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Lunch & Learn 1
Tuesday, March 26th at The Den in Denver from 12:30-2:30
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This event is an intentional space for providers committed to supporting the black birthing community. Thus, it is important for participants of diverse racial backgrounds to be able to fully participate in conversations without causing harm.
What is your racial identity & please describe your professional commitment to anti-racism?
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Are you able to attend this date? We have a max of 16 spots, if you are a maybe we can add you to a waitlist. Feel free to email as it gets closer to see if there are any spots available and let us know if you can no longer make it.
Yes, I have it on my calendar and look forward to attending!
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If unable to attend this date, are you interested in being contact for future dates?
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Any dietary restrictions?
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These networking events will occurring quarterly through June 2025. If you are interested in providing a 20-30 minute presentation at a future event please write below what you are interested in presenting about. Specific topics of interest include the impact of the following on black birthing people: eating disorders as mental health concerns, doula/midwife services, nutrition in pregnancy/post-partum, etc.
*There is monetary compensation available for speakers.
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Is there anyone else that you think would be interested/we should reach out to?
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