Almanza Jennifer I, Karbeah J 'Mag, Tessier Katelyn M, Neerland Carrie, Stoll Kathrin, Hardeman Rachel R, Vedam Saraswathi
Department of OBGyn, University of Minnesota Medical School, 606, 24th Avenue South, Suite 300, Minneapolis, MN, 55454, USA.
, 1002 Livingston Ave, West St. Paul, MN, 55118, USA.
Matern Child Health J. 2022 Apr;26(4):895-904. doi: 10.1007/s10995-021-03245-w. Epub 2021 Nov 24.
National studies report that birth center care is associated with reduced racial and ethnic disparities and reduced experiences of mistreatment. In the US, there are very few BIPOC-owned birth centers. This study examines the impact of culturally-centered care delivered at Roots, a Black-owned birth center, on the experience of client autonomy and respect.
To investigate if there was an association between experiences of autonomy and respect for Roots versus the national Giving Voice to Mothers (GVtM) participants, we applied Wilcoxon rank-sum tests for the overall sample and stratified by race.
Among BIPOC clients in the national GVtM sample and the Roots sample, MADM and MORi scores were statistically higher for clients receiving culturally-centered care at Roots (MADM p < 0.001, MORi p = 0.011). No statistical significance was found in scores between BIPOC and white clients at Roots Birth Center, however there was a tighter range among BIPOC individuals receiving care at Roots showing less variance in their experience of care.
Our study confirms previous findings suggesting that giving birth at a community birth center is protective against experiences of discrimination when compared to care in the dominant, hospital-based system. Culturally-centered care might enhance the experience of perinatal care even further, by decreasing variance in BIPOC experience of autonomy and respect. Policies on maternal health care reimbursement should add focus on making community birth sustainable, especially for BIPOC provider-owners offering culturally-centered care.
全国性研究报告称，生育中心护理与减少种族和民族差异以及减少虐待经历相关。在美国，由有色人种拥有的生育中心非常少。本研究考察了一家黑人拥有的生育中心Roots提供的以文化为中心的护理对客户自主性和受尊重体验的影响。
为了调查Roots的客户在自主性和受尊重体验方面与全国性的“母亲发声”（GVtM）参与者之间是否存在关联，我们对总体样本应用了Wilcoxon秩和检验，并按种族进行分层。
在全国GVtM样本和Roots样本中的有色人种客户中，在Roots接受以文化为中心护理的客户的MADM和MORi得分在统计学上更高（MADM p < 0.001，MORi p = 0.011）。在Roots生育中心，有色人种客户和白人客户的得分没有统计学意义，但在Roots接受护理的有色人种个体之间的得分范围更窄，表明他们的护理体验差异更小。
我们的研究证实了先前的研究结果，即与占主导地位的基于医院的系统中的护理相比，在社区生育中心分娩可防止歧视经历。以文化为中心的护理可能会进一步提升围产期护理体验，通过减少有色人种在自主性和受尊重体验方面的差异。孕产妇医疗保健报销政策应更加注重使社区生育可持续，特别是对于提供以文化为中心护理的有色人种提供者所有者。
