For Hospitals, Health Centers, and Health Plans

In a Western society that does not yet respect and honor the full brilliance, self-determination, and spiritual power of black women, the oppressive tendencies of the medical-industrial complex (MIC) violate the sacredness of birth.

Pauline Ann McKenzie Day & Alexis Pauline Gumbs

Birthing Justice by Oparah and Bonaparte

The SACRED Birth Study officially ended January 31, 2021.

Congratulations to all who made this happen, especially to Black mothers and birthing people. Study enrollment for the SACRED Birth Study ended 1/15/2021. Data collection from existing enrolled participants ended 1/31/2021.  Since the online release of the Patient Reported Experience Measure of OBstetric racism©, also known as the PREM-OB Scale™, on October 19, 2020 for data collection:

  • 2,480 people clicked on the website's referral link. 
  • 64 people were referred by providers.
  • 1,655 people completed the online self-screening and signed the consent form.
  • 845 people signed the consent form AND completed the contact form, passed the phone verification process, and did NOT later withdraw or decline to continue.
  • 815 Black mothers and birthing people fully consented, completed the contact form, passed ALL phone verification processes, completed the enrollment survey, and completed the final survey by 1/31/2021.
    • Birthed in California in 2020 (goal = 400) = 297 (74.25%)
    • Birthed in Memphis, TN in 2020 (goal = 100) = 47 (47%)
    • Birthed elsewhere in the U.S. in 2020 (goal = 500) = 471 (94.2%)

By ending the study BEFORE 2/28/2021, we completed study enrollment and data collection in gratitude and abundance, with financial and social integrity.

We will have the first and only soon to be validated Patient Reported Experience Measure of OBstetric racism©, also known as the PREM-OB Scale™, one of the most culturally and scientifically rigorous perinatal PREMs.

Thank you ALL for supporting Black mothers & birthing people and our team.


What is the value of the PREM-OB Scale™ to hospitals, health centers, and health plans?

Dr. Karen A. Scott, MD, MPH, FACOG is the sole developer and owner of the Patient Reported Experience Measure of OBstetric racism©, also known as the PREM-OB Scale™, which she designed in 2019 prior to accepting a faculty position at UCSF in the Department of Obstetrics, Gynecology, and Reproductive Sciences. In less than one year during the 2020 COVID-19 pandemic, Dr. Scott and her team completed participant recruitment, enrollment, survey completion, and data collection by January 31, 2021 for the purposes of validating the PREM-OB Scale™.  The soon to be validated PREM-OB Scale provides a numerical score of how well hospital clinicians and staff promote and/or violate high(er) quality of care in safety, autonomy, communication, racism, empathy, and dignity in service provision as defined for, by, and with Black mothers and birthing people and Black women scholars.

Hospitals, health centers, and health plans who register as SACRED Birth Partners gain access to complementary training and technical assistance for clinicians and staff in order to increase patient and public awareness and involvement with the SACRED Birth Study.  Please note that the SACRED Birth survey validation study ended January 31, 2021.

What are the benefits of registering as a SACRED Birth partner?

  • Increased visibility as an organization committed to advancing Black-centered racial justice & perinatal equity in hospital-based birth services, support, and care
  • Access to data from the PREM-OB Scale™ and Quality Improvement Prioritization by Affected Communities (QPAC).
  • Improved communication and capacity building in understanding, describing, measuring, and modifying how obstetric racism is experienced by Black mothers and birthing people during hospital-based birth services, support, and care
  • Improved recognition, reporting, and responsiveness to the needs, priorities, and concerns of Black mothers and birthing communities.
  • Increased comfort, confidence, and enthusiasm to utilize the PREM-OB Scale™ as a standard hospital QI metric or key performance indicator (KPI).
  • Increased utilization of a validated short form and long form PREM-OB Scale™ for use in monitoring and evaluation to benchmark effective clinical practice techniques, policies, procedures, and processes in diagnosing and dismantling obstetric racism.
  • Increased utilization of the PREM-OB Scale as a validated systems-level measure to connect provider reimbursement to the value of care during hospital births and use payment to drive systems change,  meaning providers get paid based on their patient's birth experience AND outcome.
  • Improved strategies for transforming the culture of hospital births and provision of clinical and social services, supports, and care for Black mothers and birthing communities 
  • Increased transparency  in patient-clinician,  patient-system, and community-system interactions, communication, counseling, and shared decision-making 
  • Improved clinical outcomes over time
  • Increased birth workforce development and diversification

Which hospitals, health centers, and healthplans are currently registered as SACRED Birth Partners?

