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A San Francisco program designed to mitigate racial disparities in birth outcomes in Black and Pacific Islander communities is being targeted for violating anti-discrimination law.

Californians for Equal Rights Foundation and law firm American Civil Rights Project filed the lawsuit against the city of San Francisco and the state of California over programs like the Abundant Birth Project, alleging that they violate the 14th Amendment’s equal protection clause. They allege that such “payment schemes” are “designed to select beneficiaries on a racially exclusionary basis. This is unconstitutional. ‘Distinctions between citizens solely because of their ancestry are by their very nature odious to a free people,’ and therefore ‘are contrary to our [Nation’s] traditions and hence constitutionally suspect.’”

Weaponizing the civil rights legislation that granted—on paper at least—freed and formerly enslaved Black people (and their descendants) equal civil and legal rights following emancipation, the lawsuit follows a trend of “reverse discrimination” litigation by conservative groups eager to upend initiatives that address systemic and structural inequality.

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Shortly after the Supreme Court struck down affirmative action in college admissions, grant and fellowship programs like the Fearless Fund, which invests in women of color-led businesses, were sued for being “racially exclusive.” Though the case is ongoing, the group has been barred by a federal appeals court from proceeding with the grant program (Reuters). 

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The latest lawsuit in California targets income supplement programs that provide economic security to marginalized people. This includes GIFT, a financial assistance program for low-income transgender, non-binary, gender nonconforming, and intersex people to “combat poverty”; the Beem Project, which provides Black youth in Oakland and San Francisco with economic and financial support to “address problems created by society for Black young people” including poverty and racism; economic recovery for artists with Yerba Buena Center for the Arts; and the Abundant Birth Project. 

Launched in 2020, the Abundant Birth Project is the country’s first pregnancy income supplement program. It provides approximately 150 pregnant Black and Pacific Islander women and people a $1,000 monthly stipend during their pregnancies and six months postpartum. In collaboration with Expecting Justice, the program has expanded to Alameda, Contra Costa, Los Angeles, and Riverside counties. It initially started in San Francisco, where the median annual household income for Pacific Islander and Black families in San Francisco is under $30,000, compared to about $90,000 citywide (Expecting Justice). 

Financial strain, on top of heightened societal and environmental risk factors, negatively impacts overall health, especially for pregnant people. In San Francisco, Black newborns are almost twice as likely to be born prematurely compared to white newborns, and Pacific Islander infants have the second-highest preterm birth rate. Despite representing 4% of births, Black infants account for over 15% of infant deaths. Black maternal mortality accounts for half of maternal deaths in the city (California Preterm Birth Initiative). 



Preterm births, the second leading cause of infant mortality in the U.S., are highest amongst Black, Pacific Islander, and Native newborns nationwide (CDC). Black women are three times more likely to die due to pregnancy-related complications than white women (CDCCDC), causing some expecting mothers to be “terrified of giving birth” (DCist).

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A 2021 study analyzing preterm birth disparities (JAMA) found that historic redlining practices play a role in Black maternal health today. When the researchers took 64,804 birth certificates from 2005 to 2018 in 15 Rochester, New York zip codes and overlaid them with old redlining maps, they saw that preterm births were highest in areas historically zoned as “hazardous” (JAMA Network). They concluded that there was a link between historic inequity and modern childbirth disparities. 

A lack of access to quality healthcare, structural and obstetric racism, and implicit bias all play a role in these pregnancy-related disparities, preventing “many people from racial and ethnic minority groups from having fair opportunities for economic, physical, and emotional health” (CDC). 

Though they often fall short, supplemental income programs help people meet some of their basic needs and alleviate issues like poverty that can contribute to negative health outcomes. The same is true with pregnancy income supplements, which reduce low birth weight and preterm births. The fact that “80% of pregnancy-related deaths in the U.S. are preventable” (CDC) emphasizes the dire need for intervention to ensure that those most vulnerable and most impacted receive the support and care they are continuously denied. 

These reverse discrimination lawsuits aren’t trying to right an injustice or level the playing field. They are rooted in the same racism and disregard that has allowed this unaddressed systemic and structural inequity to take form. These lawsuits obfuscate the reality that in the absence of equity there is no equality for those who are being crushed, who are starving, and who are dying under these constitutional systems of oppression.

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Felecia Phillips Ollie DD (h.c.) is the inspiring leader and founder of The Equality Network LLC (TEN). With a background in coaching, travel, and a career in news, Felecia brings a unique perspective to promoting diversity and inclusion. Holding a Bachelor's Degree in English/Communications, she is passionate about creating a more inclusive future. From graduating from Mississippi Valley State University to leading initiatives like the Washington State Department of Ecology’s Equal Employment Opportunity Program, Felecia is dedicated to making a positive impact. Join her journey on our blog as she shares insights and leads the charge for equity through The Equality Network.

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