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Cultural Brokering in Pregnancy Care: A Qualitative Study
Lauren Spigel1,2, Maria Bazan3,4, Ami Karlage1
1Ariadne Labs at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Birth (Berkeley, Calif.)
|April 19, 2025
Summary
Cultural brokers are vital in pregnancy care for patients with limited English proficiency (LEP), offering bridging, language, social support, navigation, and advocacy. Integration into care teams requires training and fair compensation.
Area of Science:
- Maternal Health
- Health Equity
- Qualitative Research
Background:
- Cultural brokers facilitate communication between patients and healthcare providers, but their specific contributions to pregnancy care are not fully understood.
- Patients with limited English proficiency (LEP) face unique challenges in accessing and navigating healthcare services during pregnancy.
Purpose of the Study:
- To identify and describe the roles of cultural brokers in pregnancy care.
- To pinpoint critical moments where cultural brokers enhance care for LEP patients.
- To explore strategies for integrating cultural brokering into existing pregnancy care teams.
Main Methods:
- A descriptive qualitative study using semi-structured interviews with Spanish-speaking LEP patients, cultural brokers, and clinicians.
- Conducted in the Boston metropolitan area (December 2022 - May 2023).
- Qualitative content analysis and journey mapping were employed to analyze data.
Main Results:
- Cultural brokers performed five key roles: cultural bridging, language support, social support, health system navigation, and advocacy.
- Moments of impact included connecting patients to care, facilitating informed decisions, and supporting transitions to parenthood.
- Integration is desired but necessitates improved training, role clarity, and compensation for cultural brokers.
Conclusions:
- Cultural brokers play an essential role in supporting LEP patients during pregnancy.
- Further efforts are needed to formally recognize, value, and integrate cultural brokering services into standard pregnancy care models.
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