The existence of substantial racial disparities in maternal and newborn health has been a worry for decades. Obstetric outcome disparities at hospitals have an extremely negative impact on black mothers and other new parents in the US. Obstetric racism is a key factor behind health inequities in pregnancy and postpartum care, and its impact has been observed across social protections such as being married, having a high income, and being better educated. Recent research published in the Annals of Family Medicine has shown that involving community support persons (CSPs) in the birthing experience can counter obstetric racism and improve the maternal health experience for black mothers.
Role of Community Health Workers in Addressing Racial Inequalities
The role of community health workers (CHWs) has gained momentum in addressing persistent racial inequalities in healthcare. The concept of CHWs has been around for a long time and refers to individuals from the community who are trained to provide health promotion and disease prevention services in underserved communities. Research has shown that CHWs are effective in improving health outcomes, particularly among minority populations.
Can Community-Supported Individuals Alleviate Obstetric Racism?
Researchers recently looked into the possibility of reducing obstetric racism by having community support personnel (CSPs) present during hospital birth care. The study participants included 37 black cisgender women who had prior hospital births and 806 participants from 34 states and Washington, DC, who completed an online survey about their birth experiences. Of those, 89 percent reported having at least one community support person (CSP) present during labor, birth, and postpartum care.
The researchers utilized the PREM-OB Scale to evaluate three domains of obstetric racism: humanity, kinship, and anti-Black racism or “misogynoir.” These domains refer to a range of experiences, including violations of safety and accountability, disruption of community and familial bonds, and the use of societal stereotypes to perpetuate gendered anti-Black racism in hospital care.
The study found that the absence of a CSP during childbirth hospitalization was linked to less empathetic treatment, poor communication, and more violations of bodily autonomy for Black birthing individuals. Scores for all three domains of obstetric racism were higher in this group without a CSP. The presence of a community support person led to a greater reduction in kinship disruption, emphasizing the importance of involving CSPs in the birthing experience.
The Need for Democratizing Birth Spaces
The study authors emphasized the need for democratizing birth spaces in a manner that expands the understanding, recognition, and use of expertise and support. They suggested that the radical democratization of birth spaces through the prioritization of given or chosen kin as CSPs, compared with the use of doulas and perinatal support workers who require compensation, addresses structural barriers and burdens to achieving emotional and sociocultural safety such as costs, access to community birth professionals, and hospital policies that limit the type and number of visitors allowed during childbirth hospitalization.
Collaboration between Health Sector and Community Members
The researchers highlighted the importance of collaboration between the health sector and community members to improve the safety of Black birthing people in hospitals. They suggested investing in community-focused solutions, such as community health workers, perinatal support workers, and doulas, and ensuring equitable compensation for these evidence-based interventions.
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