Mapping Social Support Networks for African American Women During Childbirth in the USA: A Systematic Scoping Review.

BACKGROUND

African American women face disproportionately high maternal mortality and morbidity rates in the USA, driven by structural racism, healthcare inequities, and limited access to culturally responsive care. Social support networks are known to improve maternal health outcomes, yet a comprehensive understanding of how these supports operate for African American mothers remains underdeveloped.

OBJECTIVE

To systematically identify and characterize social support networks available to African American women during childbirth in the USA.

METHODS

We conducted a systematic scoping review following PRISMA-ScR guidelines. Literature searches were performed across PubMed, CINAHL Complete, and PsycINFO for studies published between January 2019 and October 2024. Studies were included if they addressed social support for African American women during pregnancy, labor, or postpartum. Data extraction and quality assessment using the Johns Hopkins Evidence-Based Practice Rating Scale were conducted by five reviewers.

RESULTS

Fourteen studies (4 qualitative, 8 quantitative, 2 mixed methods) involving 8243 participants were included. Four core dimensions of social support emerged: emotional support (from partners, family, and doulas) significantly reduced psychological distress; instrumental support (financial aid, childcare) improved birth satisfaction and reduced postpartum worry; informational support enhanced decision-making, with network density rather than size predicting effectiveness; and appraisal support (advocacy and validation) mitigated experiences of obstetric racism. Structural barriers, including systemic racism and economic constraints, limited access to comprehensive support across all dimensions.

CONCLUSIONS

Social support networks significantly influence maternal experiences for African American women. However, effectiveness is constrained by persistent structural inequities.

IMPACT

Healthcare professionals must expand access to culturally congruent doula services, address provider bias, and strengthen community-based support systems to improve African American maternal health outcomes.