I need to start getting healthy because I have high blood pressure and diabetes that stayed with me after [pregnancy],” Hill, 40, tells her.

“This would be a beautiful transition, just having some nice meals and sharing with the family and thinking differently,” Gebre replies.

A short drive later, we stop at the Bayview home of a pregnant woman Perkins recently met while shopping at Safeway. Perkins urges the woman, who declines to be interviewed, to enroll in the Abundant Birth Project because she is in her first trimester and thus eligible. The guaranteed income program gives $1,000 per month to a randomly selected group of Black and Pacific Islander pregnant people who face some of the greatest degrees of income inequality in one of the nation’s most expensive cities.

The experiment is part of a growing number of guaranteed income programs responding to racial and economic inequality by giving unconditional cash directly to people in need. Abundant Birth’s goal is to ease financial stress for these people and improve their health outcomes.

Gebre stopped taking cash gifts for a while due to tax reasons, but has resumed accepting them as donations after receiving fiscal sponsorship from the San Francisco Public Health Foundation.

She estimates 300 women have received deliveries from One Love Black Community in just over two years. This Christmas, she hopes to show up for 100 families with the help of volunteers from a Black sorority for registered nurses, Lambda Chi Chi.

She recalls the small acts of kindness that made a big difference for her when she was raising Devin in the Santa Cruz area. Gebre volunteered at a horse ranch when Devin was a boy. When someone there saw her struggling, they slipped a surprise in the book Gebre was reading.

“I remember one day I was running out of gas and was like, ‘I don’t know how I’m going to get through this week of school.’ I opened the book and there was $100 in cash in there,” Gebre says. “There were so many moments where my community showed up for me. Little things here and there, but they add up.”

She says she’s driven to give back because of the support she received.

When we reach Sabrina Hall at her home in an industrial part of the Bayview, Gebre and Perkins pitch the postpartum meals and online support group for Black moms facilitated by UC San Francisco.

Hall, 41, says she developed gestational diabetes during pregnancy and suffered nerve damage and other complications after delivering her daughter, Harleigh Quin, three weeks early. The baby weighed just 5 pounds.

The experience was nonetheless an improvement from four previous pregnancies, Hall says. She participated in the guaranteed income study, and says the extra cash helped her buy baby gear and catch up on some bills.

“With my other kids, no one told me about doulas. [There was] just a lack of education,” Hall says. “This birth, I had a doula, I had Black Infant Health — you know, just the support. I had no one to speak for me with the medical office or the staff. And this time I had an advocate.”

Back in the car, Gebre says since the guaranteed income pilot launched two years ago, she noticed that patients who receive the money participate more actively in their prenatal care. For example, patients in transitional housing were more likely to find transportation to show up for their appointments.

“I have not met one patient that doesn’t care about their pregnancy or want the best for themselves and their baby, though there are so many factors around them that are influencing their ability to engage or not engage in the kind of quality of care that they want,” she says. “When you’re able to provide additional resources to minimize those stress factors — that burden, that toll is no longer present — you can notice the difference in patients and how they engage in care.”

She drives across a section of the Bay Bridge and exits onto Treasure Island, passing a housing construction project and new ferry terminal. She parks in front of a cluster of townhouses to check on her former patient Danesha Johnson.

“How are you?” Gebre asks while hugging Johnson, who gave birth a month earlier.

“The recovery is fine, no complications. I’m fine,” the 21-year-old says.

When Johnson’s partner, Darrian Burrows, comes out to carry the supplies inside, Gebre tells Perkins that he assisted her in the delivery room and caught his daughter when Johnson made her final push. Perkins remembers seeing him in the hospital when Johnson was in labor, and she’s overcome with emotions.

“That was so beautiful for you to be in the tub with her when she was going through labor to help ease things,” she says as tears fill her eyes.

“You’re giving me the chills, because I work in our communities of color and they’re always giving our men a hard time,” Perkins continues. “And some programs, there’s something for the mom and the baby but they don’t want the dad involved. So just to see you all as a couple and loving one another and having a baby brung into this world together … .”

Bearing witness to a happy, healthy birth makes her want to keep this thing going, she says.

Nov. 30: This story has been updated to reflect that One Love Black Community is inclusive of all Black people accessing reproductive services in San Francisco.