December 27, 2018

Shaqualia Roach unshoulders a diaper bag and a chin-high pile of children’s winter coats. She hangs her purse on a chair back and sets down a carseat. Inside, 3-month-old Hasani, better known as “Nugget,” sucks happily from a bottle. Shaqualia’s older four children, ages 3 to 8, fire like buckshot into a growing crowd of families, running, spinning and crawling across the church carpet with other little ones from  Healthy Birth Initiatives.

Shaqualia Roach and her son, 3-month-old Hasani, celebrate the season and HBI.

As Roach shrugs off her own coat, another mom comes by and bends over “Nugget,” who is dressed in a Santa onesie.

“Oh my goodness,” the woman coos. “Hey sugar. How’s it going?”

Nugget looks up, but his lips continue working the nipple of his bottle.

“This Santa suit is getting on his nerves,” Roach tells the woman.

“You look good,” the woman says to Roach, who smiles and sighs.

“Thank you,” she says. “I’m trying not to look too tired.”

For nearly a decade, Multnomah County’s Healthy Birth Initiative has hosted a winter party to celebrate the families that grow through the program. Based out of the Northeast Health Center, Healthy Birth Initiatives, funded with federal grant dollars, provides about 200 African American families culturally-specific wrap-around services including case management, health education, community engagement, and service coordination.

“We believe in them. That’s a big part of it,” says Public Health Director Rachael Banks, who managed the program before taking over as director. “We want women to know, ‘we believe in you. You have assets that you’re bringing to the table.’”

The tier approach supports moms as they learn their own strength. Home visit help moms build relationships with African American nurses and health workers. Group programs build community among African American moms. And then the program and clients testify and advocate before local, state and federal lawmakers.

“And that’s what so powerful about HBI. Moms are on leadership councils and community action networks, designing program elements. Advocating for funding at a national level,” Banks says. “When you can be in that space, with families, holding babies and working with decision makers, it’s really powerful model.”

Shaqualia Roach is a great example of that progression, Banks says.

“She was scared to speak in public at first. She contributed, but behind the scenes,” she says. “Since then she has challenged herself to be on leadership council. She’s leading meetings, bringing out ideas about getting parents more engaged.”

Natasha Smith, left, and Rachael Banks serve up dinner at the annual HBI holiday party

Roach has been with Healthy Birth Initiatives for 8 years. She knows most of the staff and many of the families. They have grown together in a lot of ways.

“You’ll get advice from older people. Then you get the new moms,” she says. “You share experience of what works and what doesn’t work. It’s like a family. You can trust these people.”

With each child that has entered her  life, health workers scheduled monthly visits to her home. They weighed the children — and played with the children — and helped Roach schedule check-ups and navigate social services. They told her about new classes and groups at Healthy Birth Initiative. Near the end of her pregnancy with little Nugget she was so tired it was hard to keep up with the chores. When her caseworker came by for her monthly visit, she cleaned the house, just to give Roach  a break.

“Healthy Birth Initiative is like a family,” Roach  says. “They have been with me through my toughest times. I don’t know what I would have done without them.”

Shortly after joining the program, her oldest son, Dakarai, had an asthma attack during the night and died. Healthy Birth Initiatives staff checked in on the devastated mother regularly and connected her to mental health services. Roach wasn’t comfortable talking one-on-one to a therapist, but found support through an Healthy Birth Initiative-sponsored group called Seeking Safety.

“One lady pulled me aside and taught me some breathing techniques,” she remembers. “And they said if I didn’t want to talk, I could journal. That helped. And just being able to come to the group and get that out.”

As she speaks, 3-year-old Quynton runs up, then jogs in place. She leans over, “Ready?” she says, and he takes a runner’s stance. “Set. Go!” He shoots off like a pebble from a slingshot.

Fathers are encouraged to join in on the fun at the HBI holiday party.

Five-year-old Jai-Zeon and 8-year-old Queonce see Roach’s mother, Qualia, walk into the church hall. “Nana!” they shout. The woman braces for impact as the children run at her, launching themselves into her arms.

Just then, Quynton dances up to his mother, hands clutching the crotch of his sweatpants. “Excuse me,” Shaqualia says, then grabs the boy under one arm like a football and dashes toward the bathroom.

