Abstract

In the United States, maternal mortality represents a dire health crisis with a stark racial imbalance. Black women are two and a half to three times more likely to die from pregnancy and birth-related complications than their White counterparts. Racial disparities in maternal health can be explained by variations in the quality of maternal healthcare services that women tend to receive. Racial and ethnic minority women are more likely to receive inferior quality prenatal care (PNC), which brings to question the care model of traditional PNC and its adequacy in serving the healthcare needs of Black women. Since Black women disproportionately experience lower quality PNC, the overall improvement in the quality of PNC is likely to yield high benefits for Black women. This study sought to identify and give perspective to the unique challenges that Black women experience in the maternal healthcare system. Findings show that Black mothers who had home births with a race-concordant midwife experienced excellent quality of care. For Black home-birthing mothers in this study, PNC and childbirth were normalized at home, PNC was accessible, mother led, consistent, encouraging, and supportive, good quality, emotionally fulfilling and peaceful, personalized, race-concordant, and with family involvement, which made mother feel well prepared for birth. Findings from this study highlight the importance of race-concordant midwifery care for Black mothers to experience high quality care. Black midwives in this study demonstrated the provision of high-quality midwifery care to Black mothers. These findings may help inform clinical practice for the maternal care of Black women. Advocating for Black women to receive high-quality PNC, promoting race-concordant midwifery care and diversity midwifery are essential in the fight to ameliorate racial disparities in maternal health. Policies that support further research into maternal healthcare for Black women, promote midwifery care and diversity in midwifery, like the Black Maternal Health Momnibus, are instrumental to improve maternal health outcomes for Black women.

Library of Congress Subject Headings

Maternal health services; Mothers--Mortality--Women, Black; Pregnancy--Women, Black; Midwife and patient--Women, Black

Date of Award

2023

School Affiliation

Graduate School of Education and Psychology

Department/Program

Education

Degree Type

Dissertation

Degree Name

Doctorate

Faculty Advisor

Kfir Mordechay

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