Perceived Access to Health Services and Provider Information and Adverse Birth Outcomes: Findings from LaPRAMS, 2007–2008

Abstract

Findings support the need for a better understanding of discriminatory experiences and their impact on women's experiences during prenatal care and poor birth outcomes.

Racial Discrimination and Adverse Birth Outcomes: An Integrative Review

“…Four of the studies reviewed were qualitative designs, and 11 studies included quantitative designs . All of the qualitative studies were descriptive in nature.…”

“…In several of the studies, it was not clear what categories were provided to participants for self‐identification of race, and 3 of these studies included all African American participants . A study using Pregnancy Risk Assessment Monitoring System (PRAMS) data compared white women to black women without consideration of other racial groups given that white and black women comprise 95% of the population in the region examined . In one study, participants who identified as both African American and white were counted as African Americans in the analyses as the authors posited that participant experiences of racism were thought to better approximate those of African Americans versus whites .…”

“…However, women with racism scores above the median were at significantly increased risk of preterm birth with the effect moderated by depressive symptomatology . Two of the quantitative studies reviewed found significant associations between racial discrimination and preterm birth . A case‐control study conducted in Chicago, Illinois, demonstrated that African American women with preterm birth reported higher past‐year exposure to racism than their counterparts who gave birth to full‐term newborns (OR, 2.5; 95% CI, 1.2‐5.2) .…”

“…A case‐control study conducted in Chicago, Illinois, demonstrated that African American women with preterm birth reported higher past‐year exposure to racism than their counterparts who gave birth to full‐term newborns (OR, 2.5; 95% CI, 1.2‐5.2) . Using Louisiana PRAMS data, Ruiz and colleagues demonstrated that racial discrimination was significantly associated with preterm birth for black women (OR, 2.94; 95% CI, 1.1‐ 8.3) . Finally, in a qualitative study, pregnant African American women identified racial discrimination as a plausible stressor leading to higher rates of preterm birth .…”

“…Four of the studies reviewed were qualitative designs, [22][23][24][25] and 11 studies included quantitative designs. [26][27][28][29][30][31][32][33][34][35][36] All of the qualitative studies were descriptive in nature. Of the quantitative studies, 8 used convenience sampling, 26,28-33 while 3 of the population-based studies used quota sampling 27,36 and stratified sampling.…”