961: Pregnant Black women's experiences of racial discrimination

Chambers, Brittany D.; Arega, Helen; Arabia, Silvia E; Stanley, Darcy; Gómez, Anu Manchikanti; Franck, Linda S.; Rs, Berkowitz; Feuer, Sky K.; Jelliffe‐Pawlowski, Laura L.; McLemore, Monica R.

doi:10.1016/j.ajog.2017.11.448

Cited by 3 publications

(3 citation statements)

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“…Perinatal quality improvement (PQI) and implementation studies tend to focus on the disparate rates of adverse pregnancy‐related outcomes between Black mothers and birthing people and non‐Black mothers and birthing populations, namely, differences in outcomes whereby race, and not racism, is the risk factor 1 . In contrast, a growing body of knowledge, particularly generated and disseminated by Black women scholars, continues to illuminate the association between perinatal health inequities and historical and contemporary racism 2‐16 . Unfortunately, translating this knowledge into meaningful change is challenging.…”

Section: Introductionmentioning

confidence: 99%

“…1 In contrast, a growing body of knowledge, particularly generated and disseminated by Black women scholars, continues to illuminate the association between perinatal health inequities and historical and contemporary racism. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Unfortunately, translating this knowledge into meaningful change is challenging. A growing body of work highlights the failure of leading scholars and journals, 1,17,18 funders, 7 and large-scale quality improvement organizations 19,20 to earnestly interrogate racism as a critical driver of health inequities.…”

Section: Introductionmentioning

confidence: 99%

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Psychometric validation of a patient‐reported experience measure of obstetric racism© (The PREM‐OB Scale™ suite)

VanGompel

Lai

Davis

et al. 2022

Birth

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Background Perinatal quality improvement lacks valid tools to measure adverse hospital experiences disproportionately impacting Black mothers and birthing people. Measuring and mitigating harm requires using a framework that centers the lived experiences of Black birthing people in evaluating inequitable care, namely, obstetric racism. We sought to develop a valid patient‐reported experience measure (PREM) of Obstetric Racism© in hospital‐based intrapartum care designed for, by, and with Black women as patient, community, and content experts. Methods PROMIS© instrument development standards adapted with cultural rigor methodology. Phase 1 included item pool generation, modified Delphi method, and cognitive interviews. Phase 2 evaluated the item pool using factor analysis and item response theory. Results Items were identified or written to cover 7 previously identified theoretical domains. 806 Black mothers and birthing people completed the pilot test. Factor analysis concluded a 3 factor structure with good fit indices (CFI = 0.931‐0.977, RMSEA = 0.087‐0.10, R2 > .3, residual correlation < 0.15). All items in each factor fit the IRT model and were able to be calibrated. Factor 1, “Humanity,” had 31 items measuring experiences of safety and accountability, autonomy, communication, and empathy. A 12‐item short form was created to ease respondent burden. Factor 2, “Racism,” had 12 items measuring experiences of neglect and mistreatment. Factor 3, “Kinship,” had 7 items measuring hospital denial and disruption of relationships between Black mothers and their child or support system. Conclusions The PREM‐OB Scale™ suite is a valid tool to characterize and quantify obstetric racism for use in perinatal improvement initiatives.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psychometric validation of a patient‐reported experience measure of obstetric racism© (The PREM‐OB Scale™ suite)

VanGompel

Lai

Davis

et al. 2022

Birth

View full text Add to dashboard Cite

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“…Compared with White and more affluent peers, mothers of racial and ethnic minority groups and low-income individuals are more likely to enter the perinatal period with numerous SDOH stressors because of systemic inequities. 15 The health impacts of structural and interpersonal racism accumulate over generations (the weathering hypothesis). 16 Racial and ethnic minority mothers experience additional systemic mistreatment in access to high-quality perinatal care.…”

