Research In Practice Blog
Intro
Despite national advances in prenatal and postpartum care, studies consistently demonstrate that Black women experience higher rates of adverse birth outcomes than other women. In many cases, adverse birth outcomes can be psychologically distressing experiences, causing long-lasting feelings of loss, depression, or stress. In a recent study, we interviewed Black women who had all had babies born preterm as part of a larger study on how to better support mother-infant dyads after preterm birth. We didn’t plan to talk about birth experiences, but many participants described these experiences and highlighted communication issues with their health care teams driving negative experiences. The framework of obstetric racism, first introduced by Dr. Dana-Ain Davis, provides a lens of understanding such issues through incorporating aspects of obstetric violence and both interpersonal and structural racism to understand, and address, the inequities in birth outcomes currently present in the U.S.
Study Design and Findings
We conducted qualitative interviews with 30 Black women from the Philadelphia region who gave birth to pre-term infants who were Medicaid-insured. Three themes that emerged regarding communications about their care experiences exposed (1) communication gaps during emergency procedures made negative birth experiences worse, (2) peer-sharing of similar birthing experiences helped lessen the negative impact on participants’ psychological wellbeing, and (3) women did not always have a chance to discuss worries about future pregnancy risk with their clinical teams.
Implications
Our findings point to three opportunities for health systems to improve experiences for Black women by improving communication. In particular, health systems should address communication during emergency procedures, facilitate peer and provider-patient debriefings after birth, and make sure future pregnancy risks are adequately addressed.
Author(s): Emily F. Gregory, MD, MHS; Geminesse T. Johnson, Alejandra Barreto, Arthurine K. Zakama, MD; Adya I. Maddox, MPH; Lisa D. Levine, MD, MSCE; Scott A. Lorch, MD, MSCE; Alexander G. Fiks, MD, MSCE, and Peter F. Cronholm, MD, MSCE