A collage of photos featuring Black parents and their newborn babies.
Photos courtesy of Sisters in Birth

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According to CDC data, pregnant people are less likely to get vaccinated, even though they are also more likely to become seriously sick from COVID-19.

To better understand the risks pregnant people face and how vaccinations can help protect their and their babies’ health, Public Good News spoke to Getty Israel, chief executive officer at Sisters in Birth in Jackson, Mississippi.

The community-based organization has a mission to improve birth outcomes in Mississippi, with plans to open a freestanding birth center in 2024.

Here’s what Israel said:

[Editor’s note: The contents of this interview have been edited for length and clarity.]

PGN: What is Sisters in Birth’s focus, and how do you incorporate awareness about vaccines?

Getty Israel: Our whole focus is serving women, particularly pregnant women or women in the reproductive age group, on prevention of diseases, injury, and premature death primarily through behavioral health modification. In other words, getting people to adopt healthy behaviors to reduce risk for things like infectious diseases and obesity-induced diabetes, heart disease, cancer, preeclampsia, and C-sections. So it focuses on prevention and wellness. And we use nurse midwives and community health workers on an integrated team to deliver the services.

PGN: How do you achieve these objectives?

G.I.: We do that through our comprehensive, holistic childbirth education curriculum, where COVID-19 and influenza are integrated, along with all the other information: nutrition, exercise, safe sex, not smoking, not drinking. We don’t solely talk about COVID-19 in a vacuum—it doesn’t happen in a vacuum. 

Usually, people who are less likely to get a vaccination are people who are low income, on Medicaid, who are already at great risk for developing other conditions like preeclampsia, hypertension, diabetes, and heart disease. 

These are the women who are likely to have a C-section. They’re more likely to have complications. They’re more likely to die. 

These are the same women. 

COVID-19 and influenza are simply more opportunistic diseases for a population that is already at risk. So, it has to be a holistic approach.

PGN:  How do you approach the communities you serve?

G.I.: If you approach pregnant women solely about COVID-19, in many cases, you will lose them.

This is a population that has low health literacy and does not understand how having too much body weight can complicate their pregnancy.

And that is because doctors do a very poor job of educating women about these risk factors and pregnancy.

That’s what Sisters in Birth does: intervention, a lot of education, a lot of coaching for them to understand what’s at risk and the power that they have in changing it.

Too often, women rely solely on their health care providers to manage their pregnancy. And too often, Americans rely on doctors to manage their health.

What we’re saying is, “You’re in the driver’s seat. We’re on the other side. We’re going to help you steer the vehicle.”

Ultimately, it’s on her to make the changes that we recommend. These are evidence-based and feasible changes, like walking 30 minutes a day, like getting the vaccine.

Pregnancy changes your body’s ability to fight diseases, especially infectious diseases. The vaccine provides the immunity that she needs, and it passes that immunity on to her baby. 

We make sure they understand the risk to themselves and to their baby.

PGN: Mississippi has one of the highest maternal mortality rates in the U.S. What other specific risks do pregnant people face in your community?

G.I.: The highest disparities are always in the red states controlled by Republicans who claim to be pro-life legislators. That’s where most of the birth disparities occur in these red states, in the southern states.

That’s where most of the obesity is. Most of the diabetes and heart disease occur in red states. So, why would we expect pregnancy disparities to be elsewhere? It’s all here. Vaccine rates are the lowest here.

When you hear about Black women having the highest maternal mortality rate, the highest premature birth rate; [about] Black babies having the highest infant mortality rates, the highest fetal death rate, and the highest low-birth baby weight. It’s a comprehensive, complex problem.

Our greatest challenge in Mississippi is that we don’t have a system here, not private or public, that supports the work. 

We have not been able to get any funding from any institutions in the state of Mississippi to do this work in this so-called pro-life state.

PGN: What types of misinformed beliefs does the population you serve have and how do you address it?

G.I.: With public health, you’re always dispelling myths. People have the wrong information and make decisions based on the wrong information. 

Pregnant women are no different. As a matter of fact, pregnant women are more difficult because they think they are protecting their babies. 

But the best way a pregnant woman can protect her baby is by establishing a healthy weight, not drinking any alcohol; by eating healthy and exercising; walking at least 30 minutes a day, every day; and getting vaccinated against diseases. The higher risk of developing poor birth outcomes can be significantly reduced. 

Some women still believe that they may have a miscarriage if they get the vaccine. [That’s false.] And so you have to educate, coach, and help them reason as intelligent people with common sense.