Factors influencing intrapartum health outcomes among Black birthing persons: A discursive paper

Abstract

Aim: To examine factors that influence intrapartum health outcomes among Black childbearing persons, including cisgender women, transmasculine and gender-diverse birthing persons.

Background: Black childbearing persons are three to four times (243%) more likely to die while giving birth than any other racial/ethnic group. Black birthing persons are not just dying from complications but also from inequitable care from healthcare providers compared to their white counterparts.

Design: Discursive paper.

Method: Searching national literature published between 2010 and 2021 in PubMed, CINAHL, Embase and SCOPUS, we explored factors associated with poor intrapartum health outcomes among Black childbearing persons.

Discussion: Several studies have ruled out social determinants of health as sufficient causative factors for poor intrapartum health outcomes among Black birthing persons. Recent research has shown that discrimination by race heavily influences whether a birthing person dies while childbearing.

Conclusions: There is a historical context for obstetric medicine that includes harmful stereotypes, implicit bias and racism, all having a negative impact on intrapartum health outcomes. The existing health disparity among this population is endemic and requires close attention.

Impact on nursing practice: Nurses and other healthcare professionals must understand their role in establishing unbiased care that promotes respect for diversity, equity and inclusion.

No patient or public contribution: There was no patient or public involvement in the design or drafting of this discursive paper.

Keywords: childbearing; cultural issues; gender; inequalities in health; intrapartum; maternity nursing; obstetrics and gynaecology; pregnancy; reproductive health; social determinants of health.