Maternity Care Experiences of Non-Hispanic Black Women in Southern US Maternity Care Settings

The United States (US) reports disparities in maternal health outcomes across states, regions, and racial/ethnic groups. Few studies in the US South have sought to understand the perspectives of Non-Hispanic Black (NHB) women about their experiences of maternity care. This study examines NHB women's maternity care experiences in three Southern states.

Through in-depth interviews (February-September 2023), we explored maternity care experiences of NHB women experiencing adverse maternal outcomes (n = 18), and family members of deceased NHB women or infants (n = 2), in Alabama, Georgia and North Carolina. Grounded in the World Health Organization's Quality of Care Framework for Maternal and Newborn Health Care, our study elucidated the experiences of these NHB women and family members with racial and other discrimination, and their preferences for treatment during maternity care. We adopted a mixed deductive and inductive thematic approach to analyze the data using NVivo software.

Three major themes emerged: 1) experience of care, 2) perceptions of racial and other discrimination during maternity care, and 3) preferred manner of treatment in maternity services. Perceptions about discrimination due to race and other identities were shared. Issues related to provider-patient communication, respect, and emotional support were identified as main factors that influenced NHB women's experiences of maternity care.

Both positive and negative maternity care experiences, including instances of overt racism and discrimination were reported by NHB women and families who had experienced adverse pregnancy outcomes. Our findings highlight the need to prioritize respectful maternity care through targeted quality measures.