Community perspectives on the racial disparity in perinatal outcomes

Abstract

Objective: The United States' infant and maternal mortality rates are significantly higher among non-Hispanic Black women and infants than women and infants of other races, independent of educational attainment or socioeconomic status. The purpose of this research was to understand conditions that lead to these disparities and propose practices for addressing them through community perspectives.

Method: Researchers conducted six focus groups with African American women who had been pregnant previously (n = 27) and performed inductive thematic analysis looking at the interaction between race and health.

Results: Major themes included barriers to quality healthcare and support. Women perceived that healthcare professionals provided substandard care based on implicit biases and felt that asking questions of providers led to loss of autonomy.Conclusions and relevance: The perceived quality of a woman's perinatal experience is affected by women's relationships with their healthcare providers, their social support, and their sense of autonomy in decision-making. To improve the relationships between African American women and their providers, participants expressed that racism and implicit bias must be recognized and addressed. While this should be addressed in individual interactions, this study also suggests the role of policy change and system-level modifications that should be considered to effectively decrease the racial disparity in perinatal outcomes.

Keywords: Infant mortality; implicit bias; maternal mortality; racial disparity; systemic racism.