Black Birthing People's Perspectives on Racial Concordance With Obstetricians and Midwives

Area of Science:

• Perinatal Health
• Health Equity
• Qualitative Research

Background:

• Black birthing individuals face disproportionately high maternal mortality rates.
• Experiences of racism and discrimination significantly impact perinatal care.
• Patient-provider racial concordance is an area of growing interest in improving obstetric outcomes.

Purpose of the Study:

• To explore Black birthing individuals' perspectives on racial concordance with obstetricians and midwives.
• To understand how lived experiences with racism, discrimination, and stress influence these perspectives.

Main Methods:

• Qualitative descriptive study using semistructured interviews and focus groups.
• 32 non-Hispanic Black women who gave birth between 2019-2021 were included.
• Thematic analysis was used to identify key themes from transcribed data.

Main Results:

• Fear of dying is deeply embedded in the Black perinatal experience.
• Participants reported experiences of not being listened to, stereotyping, and difficulty finding racially concordant providers.
• Desire for racial concordance was viewed as a harm reduction strategy; self-advocacy was a key coping mechanism.

Conclusions:

• Black birthing individuals strongly prefer racially concordant obstetricians and midwives.
• Fear of dying and experiences of racism are primary drivers for this preference.
• Increasing opportunities for racially concordant obstetric care is a potential strategy for achieving equitable care.