BIRTH OUTCOMES AND PERINATAL HEALTH DISPARITIES IN THE US: A NARRATIVE ANALYSIS OF BLACK WOMEN’S EXPERIENCES FROM A BLACK FEMINIST THOUGHT AND LIFE COURSE PERSPECTIVE

Abstract

Background: Black maternal health disparities in the US continue to be a major public health concern. While initial approaches to close the gap have been thought to contribute to decreasing delivery-related mortality in US hospitals, Black maternal health disparities continue to worsen. Understanding the full scope of the issues impacting Black birthing women is necessary to improve birthing outcomes. This study centers on Black women’s perspectives of the facilitators and barriers faced when accessing the perinatal health care system in the US through the lens of Black Feminist Thought and Life Course perspectives. The National Institute on Minority Health and Health Disparities framework was adapted to conceptualize these lenses and health determinants over several domains of Black women’s lives.Methods: A qualitative descriptive design was employed. Purposive and snowball sampling was used to recruit participants who identified as Black/African American women living in the Midwestern region of the US. Results: Participants identified multidimensional and multilayered facilitators and barriers in their perinatal care. The major themes identified include spirituality, traumatic experiences, cultivating safe spaces when seeking perinatal care, balancing socioeconomic and class factors impacting the perinatal life course, understanding and redefining womanhood and motherhood during the perinatal life course, support systems as a facilitator, lack of provider advocacy as a barrier, system policies as facilitators and barriers, and spatial community violence. Discussion: A narrative analysis of Black women’s birth stories revealed that Black maternal health disparities are a multidimensional and multilayered phenomenon. A paradigm shift in approaches to care is needed to pull the multiple levers necessary to address this disparity. The nursing discipline is positioned to partner with and support emancipatory agencies and respect Black women’s autonomy over their bodies and healthcare decision-making through continued research that informs policy and practice extending beyond the hospital’s doors and into communities.