Women's Satisfaction With Birth Experience According to Skin Color: A Cross-Sectional Study

Racial disparities negatively impact health issues, and racism is associated with worse maternal health outcomes. Satisfaction with childbirth is influenced by many factors according to women's preferences and sociocultural beliefs. A positive birth experience allows for improving healthcare and promoting health. The study aim is to evaluate women's satisfaction with the labor and birth experience according to skin color.

Cross-sectional study with postpartum women who gave birth in a tertiary hospital. To assess satisfaction with childbirth, we applied the Mackey Satisfaction Scale. For statistical analysis, women's skin color was categorized into Black and non-Black. We categorize as Black people all persons who identify as Black and Brown. Sociodemographic and obstetric data were obtained from a collection form. For bivariate analysis, we used chi-square or Fisher's exact and the Mann-Whitney tests. The significance level was 5%, and the software used was SAS 9.4.

A total of 300 postpartum women were included, 182 (60.7%) black skin color. Black women were less satisfied with the ability to deal with contractions (p = 0.046), comfort and well-being during labor (p = 0.035), control of actions during labor (p = 0.003) and delivery (p = 0.03), number of explanations received from the nursing staff (p = 0.039), physician's attitude (p = 0.023), and lower overall satisfaction with the birth experience (p = 0.013) compared to non-Black women. Black women had a lower overall satisfaction score (p = 0.011) and self-subscale score (p = 0.02).

Black women had lower satisfaction scores with birth experience compared to non-Black ones. Reducing racial disparities in health is essential to improving obstetric assistance and care satisfaction.