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confidence: 99%

Prioritizing Maternal Mental Health in Addressing Morbidity and Mortality

Wisner,

Murphy,

Thomas

2024

JAMA Psychiatry

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ImportanceThe rate of maternal mortality in the United States is 2-fold to 3-fold greater than that in other high-income countries. While many national initiatives have been developed to combat maternal mortality, these efforts often fail to include mental illness.ObjectiveTo highlight the underrecognized contribution of mental illness to maternal mortality, which is nearly double that of postpartum hemorrhage.Evidence ReviewA topic outline was developed to include challenges in measuring perinatal mental conditions and mortality rates; contributions of social determinants of health to mental conditions and mortality; perinatal psychiatric disorder characterization; mechanisms by which maternal mental illness increases mortality, specifically, suicide and addictive disorders; access limitations and care “deserts”; prenatal stress and its impact on reproductive outcomes; increasing clinician expertise through cross-disciplinary education; intervention sites and models; and asserting that mental health is fundamental to maternal health. Publications in the last 3 years were prioritized, particularly those relating to policy. References were selected through consensus. Sources were PubMed, Ovid, direct data published on government websites, and health policy sources such as the Policy Center for Maternal Mental Health.FindingsPriority was given to recent sources. Citations from 2022-2023 numbered 26; within the last 5 years, 14; and historical references, 15. Recommendations to address each topic area serve as concluding statements for each section. To mitigate the contributions of mental illness to the maternal mortality risk, a coordinated effort is required across professional and governmental organizations.Conclusions and RelevanceConcrete programmatic and policy changes are needed to reduce perinatal stress and address trauma, standardize the collection of social determinant of health data among perinatal patients, increase access to reproductive psychiatry curricula among prescribers, reduce perinatal mental health and obstetrical deserts, institute paid parental leave, and support seamless integration of perinatal and behavioral health care. Moreover, instead of focusing on a relatively minor portion of the contributors to health that current medical practice targets, fortifying the social foundation strengthens the prospects for the health of families for our current and future generations.

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Racial Discrimination, Social Support, and Psychological Distress Among Black Pregnant Women

Carey,

Xie,

Davis

et al. 2024

West J Nurs Res

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Background: Black pregnant women who experience racial discrimination are at an increased risk of psychological distress. Studies have not adequately addressed if social support may moderate the association between experiences of racial discrimination and psychological distress among Black pregnant women. Objective: We sought to examine the moderating effect of social support on the association between experiences of racial discrimination and psychological distress among Black pregnant women. Methods: We report findings based on cross-sectional data collected from 599 Black pregnant women enrolled in a prospective cohort study prior to the COVID-19 pandemic. Women completed questionnaires about experiences of racial discrimination (Experiences of Discrimination), social support (MOS Social Support Survey), and psychological distress (Psychological General Wellbeing Index). Results: Women had an average age of 26 ± 5 years and gestational age at data collection of 17 ± 6 weeks. Approximately 53% of women reported ever experiencing racial discrimination in at least one situation, and 54% reported psychological distress. After adjustment for covariates, racial discrimination was associated with a 2.2-fold increase in psychological distress (odds ratio [OR] = 2.24; 95% confidence interval [CI] 1.35-3.70; P = .002). Low social support (scores below the median) was associated with a 3.8-fold higher likelihood of psychological distress (OR = 3.84, 95% CI 2.27-6.48, P < .001). Social support did not moderate the association of lifetime experiences of racial discrimination with psychological distress. Conclusions: Findings of the study contribute to evidence that lifetime experiences of racial discrimination and low levels of social support relate to psychological distress among Black pregnant women.

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961: Pregnant Black women's experiences of racial discrimination

Cited by 3 publications

References 0 publications

Psychometric validation of a patient‐reported experience measure of obstetric racism© (The PREM‐OB Scale™ suite)

Psychometric validation of a patient‐reported experience measure of obstetric racism© (The PREM‐OB Scale™ suite)

Prioritizing Maternal Mental Health in Addressing Morbidity and Mortality

Racial Discrimination, Social Support, and Psychological Distress Among Black Pregnant Women

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