Black Women’s Perspectives on Structural Racism across the Reproductive Lifespan: A Conceptual Framework for Measurement Development

Chambers, Brittany D.; Arega, Helen; Arabia, Silvia E; Taylor, Brianne; Barron, Robyn; Gates, Brandi; Scruggs-Leach, Loretta; Scott, Karen A.; McLemore, Monica R.

doi:10.1007/s10995-020-03074-3

Cited by 88 publications

(81 citation statements)

References 29 publications

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“…We also found that women emphasized comprehensive, accessible and race-conscious behavioral health services as a highly needed and desirable component to patient-centered perinatal care. This desire for care that directly addresses structural racism has also been reported elsewhere (Chambers et al, 2021). Our participants' focus on mental health needs is not surprising given recent data in a cohort similar to ours that Black peripartum women experience multidimensional chronic stressors rooted in racism that may affect their mental health and birth outcomes (Chambers et al, 2020).…”

Section: Discussionsupporting

confidence: 79%

“When I think of mental healthcare, I think of no care.” Mental Health Services as a Vital Component of Prenatal Care for Black Women

Kemet

Yihui

Nseyo

et al. 2021

Matern Child Health J

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Purpose Black people give birth joyously despite disproportionate rates of adverse perinatal outcomes. Given that group prenatal care shows promise in mitigating these inequities, we sought to solicit the opinions of Black peripartum women on how group prenatal care could be tailored to fit their specific needs. In this study, we describe attitudes about a proposed Black group prenatal care in a single focus group of 11 Black women who receive maternal health services from Black Infant Health (BIH, a state and federal funded state-wide program for Black pregnant people with the goal to improve infant and maternal health). These data were used to design a race-conscious group prenatal care curriculum specifically for Black women at UCSF. Description This study was an analysis of focus group data generated as part of a larger project focused on community involvement in Black maternal health. English speaking pregnant or recently postpartum women age 18 or older who receive services from BIH were recruited to participated in the focus group analyzed in this study. All facilitators of the focus group were Black women in order to facilitate candid conversation about racism in prenatal care. Assessment The need for mental health care was common thread underlying all conversations about prenatal health improvements desired by our focus groups. Participants expressed the centrality of mental health access during our discussion of other themes (e.g.: ease of access, inclusion of partners, special classes for teen moms) by discussing them in terms of their relationship to mental health. Our participants’ clear expression of the centrality of mental health care to their prenatal health guided our decision to focus on mental health as a necessary pillar of any group prenatal care intervention designed to mitigate perinatal healthcare disparities in this paper. Three themes related to mental health integration into group prenatal care emerged from thematic analysis of the transcripts. Participants expressed insufficient access and advocacy, and provider distrust. Conclusion Evidence exists supporting group prenatal care as a tool for mitigation of perinatal health disparities among Black women. There is also a large body of data describing the disproportionate burden of mental health needs among Black women. The rich data we present here from Black women on their desire for the integration of these two needs fits well into the parallel conversation occurring in the literature. To our knowledge, this is the first study investigating desires of Black women regarding group prenatal care designed specifically for them. They expressed a strong desire for more access to mental health care providers who are racially conscious and aware of white supremacy, and nuanced opinions on the role of racial concordance in health equity.

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Section: Discussionsupporting

confidence: 79%

“When I think of mental healthcare, I think of no care.” Mental Health Services as a Vital Component of Prenatal Care for Black Women

Kemet

Yihui

Nseyo

et al. 2021

Matern Child Health J

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“…Inequality in obstetric and prenatal care in the United States leads to racial and ethnic disparities in maternal morbidity and mortality as well as infant mortality, low birth weight, and preterm birth [ 22 – 24 ]. Newborns are not exempt from racial inequities that exist in healthcare; healthcare provider recognition of sepsis and approaches to treatment as well as patient access to healthcare services influence disparate racial outcomes in children [ 25 ], and early-onset sepsis disproportionately impacts non-Hispanic Black and preterm infants [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Illness severity indicators in newborns by COVID-19 status in the United States, March–December 2020

et al. 2021

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“…More importantly, Sojourner syndrome both catalyzes and justifies a necessary paradigm shift in perinatal QI: the field must move beyond individual-level risk selection, stratification, analysis, and reduction (Ekeke et al 2020;Mendez et al 2020;Mendez, Hogan, and Culhane 2011;Scott, Bray, and McLemore 2020;Sealy-Jefferson et al 2015;Sealy-Jefferson, Mustafaa, and Misra 2019). Instead, Sojourner syndrome reveals why perinatal QI should publicly acknowledge and reconcile decades of disseminating half-truths through the omission of Black women's resistance and resilience, including the radical love, care, and scholarship of Black women doulas, lactation educators, midwives, obstetricians, activists, and experts in the humanities, social sciences, public health, and legal studies (Black Women Scholars 2020; Bridges 2020; Chambers et al 2020Chambers et al , 2021Goode 2014;Goode and Katz Rothman 2017;Julian et al 2020;Muse 2018).…”

mentioning

confidence: 99%

The Rise of Black Feminist Intellectual Thought and Political Activism in Perinatal Quality Improvement: A Righteous Rage about Racism, Resistance, Resilience, and Rigor

Scott

2021

Feminist Anthropology

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In this description of her work in perinatal quality improvement, obstetrician and crunk public health scholar Dr. Karen A. Scott describes the ways in which perinatal quality improvement has typically prioritized the deaths or near deaths of Black women at the exclusion of the lived experiences of Black women and people as patient, community, and content experts. Drawn into the work to apply a Black women-centered and liberatory analytic, Dr. Scott turned to Black feminist anthropology to transform perinatal quality improvement ethics and theories of change. The work of Leith Mullings, particularly her excursus on the Sojourner Syndrome, was at the center of Dr. Scott's approach to abating Black perinatal death and redesigning perinatal quality improvement.

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Black Women’s Perspectives on Structural Racism across the Reproductive Lifespan: A Conceptual Framework for Measurement Development

Cited by 88 publications

References 29 publications

“When I think of mental healthcare, I think of no care.” Mental Health Services as a Vital Component of Prenatal Care for Black Women

“When I think of mental healthcare, I think of no care.” Mental Health Services as a Vital Component of Prenatal Care for Black Women

Illness severity indicators in newborns by COVID-19 status in the United States, March–December 2020

The Rise of Black Feminist Intellectual Thought and Political Activism in Perinatal Quality Improvement: A Righteous Rage about Racism, Resistance, Resilience, and Rigor

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