Areca Smit
Executive Director
The UCSF Center for Birth Justice lives at the intersection of research, community partnerships, and education to create positive change alongside Black and Brown families.
The Center for Birth Justice (CBJ) is a permanent research center housed at the University of California, San Francisco (UCSF), dedicated to eliminating racial inequities in birth outcomes.
Born from the California Preterm Birth Initiative (PTBi), CBJ builds on a decade of groundbreaking community-partnered research, policy advocacy, and systems change efforts that have transformed how the nation approaches maternal and infant health.
In California, the stark reality of these inequities is evident in the significantly higher rates of preterm birth and maternal mortality among Black women. The UCSF Center for Birth Justice confronts this crisis head-on, acknowledging that structural and interpersonal racism are the root cause of these devastating outcomes.
BIPOC communities bear the brunt of social and environmental risk factors stemming from the nation’s history of racist policies, leading to challenges like food and housing insecurity and limited access to quality healthcare. Furthermore, the toxic stress from living within racist systems can lead to “weathering” of the body, contributing to adverse birth outcomes. Despite decades of research, progress in reducing these inequities has been insufficient, partly because BIPOC birthing people have often been subjects rather than leaders of research.
BIPOC communities in the U.S. bear the brunt of social and environmental risk factors for adverse birth outcomes – from food and housing insecurity to greater exposure to pollution and lack of access to quality healthcare. All of these factors can be traced back to the U.S.’ long history of instituting racist policies and beliefs.
BIPOC also experience toxic stress from living in a country that harms them through racist systems and interactions. Continued exposure to this stress over time can lead to premature aging of the body (called “weathering”) and adverse birth outcomes, including prematurity, also known as preterm birth (birth before 37 weeks of gestation). See
One possible reason for this is that BIPOC birthing people have historically been the subjects of research rather than leading it. Typical research methods often involve traditional medical establishment priorities, which can inadvertently overshadow those of the people directly affected by the condition.
Guided by the powerful principle of “Nothing About Us Without Us!”, CBJ represents the next evolution of this work — a bold step toward institutionalizing a vision for birth justice that was once an initiative and is now a lasting commitment. By centering Black women and birthing people, and by partnering directly with communities most impacted by inequities, CBJ aims to create a world where Black families are safe and no longer need special tools or resources to experience healthy pregnancies, births, and postpartum journeys.
Join us in building this hopeful future. We are researchers, parents, providers, and community advocates who unapologetically center Black communities to advance birth justice.
The Center for Birth Justice builds on the foundation of the California Preterm Birth Initiative (PTBi) — a multi-year, multi-sector effort launched in 2013 by UCSF with the support of the Benioff family and a shared vision to reduce preterm birth in California. Over a decade, PTBi’s research, community engagement, and policy efforts helped redefine how birth equity work is done: in partnership, across disciplines, and grounded in the lived experiences of Black birthing people.
In 2023, as PTBi’s founding phase came to a close, UCSF established the Center for Birth Justice to carry this legacy forward — ensuring that the innovations, partnerships, and lessons learned from PTBi continue to grow and influence change nationwide.
We reject the traditional research paradigm in which communities are studied but not engaged. Instead, we co-design our research, policies, and programs in collaboration with Black
birthing people, families, and communities. This community-partnered model ensures that the insights, solutions, and leadership of those most affected drive the change we seek.
CBJ’s work thrives through collaboration. Whether you are a researcher, clinician, community member, or advocate, we invite you to connect with us, learn from our work, and take part in advancing birth justice for all.
