“Black Nurses in the Home is Working”: Advocacy, Naming, and Processing Racism to Improve Black Maternal and Infant Health

Abstract

Objectives 1) To explore how racism-related stress impacts Black women's health, pregnancy, and parenting. 2) To explore how a culturally-specific program affects the relationship between racism-related stress and Black women's health, pregnancy, and parenting. Methods This qualitative study uses a Black Feminist approach to center the lived experiences and perspectives of Black women. Focus groups were conducted with clients and staff of a culturally-specific program that provides perinatal care for Black families. A thematic analysis was conducted using a Reproductive Justice framework as a guide. Results Participants consisted of 23 program clients and staff who all identified as Black women. Four themes emerged from the analysis: 1) The pervasive reach of structural racism, 2) Shared identities facilitate trust and healing, 3) Racism directly impacts mental health, and 4) Advocacy on macro and micro levels is a vital service. Conclusions for Practice Results show the chronicity and toxicity of structural racism on Black women's physical and mental health. The presence of overt and subtle forms of racism occur in multiple systems and require interventions on macro-and micro-levels. Culturally-specific perinatal care programs that prioritize racial concordance between providers and clients/ patients are well-received and effective models of care. Black perinatal care should include culturally-specific approaches, advocacy on behalf of and alongside Black people, mental health support with attention to racism-related stress, and interrogation of implicit bias. Multipronged interventions guided by Reproductive Justice principles provide a holistic framework to address interpersonal and systemic racial oppression.

“We Experience What They Experience”: Black Nurses’ and Community Health Workers’ Reflections on Providing Culturally Specific Perinatal Health Care

“…Our use of qualitative methods intervenes in the exclusion and erasure of Black people as community and content experts, and instead elevates and honors their perspectives, knowledge, and experiences (Scott, 2021). This analysis emerged from a larger study conducted in 2019 that explored racism-related stress among Black people who are either clients or staff of HBI, and a more detailed accounting of study methodology also is included in that paper (Hunte et al, 2022). In this analysis, we specifically asked, “What are the experiences of Black nurses and community health workers serving Black people in a culturally-specific perinatal care program?” This study was approved by the researchers’ university and study site’s county institutional review boards.…”

“…Black midwives locate the causes of these inequities in the realities of systemic racism, the epigenetic legacy of slavery, the embodiment of racism-related trauma, and cultural loss through community displacement (Bridgeman-Bunyoli et al, 2022). Racism-related stress compounds Black people’s embodied experience of pregnancy and parenting (Hunte et al, 2022). As such, Black reproduction can be understood as a site of both racial oppression and anti-racist struggle for the survival and autonomy of the Black family (Hays, 2016).…”

Pregnancy Decision Making for Women With Mental Health Conditions: The Roles of Distress, Lay Beliefs, and Self-Efficacy

“…We apply the framework of reproductive justice to investigate how societal forces around mental health, such as dominant narratives that reflect stigma, may influence people's reproductive decision making. We join other feminist researchers (e.g., Fortuna et al, 2019; Hunte et al, 2022) in conceptualizing mental health justice as a necessary inclusion in the reproductive justice framework.…”

The Birth Bundle Project: A Rainier Valley Midwifery‐led Collaborative Care Initiative Offering Patients and Providers a Paradigm Shift to Impact Health Equity

“…This evidence-based approach operates on many fronts to confront systemic oppression and interpersonal bias. 30…”