When Eleisa Groomes discovered she was pregnant at 18, she just couldn't accept the new responsibility. She avoided her parents, hung out with friends who smoked and drank and, as she would recall later, did all she could to take her mind off the baby.
Then, when she was four months pregnant, she joined the Black Infant Health Program and, with its help, gave birth to a son who escaped from becoming another grim statistic.
In Los Angeles County, California and nationwide, black infants are more than twice as likely as other babies to die before their first birthday, according to the California Department of Health Services and the national Centers for Disease Control and Prevention. And black babies are more than twice as likely to weigh less than 3 pounds, 4 ounces when they are born.
The Black Infant Health Program, a statewide initiative, tries to combat those trends with counseling and training. It teaches women to cope with being single mothers.
"I had a lot of fears about being a young mother," said Groomes, who joined the program in South Los Angeles almost two years ago. "I was scared to face the reality of being pregnant and having to take care of him. But when I went to Black Infant Health, they made me start facing these problems. . . . They care and they show it."
She also learned the basics: what to do if her son developed a fever, how to put him down so he wouldn't choke if he spit up, how to breastfeed. This was all new to Groomes, whose contact with babies had been limited to changing her sister's diaper.
With the program's help, Groomes belatedly adopted a healthy lifestyle -- eating a proper diet and getting bed rest after doctors warned her that she faced a difficult pregnancy. It worked. When her son, Elijah, was born almost two years ago, he was healthy and weighed 7 pounds.
"Eleisa's participation helped her to have a full-term baby," said Cyrail Smith, Groomes's community health outreach worker. "We helped her weed out things that would worry her more and gave her more of a focus with her and the baby."
Michael Lu, a professor at UCLA's medical and public health schools who researches racial and ethnic disparities in birth outcomes, suggests that social factors, such as stress and racism, throughout a black woman's life might play a large part in the racial disparities.
According to his research, a black woman who received prenatal care would still have a baby twice as likely to die before age 1, when compared with a white woman who received no prenatal care. That holds true for black women who do not smoke compared with white women who do, and black women who have college degrees versus white women who do not.
"This has been going on for a very long time," Lu said. "And unfortunately, despite medical advances and physiological advances, we haven't done much on closing the gap."
The Black Infant Health Program has attempted to close that gap since it was founded in 1989, and teaches prenatal and infant care in 14 California counties. During the 2002-03 fiscal year, the program's Los Angeles County locations served 3,662 women, infants and children. The program in South Lost Angeles serves about 320 mothers.
For mothers who need more than baby help, the program provides job and housing referrals, bus and subway tokens to travel for appointments, and free items, such as parenting books and diaper bags. Many women must learn to help not just their babies but also themselves.
The shared sense of responsibility and support brought Angela Barnes back to the South Los Angeles program when she discovered she was pregnant with her sixth child. Barnes, who had attended the program three years earlier when she was pregnant with her daughter, was experiencing guilt and shame about being a single Christian mother. She also said she lacked family support.
"I just wanted somebody on my side who understood and said, 'It's great that you're drinking milk,' 'Did you eat a carrot today?' and 'It's great you don't smoke cigarettes,' " said Barnes, 33. "The little stuff people say that's positive, they gave me that at Black Infant Health."
Barnes still recalls the affirmation her class developed: "I am a queen. I can do all things. I can rule the world." It became a calming mantra.
When the father of Barnes's baby was not there to make sure she was comfortable or to fetch food to satisfy her midnight cravings, Barnes would repeat her affirmation. Last August, she delivered a healthy 8-pound son named Joseph.
Winnie Willis, a professor at San Diego State University's Graduate School of Public Health, was contracted by the Black Infant Health Program to evaluate its success throughout the state. She collected statistics on babies with very low birth weights (less than 3 pounds, 4 ounces) and those with low birth weights (less than 5 pounds, 8 ounces).
Results were mixed. Willis's study showed that the percentage of very low birth weight babies born to program participants was lower than the percentage of such babies born to black women not in the program.
The percentages of low birth weight or pre-term birth babies born to mothers of both groups were similar. But Willis said the results still show a trend toward better birth outcomes for babies whose mothers participated in the program.
"It's hard to cram [medical care, nutrition and social support] into nine months of prenatal care and turn everything around," Lu said. "This is for the next generation. If you want to see a decrease in disparities, look into the next generation."
A mother stays in the program until her child turns 2, meaning Groomes's formal participation will end next month, when Elijah receives a card from Black Infant Health wishing him a happy birthday.
Groomes, who acknowledges she will miss the program, is ready for the separation. After all, this is what the program has been preparing her for. Now 21, she attends Los Angeles Southwest College and has a full-time and a part-time job. She reads to Elijah regularly to teach him the importance of reading.
Although she has not yet declared a major, she said she wants to counsel young mothers, and young men in prison.
"Right now, I talk to pregnant women who think because they are pregnant everything stops," Groomes said. "They wonder why I'm so strong. I'm strong because I have other people helping me to be strong. I want people to look up to me like I look up to Black Infant Health. I want to accomplish a lot, and then I want to give back."