For too many Black mothers in St. Louis, pregnancy and childbirth carry risks that should never exist. Black women in Missouri are 2.5 times more likely to die from pregnancy-related complications than white women — a stark reminder that where and to whom you’re born can still determine whether you survive motherhood. Behind those numbers are mothers, babies, and families forever changed by a preventable crisis.
Generate Health, a local multi-racial coalition, is working to change that narrative. In its new #2BHeard campaign, the organization is amplifying the voices of Black mothers — calling on healthcare systems to listen and act. Inspired by the Centers for Disease Control and Prevention’s “Hear Her” initiative, #2BHeard aims to raise awareness about urgent maternal warning signs and empower women to advocate for themselves before, during, and after pregnancy.
“We envision a future where Black families in St. Louis thrive before, during, and beyond pregnancy,” said Lora Gulley, Chief Operating Officer of Generate Health. “Yet Missouri continues to be one of the most challenging places in the nation for maternal health. Eighty percent of these deaths are preventable. This isn’t just data — it represents mothers, babies, and families forever impacted.”
The campaign’s goal is clear: to ensure pregnant and postpartum people, their support systems, and healthcare providers recognize when something is wrong — and take action when it matters most. While outcomes are still emerging, Gulley said #2BHeard is already laying the groundwork for deeper community engagement, stronger clinical partnerships, and a culture where Black women’s voices are not only heard but valued.
Despite years of advocacy, Black mothers in St. Louis continue to face inequities deeply rooted in the healthcare system. The barriers, Gulley said, go beyond access to care — they include racism, bias, and a lack of accountability within the systems that shape women’s health.
“The data speaks for itself: Black women in Missouri are 2.5 times more likely to die from pregnancy-related causes than white women,” Gulley said. “Too often, Black women are not believed when they speak up about their symptoms or concerns, and bias in care can delay or deny lifesaving support.”
Doula and OB-GYN nurse Tannelle Hanks sees this disconnect every day. From a clinical standpoint, she said one of the biggest problems is simply not listening.
“Providers miss urgent warning signs because they’re not taking patients seriously,” Hanks said. “Education can prevent these oversights. When we educate mothers prenatally and postpartum, we can prevent so many of these deaths.”
Sandra Thornhill, a doula and Vice President of Jamaa Birth Village in Ferguson, said the crisis begins with the narratives imposed on Black women. “For generations, the dominant narrative has focused on negative outcomes in Black bodies, which leads people — even Black birthing people themselves — to internalize the idea that something is inherently wrong with them,” she said. “But the truth is, the problem isn’t us. The real solutions have to come from the institutions that created these outcomes in the first place.”
Thornhill points to historic and current policies that continue to shape poor maternal outcomes. “Our bodies have never been the issue,” she said with passion.
Her experience in delivery rooms inspired her to become a doula. “Historic racism shows up in birthing spaces that are supposed to be places of care and safety,” she said. Too often, she added, Black women experience unnecessary pain. “We’re not seen as fully human, as people who deserve comfort, attention, and responsive care.”
Hanks agrees the issue extends far beyond individual provider behavior. Structural forces limit what patients receive — and what providers can offer.
“The whole concept of systemic racism plays a role in every part of the health system,” Hanks said. “Everything from private pay to lower-income patients is affected. Sometimes our hands are tied because of the insurance and the care we’re allowed to provide.”
Still, she believes providers have a responsibility to bridge gaps where they can.
“It’s up to us to help families find resources — housing, healthy food options, wrap-around services,” she said. “Policies should allow healthcare workers to do more.”
That lack of trust and responsiveness has far-reaching consequences. Studies show that when mothers are dismissed or ignored, their risk of serious complications rises. Gulley said improving outcomes starts with one critical step: listening.
“When we listen to women, address racism in care, and ensure every mother has access to informed, respectful, culturally centered support, outcomes improve for everyone,” she said.
At the heart of #2BHeard is storytelling — a tool Gulley describes as both healing and transformative. The campaign invites mothers to share their experiences, shedding light on the gaps that still exist between care and compassion.
“Every story shared through #2BHeard reinforces that mothers are experts in their own experience,” Gulley said. “When they say, ‘I didn’t feel heard,’ that’s a call to act.”
Those stories guide Generate Health’s advocacy efforts, shaping initiatives such as “Know Your Power,” a resource designed to help women recognize warning signs and speak up in clinical settings. The organization also works to expand access to doulas, midwives, and community health workers — trusted partners who can help bridge the gap between mothers and medical systems.
“Storytelling turns pain into purpose,” Gulley said. “It becomes a bridge between policy and lived reality, driving empathy, accountability, and reform. When mothers share the truth of what they’ve lived, systems begin to shift.”
At Jamaa Birth Village, the care is rooted in humanity. “When a mother walks through our doors, she’s our sister,” Thornhill said. “We walk with families during pregnancy, birth, and postpartum. We provide culturally grounded, trauma-informed support at every step.”
Missouri’s 2023 decision to extend postpartum Medicaid coverage from 60 days to 12 months is one policy change that gives providers more tools to respond. Hanks calls it “one of the greatest things the state could have done.”
“Many moms and babies are dying in those early months,” she said. “Now we finally have the time to partner with mothers during that first year. It even allows families to access postpartum doulas — and Missouri helps pay for that support.”
Gulley said real progress requires transforming not only how providers deliver care, but how systems value and respond to Black women’s voices. She points to expanding culturally congruent care, investing in community-based supports, and strengthening trauma-informed practices.
“We need to transform the way we listen, care, and respond,” Gulley said. “That means expanding doulas, midwives, and community health workers, training providers to recognize urgent warning signs, increasing trauma-informed care, and advancing policies like paid leave and doula reimbursement.”
Partnership, she added, is key. “When health systems, community leaders, and families work together, we create safer and more equitable care.”
Decades of inequity have eroded trust between Black women and the healthcare system — a reality #2BHeard aims to repair. By creating spaces for mothers to share their truth, Generate Health is fostering understanding across hospitals, clinics, and community organizations.
“Trust grows when voices are respected and acted on,” Gulley said. “We’re not only raising awareness — we’re building shared understanding, fostering empathy, and strengthening relationships across systems. Our message is simple: listen first, believe women, and respond with action.”
The next phase of #2BHeard will expand storytelling efforts statewide, deepen partnerships with healthcare providers and faith leaders, and elevate policy advocacy. The long-term vision, Gulley said, aligns with Generate Health’s “North Star” — achieving zero racial disparities in infant and maternal health by 2033.
“Success looks like fewer preventable deaths, more women feeling safe and supported, and a healthcare system where being heard is the standard — not the exception,” Gulley said.
Generate Health invites community members to share their stories, join advocacy efforts, and attend upcoming storytelling events at Delmar DivINe (5501 Delmar Blvd.):
- Saturday, November 22, 11 a.m.–1 p.m.
- Saturday, December 6, 11 a.m.–1 p.m.
- Tuesday, December 19, 6–8 p.m.
Stories can also be shared by emailing info@generatehealthstl.org or following #2BHeard on social media.
“Every voice brings us one step closer to safer, more equitable care for all families,” Gulley said.