Thomas Teresa Hagan, Vetterly Savannah, Kaselitz Elizabeth B, Doswell Willa, Braxter Betty
Department of Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.
Stritch School of Medicine, Loyola University, Chicago, Illinois, USA.
Birth. 2025 Jun;52(2):291-298. doi: 10.1111/birt.12885. Epub 2024 Oct 16.
Black women experience many barriers to receiving high-quality maternal healthcare. The ability of Black women to self-advocate may mitigate these threats to their health. Limited research describes Black women's self-advocacy during the perinatal period and how self-advocacy related to other relevant concepts. The aim of this study was to describe the relationship between self-advocacy, patient-provider relationships, and mental health outcomes among Black women in the perinatal period.
This cross-sectional descriptive pilot study recruited Black women who were either in their 3 trimester of pregnancy or within a year postpartum to complete surveys describing their self-advocacy (Female Self-Advocacy in Cancer Survivorship Scale adapted for perinatal period) and maternal health outcomes (trust and comfort with maternal healthcare providers-Patient-Provider Relationship Scale; abuse and disrespect during childbirth-Mothers of Respect Index; experiences of discrimination-Experiences of Discrimination scale; depression-Edinburgh Postnatal Depression Scale; and postpartum posttraumatic stress-City Birth Trauma Scale).
N = 40 participants were recruited between January and September 2022. Participants reported moderate levels of self-advocacy which were associated with trust and comfort with healthcare providers (r = 0.57-0.76, p < 0.001). Feeling respected by healthcare providers was positively associated with two self-advocacy subscales (r = 0.42-0.44, p < 0.01). Depression was inversely related to all self-advocacy subscales (r = -0.47-0.62, p < 0.001).
Black women's self-advocacy during the perinatal period is associated with trust and comfort with healthcare providers, perceptions of respect from their providers, and perinatal depression. Future research should focus on promoting trusting, respectful relationships between Black women and their maternal health providers.
黑人女性在获得高质量孕产妇保健方面面临诸多障碍。黑人女性自我维权的能力可能会减轻这些对其健康的威胁。有限的研究描述了黑人女性在围产期的自我维权情况以及自我维权与其他相关概念的关系。本研究的目的是描述围产期黑人女性的自我维权、医患关系和心理健康结果之间的关系。
这项横断面描述性试点研究招募了处于妊娠晚期或产后一年内的黑人女性，以完成描述其自我维权（改编自癌症幸存者女性自我维权量表的围产期版本）和孕产妇健康结果（对孕产妇保健提供者的信任和舒适度——医患关系量表；分娩期间的虐待和不尊重——尊重母亲指数；歧视经历——歧视经历量表；抑郁症——爱丁堡产后抑郁量表；以及产后创伤后应激——城市分娩创伤量表）的调查。
2022年1月至9月期间招募了N = 40名参与者。参与者报告的自我维权水平中等，这与对医疗保健提供者的信任和舒适度相关（r = 0.57 - 0.76，p < 0.001）。感到受到医疗保健提供者的尊重与两个自我维权子量表呈正相关（r = 0.42 - 0.44，p < 0.01）。抑郁症与所有自我维权子量表呈负相关（r = -0.47 - 0.62，p < 0.001）。
围产期黑人女性的自我维权与对医疗保健提供者的信任和舒适度、对提供者尊重的感知以及围产期抑郁症相关。未来的研究应侧重于促进黑人女性与其孕产妇保健提供者之间信任、尊重的关系。
