Counseling advocacy: seeking justice for black birth equity

ABSTRACT

Black women and infants are up to 3.5 times more likely to die due to birth-related complications than their White and Hispanic counterparts. Research points to complex racial and social inequities, including inadequate perinatal mental health care, as primary contributors to the gap in birth outcomes. During pregnancy, untreated perinatal mood and anxiety disorders are associated with adverse birth outcomes and, therefore, contribute to increased mortality and morbidity risks for Black mothers and their infants. Cultural competency is empirically supported as a framework for reducing racial health disparities. Professional counselors are well-positioned to play a vital role in addressing perinatal mental health disparities impacting Black women. This article provides a contextual overview of the intersecting perinatal medical and mental health disparities affecting Black women and discusses implications for counselor advocacy.

KEYWORDS:

• Counseling racism
• social justice
• black birth equity

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Definitions of Terms

This section provides operational definitions for key terms used in this paper.

Adverse Birth Outcomes. Complications that occur during childbirth, including preterm birth, low birth weight. These outcomes contribute to infant death before one year of age or infant mortality Centers for Disease Control and Prevention, 2021a.

Health Disparities. Health disparities refer to the unequal distribution of disease and mortality across different groups that are unavoidable and unjust (Adler, 2009).

Infant Mortality. Death of an infant before the first year of age (Centers for Disease Control and Prevention, 2021a).

Infant Mortality Rate (IMR). The rate of infant deaths per 1,000 live births (Centers for Disease Control and Prevention, 2021a)

Low Birth Weight (LBW). Infant birth weight that is less than 2500 grams or 5.5lbs. (WHO, 2021)

Maternal Mortality. The death of a woman during pregnancy, during delivery, or within the first year of childbirth. The maternal mortality rate (MMR) is the rate of maternal deaths per 100,000 live births (Centers for Disease Control and Prevention, 2021b).

Multicultural counseling. “A helping role and a process that uses modalities and defines goals consistent with the life experiences and cultural values of diverse clients” (Sue & Sue, 2008, p. 749).

Perinatal. Perinatal refers to the period of pregnancy through the first year of Childbirth (Postpartum Support International (PSI), 2015).

Perinatal Health. “Perinatal health refers to issues affecting women before, during, and after childbirth” (Association of Maternal & Child Health Programs, 2021, n.p.).

Perinatal Mental Illness. “Perinatal mental illness refers to psychiatric disorders that are prevalent during pregnancy and as long as 1 year after delivery” (O’Hara & Wisner, 2014, p. 2).

Perinatal Mood and Anxiety Disorders (PMAD). A spectrum of mental disorders occurring during pregnancy through the postpartum period, including depression, anxiety, bipolar disorder, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and postpartum psychosis (Postpartum Support International (PSI), 2015).

Perinatal Period. The periods of pregnancy and up to one year after childbirth (WHO, 2021).

Preterm Birth (PTB). Delivery of an infant before 37 weeks of gestation (WHO, 2021).

Very Low Birth Weight (VLBW). Infant birth weight that is less than 1500 grams or 3.3lbs. (WHO, 2021).