Enhancing Healthier Birth Outcomes by Creating Supportive Spaces for Pregnant African American Women Living in Milwaukee

Abstract

Objectives Nationwide, African American women report higher stress levels and less access to pre- and postnatal resources. Wisconsin mirrors national infant mortality trends that show a persistent four-decade gap in infant survival between African American and White populations. The objective of the Milwaukee Birthing Project (MBP) was to implement a community-based health promotion intervention to improve birth outcomes for pregnant, low-income African American women, evaluate its effectiveness, and document its usefulness to inform development of future interventions. The project involved a mentoring and supportive relationship between 28 volunteer mentors (Sister Friends) and 20 pregnant women (Little Sisters). Methods The project implementation and evaluation were informed by the lifecourse perspective and a postcolonial feminist framework. Thematic analysis was used to analyze ethnographic data from monthly meetings and interviews with pregnant Little Sisters and Sister Friends. Results Our findings showed patterns both in community spaces and spaces created during the MBP. Program spaces contrasted with everyday life spaces and allowed women to experience community support. Based on our analysis, we classify these spaces as: (1) community spaces lacking support, (2) safe spaces of belonging and understanding, (3) spaces that foster meaningful interaction, and (4) safe, supportive spaces for other women in the future. Conclusions for Practice Future interventions should consider intentionally developing safe spaces to attain health goals. From a postcolonial feminist perspective, the voices of women who are at greatest risk for experiencing poor birth outcomes are crucial to the development of effective policies.

Nia Imani Model of Care’s Impact on Homeless African-American Women

“…Nursing research related to crucial social support points to the importance of deliberatively creating spaces where women who identify as African American and share common experiences can share a mutual understanding, and together foster more positive health and social outcomes, a finding that corroborates recent research with low-income African-American women in Milwaukee (Mkandawire-Valhmu et al, 2018). The results of our study exemplified the key role that social support plays in helping African-American women to recover from addiction, learn life skills, and become self-sufficient.…”

A new perspective on the maternal mortality disparity

“…Well‐intended research agendas often focus on problem solving as a means to eliminate health disparities. For example, in the case of the disproportionate maternal mortality rate among Black women, much research focuses on experiences in prenatal care, 14–22 discrimination in healthcare, 23–27 and support in pregnancy 14–32 . In these studies, Black women are indeed at the center as care recipients and as informants, 14–32 but only one study asked Black women their perceived research priorities 19 .…”

“…For example, in the case of the disproportionate maternal mortality rate among Black women, much research focuses on experiences in prenatal care, 14–22 discrimination in healthcare, 23–27 and support in pregnancy 14–32 . In these studies, Black women are indeed at the center as care recipients and as informants, 14–32 but only one study asked Black women their perceived research priorities 19 . Investigating experiences of Black women in pregnancy is an important endeavor; however, approaching the issue from the problem‐solving lens tends to focus on the deficits.…”

The Association between Travel Time and Prenatal Care Attendance

“…Other studies emphasize the critical need to engage voices of women at greater risk in developing effective policies to overcome challenges related to care attendance. 40 Finally, strengthening patient-provider interactions and communication during prenatal visits may facilitate continuity of care, particularly for racial/ethnic minorities. 41 Several innovations that may improve access to prenatal care services among high-risk populations have been tested but are not yet widely adopted.…”