Karbeah J'Mag, Hardeman Rachel, Katz Numi, Orionzi Dimpho, Kozhimannil Katy Backes
Center for Antiracism Research for Health Equity, University of Minnesota School of Public Health.
Yale University.
J Health Dispar Res Pract. 2022 Summer;15(2):47-60.
Racial and ethnic disparities in perinatal health outcomes are among the greatest threats to population health in the United States. Black birthing communities are most impacted by these inequities due to structural racism throughout society and within health care settings. Although multiple studies have shown that structural racism and the disrespect associated with this system of inequity are the root causes of observed perinatal inequities, little scholarship has centered the needs of Black birthing communities to create alternative care models. Leaning on reproductive justice and critical race theoretical frameworks, this study explores good birth experiences as described by Black birthing people.
Thematic analysis of two focus groups and three one-on-one interviews conducted with clients at a Black-owned free-standing culturally-centered birth center (n=10).
We found that Black birthing persons' concerns centered on three main themes: agency, historically- and culturally-safe birthing experiences, and relationship-centered care. Many participants pointed directly to past experiences of medical mistreatment and obstetric racism when defining their ideal birth experience.
Black birthing people seeking care from culturally-informed providers often do so because they have been mistreated, disregarded, and neglected within traditional care settings. The needs articulated by our study participants provide a powerful framework for understanding alternative patient-centered models of care that can be developed to improve the care experiences of Black birthing people in the pursuit of birth equity.
围产期健康结果中的种族和族裔差异是美国人口健康面临的最大威胁之一。黑人分娩群体受这些不平等现象的影响最大,这是由于整个社会以及医疗保健环境中存在结构性种族主义。尽管多项研究表明,结构性种族主义以及与这种不平等制度相关的不尊重是观察到的围产期不平等的根本原因,但很少有学术研究关注黑人分娩群体的需求以创建替代护理模式。基于生殖正义和批判种族理论框架,本研究探讨了黑人分娩者所描述的良好分娩经历。
对一家黑人所有的独立文化中心分娩中心的客户进行了两个焦点小组和三次一对一访谈的主题分析(n = 10)。
我们发现黑人分娩者的担忧集中在三个主要主题上:自主权、历史和文化上安全的分娩经历以及以关系为中心的护理。许多参与者在定义他们理想的分娩经历时直接指出了过去遭受医疗虐待和产科种族主义的经历。
寻求具有文化素养的提供者护理的黑人分娩者通常是因为他们在传统护理环境中受到了虐待、忽视和冷落。我们的研究参与者所表达的需求为理解可以开发的以患者为中心的替代护理模式提供了一个有力的框架,这些模式可用于改善黑人分娩者在追求分娩公平方面的护理体验。