Department of Kinesiology and Nutrition, University of Illinois Chicago 1747 W Roosevelt Road, Chicago, IL, 60608, USA.
Department of Human Development Nursing Science, University of Illinois Chicago, 845 S. Damen Ave. MC 802, Chicago, IL, 60612, USA.
Soc Sci Med. 2023 Jan;317:115604. doi: 10.1016/j.socscimed.2022.115604. Epub 2022 Dec 9.
In Chicago, maternal morbidity and mortality is six times more likely among Black birthing people than white, despite policy initiatives to promote maternal health equity. Disparities in maternal morbidity and mortality reflect experiences of structural inequities - including limited quality obstetric care, implicit bias, and racism resulting patient mistrust in the health care system, inadequate social support, and financial insecurity. Although there is published literature on Black women's experiences with obstetric care, including experiences with individual and structural racism, little is known about the intersection of age and race and experiences with health care. The purpose of this study was to explore the maternal health and pregnancy experiences of young Black women utilizing an intersectional theoretical lens.
In this study, we conducted two focus groups in a sample of 11 young Black pregnant people. We conducted a thematic analysis to identify codes, themes, and subthemes of the data.
We developed two overarching themes: obstetric racism and obstetric resistance. To elucidate how obstetric racism framed our participants' healthcare experiences, we identified sub-themes: intersectional identities as young Black women, medical mistrust, and pregnancy trauma. The second major theme describes ways in which participants protected themselves against obstetric racism to engender positive health experiences. These methods of resistance included identifying advocates and relying on trusted providers.
The current standard of obstetric care in the US is suboptimal due to individual and structural racism. This study provides unique data on the experiences with health care for young, Black pregnant individuals and delivers valuable insight into how individual and structural racism impacts obstetric care for young Black women.
在芝加哥，黑人产妇的发病率和死亡率比白人高六倍，尽管有政策举措来促进产妇健康公平。产妇发病率和死亡率的差异反映了结构性不平等的经历，包括有限的高质量产科护理、隐性偏见以及由此导致患者对医疗保健系统不信任的种族主义、社会支持不足和经济不安全。尽管有关于黑人女性在产科护理方面的经历，包括个体和结构性种族主义方面的经历，但是对于年龄和种族的交叉点以及医疗保健经历知之甚少。本研究的目的是利用交叉理论视角探讨年轻黑人女性的产妇健康和怀孕经历。
在这项研究中，我们在 11 名年轻黑人孕妇样本中进行了两次焦点小组。我们进行了主题分析，以确定数据的代码、主题和子主题。
我们得出了两个总体主题：产科种族主义和产科抵制。为了阐明产科种族主义如何框定了我们参与者的医疗保健经历，我们确定了以下子主题：作为年轻黑人女性的交叉身份、医疗不信任和怀孕创伤。第二个主要主题描述了参与者保护自己免受产科种族主义侵害以产生积极健康体验的方法。这些抵抗方法包括寻找拥护者和依赖可信赖的提供者。
由于个体和结构性种族主义，美国目前的产科护理标准并不理想。本研究提供了有关年轻黑人孕妇医疗保健经历的独特数据，并深入了解个体和结构性种族主义如何影响年轻黑人女性的产科护理。
