School of Medicine, University of Colorado, Aurora, CO, USA.
Department of OB/GYN, Stanford University, Stanford, CA, USA.
J Matern Fetal Neonatal Med. 2022 Jul;35(13):2512-2517. doi: 10.1080/14767058.2020.1786525. Epub 2020 Jul 13.
The United States' infant and maternal mortality rates are significantly higher among non-Hispanic Black women and infants than women and infants of other races, independent of educational attainment or socioeconomic status. The purpose of this research was to understand conditions that lead to these disparities and propose practices for addressing them through community perspectives.
Researchers conducted six focus groups with African American women who had been pregnant previously ( = 27) and performed inductive thematic analysis looking at the interaction between race and health.
Major themes included barriers to quality healthcare and support. Women perceived that healthcare professionals provided substandard care based on implicit biases and felt that asking questions of providers led to loss of autonomy. The perceived quality of a woman's perinatal experience is affected by women's relationships with their healthcare providers, their social support, and their sense of autonomy in decision-making. To improve the relationships between African American women and their providers, participants expressed that racism and implicit bias must be recognized and addressed. While this should be addressed in individual interactions, this study also suggests the role of policy change and system-level modifications that should be considered to effectively decrease the racial disparity in perinatal outcomes.
在美国,非西班牙裔黑人群体的婴儿和孕产妇死亡率明显高于其他种族的婴儿和孕产妇,而不论其受教育程度或社会经济地位如何。本研究旨在从社区角度了解导致这些差异的原因,并提出解决这些问题的实践方法。
研究人员对之前怀孕过的 27 名非裔美国女性进行了六组焦点小组讨论,并进行了归纳主题分析,探讨了种族和健康之间的相互作用。
主要主题包括获得优质医疗保健和支持的障碍。女性认为医疗保健专业人员存在基于隐性偏见的次等护理,并且认为向提供者提问会导致丧失自主权。女性对围产期体验的感知质量受到她们与医疗保健提供者的关系、社会支持以及她们在决策中的自主权感的影响。为了改善非裔美国女性与提供者之间的关系,参与者表示必须认识到并解决种族主义和隐性偏见问题。虽然这应该在个人互动中解决,但本研究还表明,应该考虑政策变革和系统层面的调整,以有效减少围产期结局的种族差异。