Black mothers’ birthing experiences: in search of birthing justice

ABSTRACT

Objectives

Previous studies have suggested that often, Black mothers’ birthing experiences are not what they expected because of how they were treated by healthcare providers during labor and birth. Our goal in this study was to ask Black mothers who had recently given birth about the quality of their birthing experiences as well as their level of respect from, trust in, and satisfaction with their maternity healthcare providers.

Design

This study gathered data from Black mothers (N = 209) who had given birth within the past two years, using a cross-sectional online survey measuring several variables about the birthing experience including types of healthcare provider communication, provider respect for the mother, trust, birth satisfaction, and emotional responses to birth.

Results

Provider-centered communication, although preferred by some mothers, was associated with lower birth satisfaction and stronger negative emotions whereas positive birth satisfaction was linked to patient-centered communication which resulted in positive emotions. While most mothers reported overall satisfaction with their birth experience, nearly half reported experiencing some degree of disrespect from their healthcare providers during labor and birth. Moreover, trust and respect mediated the relationship for patient-centered communication with positive emotion and birth satisfaction. Over one-third of participants gave birth with a certified nurse midwife attending. There were no differences in perception of being respected or the quality of birth given the professional identity of the provider as an Obstetrician/Gynecologist or as a midwife. The advice suggested by Black mothers for their healthcare providers was instructive in identifying ways those providers could better serve their patients during birth.

Conclusion

This study showed that there is still additional work that needs to be done for racial equity and respect during birth. Practical implications for addressing health inequities are discussed.

KEYWORDS:

• Black mothers
• obstetric violence
• harms to Black mothers
• Reproductive Justice
• racial equity in childbirth
• healthcare providers and Black mothers

Acknowledgements and funding

Thank you to the 209 Black mothers who agreed to participate in this study.

Disclosure statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Availability of data and materials

These are available from the corresponding author

Ethics approval

The study received approval from Michigan State University’s Institutional Research Review Board (Study #00006187, granted exempt review 4-27-2021).

Additional information

Funding

This work was supported by Marjorie A. Holmes College of Nursing Endowed Faculty Enrichment Award at Michigan State University: [Grant Number none].