Birthing Cultural Rigor, LLC, Nashville, Tennessee.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Ann Fam Med. 2023 May-Jun;21(3):227-233. doi: 10.1370/afm.2958. Epub 2023 Apr 5.
We undertook a study to assess whether presence of community support persons (CSPs), with no hospital affiliation or alignment, mitigates acts of obstetric racism during hospitalization for labor, birth, and immediate postpartum care.
We conducted a cross-sectional cohort study, measuring 3 domains of obstetric racism as defined for, by, and with Black birthing people: humanity (violation of safety and accountability, autonomy, communication and information exchange, and empathy); kinship (denial or disruption of community and familial bonds that support Black birthing people); and racism in the form of anti-Black racism and misogynoir (weaponization of societal stereotypes and scripts in service provision that reproduce gendered anti-Black racism in the hospital). We used a novel, validated instrument, the Patient-Reported Experience Measure of Obstetric Racism (the PREM-OB Scale suite), and linear regression analysis to determine the association between CSP presence during hospital births and obstetric racism.
Analyses were based on 806 Black birthing people, 720 (89.3%) of whom had at least 1 CSP present throughout their labor, birth, and immediate postpartum care. The presence of CSPs was associated with fewer acts of obstetric racism across all 3 domains, with statistically significant reductions in scores in the CSP group of one-third to two-third SD units relative to the no-CSP group.
Our findings suggest that CSPs may be an effective way to reduce obstetric racism as part of quality improvement initiatives, emphasizing the need for democratizing the birthing experience and birth space, and incorporating community members as a way to promote the safety of Black birthing people in hospital settings. "Online First" article.
我们开展了一项研究，评估在因分娩、生产和产后即刻护理而住院期间，有无与医院无隶属或结盟关系的社区支持人员（CSP）的存在是否可以减轻产科种族主义行为。
我们进行了一项横断面队列研究，根据黑人产妇定义、由黑人产妇定义并为黑人产妇定义了三个领域的产科种族主义：人性（侵犯安全和问责制、自主权、沟通和信息交流以及同理心）；亲情（否认或破坏支持黑人产妇的社区和家庭纽带）；以及以反黑人和厌恶女性主义形式存在的种族主义（在服务提供中利用社会刻板印象和剧本武器化，在医院中再现性别化的反黑人民族主义）。我们使用了一种新颖的、经过验证的工具，即患者报告的产科种族主义体验测量工具（PREM-OB 量表套件），并使用线性回归分析来确定在医院分娩期间 CSP 存在与产科种族主义之间的关联。
分析基于 806 名黑人产妇，其中 720 名（89.3%）在整个分娩、生产和产后即刻护理过程中至少有 1 名 CSP 在场。CSP 的存在与所有 3 个领域的产科种族主义行为较少相关，与无 CSP 组相比，CSP 组的分数减少了三分之一到三分之二的标准偏差单位，具有统计学意义。
我们的研究结果表明，CSP 可能是减少产科种族主义的一种有效方法，作为质量改进计划的一部分，这强调了需要民主化分娩体验和分娩空间，并将社区成员纳入促进黑人产妇在医院环境中安全的方式。“在线优先”文章。
