Kyei Grace K, Omeokwe Faith Precious, Kwaning Esther Nana, Banda Esther Latif, Panyasarawut Jittima, Ibrahim Nuheila, Kyei Evans F
Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, USA.
School of Nursing, The George Washington University, Washington, DC, USA.
J Racial Ethn Health Disparities. 2025 Aug 8. doi: 10.1007/s40615-025-02594-4.
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.
To systematically identify and characterize social support networks available to African American women during childbirth in the USA.
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.
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.
Social support networks significantly influence maternal experiences for African American women. However, effectiveness is constrained by persistent structural inequities.
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.
在美国，受结构性种族主义、医疗保健不平等以及获得具有文化适应性护理的机会有限等因素影响，非裔美国女性面临着极高的孕产妇死亡率和发病率。社会支持网络已知可改善孕产妇健康结局，但对于这些支持如何作用于非裔美国母亲，仍缺乏全面了解。
系统识别和描述美国非裔美国女性分娩期间可获得的社会支持网络。
我们按照PRISMA-ScR指南进行了系统的范围综述。在PubMed、CINAHL Complete和PsycINFO数据库中检索了2019年1月至2024年10月发表的研究。如果研究涉及孕期、分娩期或产后非裔美国女性的社会支持，则纳入研究。由五名评审员使用约翰霍普金斯循证实践评分量表进行数据提取和质量评估。
纳入了14项研究（4项定性研究、8项定量研究、2项混合方法研究），涉及8243名参与者。社会支持出现了四个核心维度：情感支持（来自伴侣、家人和导乐）显著减轻心理困扰；工具性支持（经济援助、儿童照料）提高分娩满意度并减少产后担忧；信息支持增强决策能力，网络密度而非规模预测有效性；评估支持（倡导和认可）减轻产科种族主义经历。包括系统性种族主义和经济限制在内的结构性障碍，限制了获得所有维度全面支持的机会。
社会支持网络对非裔美国女性的孕产妇经历有显著影响。然而，有效性受到持续存在的结构性不平等的限制。
医疗保健专业人员必须扩大获得文化适配导乐服务的机会，解决提供者偏见问题，并加强基于社区的支持系统，以改善非裔美国孕产妇的健康结局。
