Introduction:There is empirical evidence that the quality of interpersonal care patients receive varies dramatically along racial and ethnic lines, with African American people often reporting much lower quality of care than their white counterparts. Improving the interpersonal relationship between clinicians and patients has been identified as one way to improve quality of care. Specifically, research has identified that patients feel more satisfied with the care that they receive from clinicians with whom they share a racial identity. However, little is known about how clinicians provide racially concordant care. The goal of this analysis was to identify the key components of high-quality care that were most salient for African American birthworkers providing perinatal care to African American patients. Methods:We conducted semistructured interviews (30 to 90 minutes) with clinicians (N = 10; midwives, student midwives, and doulas) who either worked at or worked closely with an African American-owned birth center in North Minneapolis, Minnesota. We used inductive coding methods to analyze data and to identify key themes. Results:Providing racially concordant perinatal care to African American birthing individuals required clinicians to acknowledge and center the sociocultural realities and experiences of their patients. Four key themes emerged in our analysis. The first overarching theme identified was the need to acknowledge how cultural identity of patients is fundamental to the clinical encounter. The second theme that emerged was a commitment to racial justice. The third and fourth themes were agency and cultural humility, which highlight the reciprocal nature of the clinician-patient relationship. Discussion:The most salient aspect of the care that birthworkers of color provide is their culturally centered approach. This approach and all subsequent themes suggest that achieving birth equity for pregnant African American people starts by acknowledging and honoring their sociocultural experiences.

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Introduction: Racial disparities in birth outcomes originate with a confluence of factors including social determinants of health, toxic stress, structural racism, and barriers to engaging, high-quality perinatal care. Historically and currently, midwives are disproportionately white, and attention to the racial and ethnic diversity of midwives is an increasing focus in birth equity efforts. This qualitative study helps fill the gap in literature by assessing the perspectives and motivations of midwives of color.Methods: Building on concepts from critical race theory, semistructured interviews (30-90 minutes long) were used to elicit an authentic voice from midwives of color, who primarily identified as African American. Participants (N = 7) were midwives who were affiliated with an African American-owned birth center in north Minneapolis, Minnesota. Participants represented an estimated 58% of all midwives of color in the state of Minnesota. Emergent themes were identified using a grounded theory, inductive approach. Three rounds of coding were conducted, and key themes were identified and analyzed.Results: Three primary themes emerged as motivations for midwives of color: 1) offering racially concordant care to the community, 2) racial justice as a primary motivation in their work, and 3) providing physically and emotionally safe care. Racially concordant care was identified both as a motivating factor and as a way of providing physically and emotionally safe care.Discussion: Findings suggest that midwives of color maintain a critical analysis of and commitment to eliminating racial perinatal inequities. Their motivation to provide racially concordant care elicits an urgency in current efforts to recruit and train more midwives of color, recognizing the current lack of racial and ethnic diversity in the field. Understanding how to support the work of equity-minded midwives of color may help to improve access to racially concordant health care providers and care that better meets the unique needs of African American individuals.