Black pregnant women prefer obstetric providers of same race due to racism, discrimination
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Key takeaways:
- Black women say they prefer to see Black obstetric providers during pregnancy.
- This was a popular preference among interviewees and focus groups, who cited prior experiences of racism and/or discrimination.
Black women tend to prefer to be cared for by Black obstetric providers during pregnancy due to past experiences of discrimination and racism, according to a presenter at The Pregnancy Meeting.
“Increasing opportunities for racially concordant obstetric care may be one effective strategy for improving care for Black birthing people and should be studied further,” E. Nicole Teal, MD, MPH, maternal-fetal medicine fellow at the University of North Carolina at Chapel Hill, told Healio. “Black birthing people are facing blatant bias and racism in our health care systems on a regular basis and, as a result, fear for their lives.”
Teal and colleagues conducted a multi-method study with data from 32 women (mean age, 34 years) who self-identified as non-Hispanic Black or African American and delivered a baby from 2019 to 2021. Researchers conducted one-on-one semi-structured interviews with 16 participants, and the remaining 16 participants took part in five focus groups. Interviews and focus groups were designed to create discussion regarding lifetime experiences with racism and discrimination, health care system experiences during pregnancy and perspectives on racial concordance with obstetric providers. All interviewers identified as Black women, and interviews were audio-recorded and transcribed prior to analysis.
Researchers observed the following popular themes among non-Hispanic Black or African American birthing people:
- a desire for providers of the same race as themselves;
- difficulties finding providers of the same race;
- prior experience being stereotyped during obstetric care;
- not being heard by obstetric providers and staff; and
- worries of dying during their pregnancy or during childbirth.
“Our work is not done. It has just begun,” Karen Sheffield-Abdullah, PhD, RN, CNM, FACNM, assistant professor at the University of North Carolina at Chapel Hill School of Nursing and co-investigator of the study, said. “The call to action is for each of us who are passionate about Black maternal and infant health to ask ourselves, ‘Where can I have the greatest impact to effect meaningful change in this crisis?’”
One way to initiate change is to listen to the community and build on insights with a shared commitment to respect and humility to navigate the experiences of racism and discrimination that Black women experience in this country, Sheffield-Abdullah said.
“Health care systems should work to diversify their workforces, increasing the number of Black obstetric care providers, including OB/GYNs and midwives, as well as nurses. This will require increasing the number of individuals entering medical and nursing school,” Teal said. “Additionally, there should be concerted efforts to eradicate discrimination and racism throughout health care systems across the country.”