Hospitals

Alameda Health System Department of Obstetrics & Gynecology, Family Birthing Center, Oakland, California 

Beth Israel Deaconess Medical Center, Inc, affiliated with Harvard Medical School, Department of Obstetrics and Gynecology, Boston, Massachusetts

Black Mothers Matter Committee, Department of Obstetrics & Gynecology at New York University Langone Health, New York, New York

Boston Medical Center/Boston University School of Medicine, Department of Obstetrics & Gynecology, Boston, Massachusetts

Eastern Virginia Medical School, Department of Obstetrics & Gynecology, Norfolk, Virginia

Massachusetts General Hospital, Department of Obstetrics & Gynecology, Boston, Massachusetts

Merit Health Central, Jackson, Mississippi

Temple University School of Medicine, Department of Obstetrics & Gynecology, Philadelphia, Pennsylvania

Temple University School of Medicine, Department of MedicinePhiladelphia, Pennsylvania

Temple University School of Medicine, Center for Urban Bioethics, Program for Maternal Health EquityPhiladelphia, Pennsylvania

The University of Chicago, Department of Obstetrics & Gynecology, Midwifery Group, Chicago, Illinois

Torrance Memorial Medical Center, Maternity and Child Health, Torrance, California 

UC Davis Health, Department of Obstetrics & Gynecology, Sacramento, California

University of California San Francisco Birth Center, Department of Obstetrics, Gynecology, and Reproductive Sciences, San Francisco, California

UNC Health, Chapel Hill, North Carolina

University of Maryland St. Joseph Medical Center, Department of Obstetrics & Gynecology, Townson, Maryland

University of Mississippi Medical Center, Department of Obstetrics & Gynecology, Jackson, Mississippi

Washington University School of Medicine, Department of Obstetrics & Gynecology, St Louis, Missouri

Zuckerberg San Francisco General Hospital Department of Obstetrics & Gynecology, Family Birth Center, San Francisco, California 

Health Centers

CHOICES Memphis Center for Reproductive Health, Memphis, Tennessee 

Health Plans

Health Net 

San Francisco Health Plan

How do hospitals, health centers, and health plans learn more about supporting the study as a partner? Please note the SACRED Birth survey validation study ended January 31, 2021.

Click here for a list of frequently asked questions specific to supporting the study as a hospital partner.  

Do hospitals, health centers, or health plans need to submit an IRB application to UCSF to be a study partner?

UCSF IRB does NOT require hospitals, health centers, or health plans to submit a separate IRB application in order to refer or recruit patients as a study partner.  UCSF IRB has given permission for you to refer a patient and send their contact information as long as they have agreed to you sending their contact information to us. ​As a hospital partner, you are NOT engaged in research activities based on federal definition of “engaged” in human subjects research. Also, a hospital partner is NOT considered an agent of the SACRED Birth study. Thus, UCSF IRB does NOT require IRB approval from any site unless the site meets the federal definition of “engaged” human subjects research. For a list of what is considered engaged vs not engaged activities, go to https://irb.ucsf.edu/working-other-institutions.  For more information, please click here to review our FAQs document for hospital partners, question #4 covers this topic.

How do hospitals, health centers, and health plans refer patients to the study?

If you would like to refer your patients to the SACRED Birth study: CLICK HERE . 

If you would like, you may document in the medical record that the patient has given permission to share their information.  We have attached a template formto use for this purpose.

How do interested hospitals, health centers, and health plans register as a SACRED Birth partner? The SACRED Birth survey validation study ended January 31, 2021.

Step 1. Submit a Letter of Support

Complete and submit a letter of support to our study at [email protected] Click here to download the template letter of support which provides some content that you can use, modify, AND customize to demonstrate your interest, capacity, and commitment in collaborating with the SACRED Birth study as a hospital, health center, or health plan partner. Please also determine the number of births by Black mothers and birthing people that you are interested in recruiting and enrolling in the study. You must email the completed, customized, and signed letter of support on your institution's letterhead to our study at [email protected] or Click here to email the study team your letter of support.

