Dove-Medows Emily, Thompson Lucy, McCracken Lindsey, Kavanaugh Karen, Misra Dawn P, Giurgescu Carmen
MCN Am J Matern Child Nurs. 2021;46(3):137-142. doi: 10.1097/NMC.0000000000000707.
Non-Hispanic Black women in the United States experience disproportionately higher rates of adverse birth outcomes including preterm birth and low birth weight infants compared with White women. Racial discrimination has been associated with these adverse outcomes. However, not all Black women experience discrimination in the same way. The majority of studies that report on the relationship between racial discrimination and maternal health have used quantitative methods that may present a monolithic understanding of this relationship. Qualitative methods, specifically those that incorporate intersectionality, may illuminate the nuances in pregnant Black women's experiences of discrimination. We present a qualitative analysis of Black women's experiences of racial discrimination and pregnancy to shed light on some of these complexities.
Qualitative interviews that addressed racial discrimination and pregnancy were conducted as part of a larger study of pregnant Black women that examined social support, neighborhood disorder, and racial discrimination. Interviews were coded for descriptions of racial discrimination and within and across case analysis was conducted.
Women described varying experiences of racial discrimination in different contexts. Shielding emerged as a recurring theme in women's accounts of dealing with racial discrimination during pregnancy.
Nurses engaged in maternity care need an understanding of how pregnant Black women experience racial discrimination in different ways. Black women may be likely to take personal responsibility for managing discrimination-related stress in pregnancy as a consequence of direct experiences of discrimination. Nurses can support pregnant Black women by recognizing varied experiences of racial discrimination, and by not blaming them for experiences or potential resultant outcomes.
与白人女性相比,美国非西班牙裔黑人女性经历不良分娩结局(包括早产和低体重儿)的比例要高得多。种族歧视与这些不良结局有关。然而,并非所有黑人女性都以相同的方式经历歧视。大多数报告种族歧视与孕产妇健康之间关系的研究都采用了定量方法,这些方法可能会对这种关系形成单一的理解。定性方法,特别是那些纳入交叉性的方法,可能会揭示怀孕黑人女性歧视经历中的细微差别。我们对黑人女性的种族歧视和怀孕经历进行了定性分析,以阐明其中的一些复杂性。
作为一项关于怀孕黑人女性的更大规模研究的一部分,我们进行了关于种族歧视和怀孕的定性访谈,该研究考察了社会支持、社区混乱和种族歧视。对访谈进行编码,以描述种族歧视情况,并进行个案内和跨个案分析。
女性描述了在不同背景下不同的种族歧视经历。在女性讲述怀孕期间应对种族歧视的经历中,“屏蔽”成为一个反复出现的主题。
从事产科护理工作的护士需要了解怀孕的黑人女性如何以不同方式经历种族歧视。由于直接的歧视经历,黑人女性可能倾向于为应对孕期与歧视相关的压力承担个人责任。护士可以通过认识到种族歧视的不同经历,并避免因这些经历或潜在的结果而责备她们,来支持怀孕的黑人女性。