Across the hall, a table is piled with foliage and big red bows. Dyvisha Gordon threads pine branches through the round wire frame of a wreath. Her son Omari  — “O” for short — pulls at the twigs of pine, loses interest and then tugs on Gordon’s shirt until she raises him to her breast. Gordon has been in the program for two years, she says over the din of Christmas carols. As a first-time mom, it was helpful to get the birthing support and to find out about social services. And it meant a lot to be served by people of color.

“The culturally-specific piece is important, working with medical professionals who look like me,” she says.

Nurse Sherly Paul agrees. It was that culturally-specific lens that made her fall in love with Healthy Birth Initiatives.

“It’s a privilege to provide services — services that shouldn’t be a privilege,” Paul says. “African American women get poorer health care everywhere they go.”

People make assumptions about black women, Paul says. They ask her clients, “Do you know who the baby’s father is?” They ask, “Are you sure you want more children?” They ask, “Don’t you want birth control?”

It’s all too easy for Paul to come up with an example. A few days ago a client called from a hospital, distraught when a nurse had been rude, then refused to leave after the woman requested a different provider. Paul went to the hospital and spoke to administrators. Sherly can fill a space, straightening into the unflinching character she built during a stint in the Army. And she hopes that’s an example of what her clients can do for themselves.

“I arm my clients with certain phrases, like ‘You’re not respecting my autonomy’, she says. She also tells them, “You don’t have to be quiet, you don’t have to be nice. You can say, ‘Do not speak to me that way.’ You can even say, ‘get the hell out of my room.’”

Nurse Sherly Paul says working for HBI is the best job she's ever had.

Paul interrupts herself to wave at a client standing nearby as the room grows louder. Along the back wall, children lean on, sit on and hug on Santa Claus who smiles broadly while parents snap photos. Healthy Birth Initiatives staff join Public Health Director Rachael Banks to serve spaghetti, salad, fruit and slices of cake.

Community Health Specialist Jeff Washington stands at a table advertising “Male Father Involvement” and welcomes fathers attending the holiday party.

“As far as social services, we’ve noticed it’s mostly about mother and child. Fathers don’t really fit in as far as education and services,” Washington says as a young man bends down to add his name to a registration list. “We want dads to participate. If you’re 20 or 22, especially if your dad wasn’t around, you have to figure out how to be a dad.”

In much the way the community health team works with moms, Washington envisions working with fathers, supporting them with social service and employment services. or expunging old criminal charges that might make it harder to find work. Fourteen dads have expressed interest so far.  “Now fifteen,”Washington says, smiling as Deonzie Howard adds his name to the list as his 2-year-old daughter, Akylah, jumped up and down at his side.

“I’m just really involved in my family,” Howard says. “I think it’s very important.” He follows his daughter to join the rest of his family around a crowded table.

Caseworker Dianne Clay buzzes through the room, greeting families in her Christmas sweatshirt. She’s been part of the Healthy Birth Initiatives team for seven  years, visiting families at their homes, doing whatever she can to make parenting easier. She connects mothers with health and social services. And she helps with simple things too, such as securing a supply of diapers.

“We want to support moms so they are confident in who they are,” she says. “We advocate for them so they can advocate with professionals.”

Alisha Carter grins at Clay, who has watched Alisha raise her two boys, Aiden, age 8, and Averey, age 2.

Alisha Carter with her boys, Aiden, age 8, and Averey, age 2, pose with Santa, played by volunteer Ian Scott.

“She grabs ahold of you and doesn’t let go,” Carter says of the caseworker. “It’s nice to be supported. The calls, the support groups, to hear that encouragement, the network of resources. HBI is my bread and butter.”

Healthy Birth Initiatives helped Carter find clothes when she couldn’t afford them, and food when she didn’t have money for groceries. They helped her secure child care so she could attend college classes. A couple years ago they nominated her for a Christmas Family Adoption. She came home to a living room filled with bunk beds, a new vacuum, fresh towels and toys.

Being a single mom is hard. But she’s made time to join the Healthy Birth Initiative leadership council, organizing baby showers for new moms, storytimes for little kids, advocating for funding on Capitol Hill.

“It’s tough but they don’t let you feel alone,” Carter  says. “I’ve evolved and grown with the organization.”

Carter recently finished a master’s degree in education. Now she’s pursuing a Ph.D.

“I’ll be Doctor Carter soon,” she says. “And all of it going through HBI.”