Step 2.  Share study information and refer patients

Once the study team confirms receipt of your completed, customized, and signed letter of support on your institution's letterhead, you are encouraged to start referring eligible participants who gave birth to a live newborn in a hospital in 2020. To support patient education and referral activities, we have designed two different flyers, orange flyer or blue flyerwith similar information about study focus, eligibility, expectation, and payment. A QR code is also located on each flyer for folks with smartphones to direcrly access the onsite referral links.

We also designed a telephone script and sample recruitment letter to support your efforts in increasing patient and community awareness and participation in the study. 

Please follow us on social media @SACRED_PREM_OB on Twitter and Instagram.  Vist our SACRED Birth Twitter account without needing a login and click on "Tweets" or "Tweets & replies" to find updates on study reach, referrals, and impact including data on the number of new enrolless in need of verification, completed enrollment surveys, completed PREM-OB© surveys, and preliminary study findings.  We will also be releasing a social media toolkit. We also plan to host online chats and share newsletters with our study partners.

Visit our Public Visibility and Involvement webpage to view our first SACRED Birth Virtual Town Hall Meeting, held on December 9, 2020, and to learn more about the study through recordings of other presentations and articles about our study, our team, our partners, and our sponsonrs.

We launched this study during a pandemic. Thus, 100% of all recruitment, screening, consent, and enrollment activities including interviews and communications occur online via emails, Zoom, social media platforms, and our study website. 

Participants will receive a $100 electronic gift card via email within 7-10 business days of completing the survey.

Step 3. Schedule an introductory meeting with the study PI

Click here to request an introductory meeting with the study PI, Dr. Karen A. Scott, MD, MPH, FACOG.  During the meeting, we ask hospital, health center, or health plan partners to be prepared to share the birth data stratified by race, prioritizing the outcomes and experiences of Black mothers and birthing data. We also will share the process for sharing data based on UCSF material transfer and data agreements.  

We want to remind out partners that the validation part of the SACRED Birth study is now live online. Our goal is to have 1000 eligible Black mothers and birthing people complete the PREM-OB Scale by 12/31/2020, no later than 2/28/2021 (the end date for the validation study). Specifically, we have funds to support the following eligible candidates who enroll and complete the survey in the following locations: 400 in California, 100 in Memphis, TN, and 500 in other areas across the U.S. 

We look forward to receiving your letter of support and discussing your strengths, gaps, and opportunities for growth as we learn more about the experiences of your Black birthing communities in hospital settings.

What are the next steps for SACRED Birth QI Implementation and Scale-Up?

Dr. Karen A. Scott, MD, MPH, FACOG is the sole developer and owner of the Patient Reported Experience Measure of OBstetric racism©, also known as the PREM-OB Scale™, which she designed in 2019 prior to accepting a faculty position at UCSF in the Department of Obstetrics, Gynecology, and Reproductive Sciences. In less than one year during the 2020 COVID-19 pandemic, Dr. Scott and her team completed participant recruitment, enrollment, survey completion, and data collection by January 31, 2021 for the purposes of validating the PREM-OB Scale™.  The soon to be validated PREM-OB Scale provides a numerical score of how well hospital clinicians and staff promote and/or violate high(er) quality of care in safety, autonomy, communication, racism, empathy, and dignity as defined for, by, and with Black mothers and birthing people, Black women community leaders, and Black women scholars.

Currently, Dr. Scott and her research team in Chicago are conducting psychometric testing, hypothesis testing, and confirmatory factor analysis to validate the final domains and survey items in the PREM-OB Scale™.  As the survey developer and owner, Dr. Scott requires potential users of the validated PREM-OB Scale™ to complete mandatory screening, training and certification in diagnosing and dismantling obstetric racism as designed and facilitated by Dr. Scott and her cadre of quality improvement (QI) and implementation scientists and trainers.  Completion of certification requirements allows for authorized users to obtain the necessary licensure to then utilize the validated PREM-OB Scale™ for QI or implementation science (not to be used for research only purposes). Technical assistance and maintenance of current training certification and licensure from Dr. Scott's SACRED Birth QI team are mandatory for ensuring the integrity of data collection, analysis, interpretation, utilization, and integration of the validated PREM-OB Scale™ in QI innovations and systems transformations in hospitals and health systems. 

By January 2022, Dr. Scott and a new team of patient, community, and content experts will move forward with the national launch of a SACRED Birth Quality Improvement Program in select cities across the U.S., with a special focus on states in the Mid-South, Southeast, and Midwest. For more information about the SACRED Birth QI Movement, please contact Dr. Scott and her QI team at [email protected]anarchainstitute.com