Abstract

Black women in the United States face disproportionate maternal health outcomes during pregnancy, childbirth, and postpartum compared to other racial and ethnic groups. Despite advancements in healthcare, the United States continues to report the highest maternal mortality rates among high-income developed nations, with Black women experiencing rates up to three times higher than their White counterparts. This phenomenological study explores the lived experiences of Black women in the United States to understand how they navigate the continuum of maternal healthcare, from preconception through postpartum. Guided by the social determinants of health (SDOH) theoretical framework, childbirth was examined through four interconnected lenses: physiology, psychology, sociology, and healthcare delivery systems. Through semi-structured interviews with 14 Black women aged 27-46, this qualitative research employed both inductive and deductive thematic analysis to capture the deeply personal narratives of resilience, resistance, and resourcefulness of the participants’ experiences. Four thematic categories emerged: (a) birthing experience, (b) support systems, (c) well being, and (d) healthcare systems. Their narratives revealed a complex interplay of triumph and trauma. Women described feeling unheard, unprotected, and misunderstood during some of the most vulnerable moments of their lives. However, they demonstrated spiritual strength, agency, and strategic use of community-based resources. Many emphasized the value of being seen and respected in healthcare environments, particularly by providers who shared their racial or cultural background. Findings highlight that, although many Black women experienced dismissiveness, discrimination, and bias within healthcare institutions, they relied heavily on faith, their village, community, and self-advocacy. While structural racism continues to shape maternal health outcomes, participants emphasized the importance of having culturally congruent care, including access to Black providers, doulas, and midwives. Implications include increased investment in Black maternal health research, expansion of culturally responsive training and education for providers, and broader implementation of person-centered midwifery and doula care models. This research contributes to the growing body of literature calling for a reimagining of maternal healthcare. The stories shared, revealed reflective truth, that Black women are more than receivers of care, they are also advocates and knowledge finders, navigating a complex and often unjust maternal health system.

Library of Congress Subject Headings

African American women—Medical care; Maternal health services—United States; Mothers—Mortality—Social aspects—United States; Discrimination in medical care—United States; Health services accessibility—United States

Date of Award

2025

School Affiliation

Graduate School of Education and Psychology

Department/Program

Education

Degree Type

Dissertation

Degree Name

Doctorate

Faculty Advisor

Kay Davis

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