Abstract
Objectives
The preterm birth rate for Black women in the U.S. is consistently higher than other racial groups. The crisis of preterm birth and adverse birth outcomes among Black people is a historical, systematic confluence of racism, stressors, and an unsupportive and hostile healthcare system. To inform the development of preterm birth risk reduction interventions, this study aimed to collect and synthesize the experiences of Black women who gave birth preterm along with clinicians and community-based organizations who serve them.
Methods
A qualitative study design was employed whereby nine focus groups and 17 key informant interviews that included Black women, clinicians, and representatives from community-based organizations were facilitated in Los Angeles County from March 2019 to March 2020. Participants were recruited through the organizations and the focus groups took place virtually and in person. The process of thematic analysis was employed to analyze the focus group and interview transcripts.
Results
Five overarching themes emerged from the data. Black women experience chronic and pregnancy-related stress, and have lasting trauma from adverse maternal health experiences. These issues are exacerbated by racism and cultural incongruence within healthcare and social services systems. Black women have relied on self-education and self-advocacy to endure the barriers related to racism, mistreatment, and their experiences with preterm birth.
Conclusions for Practice
Healthcare and social service providers must offer more holistic care that prioritizes, rather than ignores, the racial components of health, placing increased importance on implementing inclusive and culturally-appropriate patient education, attentiveness to patient needs, respectful care, and support for Black women.
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Data Availability
The data are fully accessible by the lead author.
Code availability
The codes are fully accessible by the lead author.
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Acknowledgements
This study was funded by the Cedar Sinai Community Benefit Giving Office. The authors also appreciate Maura Georges for providing advice and feedback on this manuscript.
Funding
Cedar Sinai Community Benefit Program.
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KLS: study design, recruitment, data collection, analysis, manuscript development. FS: recruitment, analysis, manuscript development. MK: study design, recruitment, analysis, manuscript development. SDB: study design, analysis, manuscript development. SAL: study design, recruitment, data collection, analysis, manuscript development.
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The study [00001522] was approved by the Research Integrity and Oversight Office, Institutional Review Board at the University of Houston.
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Focus group participants provided written consent to participate in this study while virtual focus group participants and key informants were given the informed consent via e-mail and provided verbal consent, documented on the audio recording.
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Smith, K.L., Shipchandler, F., Kudumu, M. et al. “Ignored and Invisible”: Perspectives from Black Women, Clinicians, and Community-Based Organizations for Reducing Preterm Birth. Matern Child Health J 26, 726–735 (2022). https://doi.org/10.1007/s10995-021-03367-1
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DOI: https://doi.org/10.1007/s10995-021-03367-1