Exploring Experiences of Structural Racism and its Influence on Maternal and Child Health. (27th October 2020)

• Record Type: Journal Article
• Authors: Bower, Kelly; Robinson, Kelley; Alexander, Kamila; Weber, Brielle; Hough, Keyona; Summers, Amber
• Is Part Of: Journal of midwifery & women's health. Volume 65:Number 5(2020)
• Page Start: 718
• Page End: 719
• Publication Date: 2020-10-27
• Subjects: Midwives -- Periodicals; Obstetrics -- Periodicals; Women's health services -- Periodicals; 618.2
• DOI: 10.1111/jmwh.13180
• Languages: English
• ISSNs: 1526-9523

Abstract

Abstract : Introduction: Systematic racism and racial discrimination have been proposed as significant risk factors that contribute to health disparities in maternal and child health outcomes for African American families. There is evidence to suggest that racism is associated with poor birth outcomes. Most studies have examined the role of interpersonal racism, whereas few explore the role of systemic racism. Additionally, few studies have examined the mechanisms by which systemic racism impacts health from the perspective of those affected. This study explored the systems and aspects of structural racism affecting racial inequities in birth outcomes in Baltimore City. Results: In this qualitative study, we conducted 3 focus groups with Baltimore City residents (n = 20) and 2 focus groups with maternal, infant, and early childhood home visiting program staff (n = 18). Participants were asked to identify and unpack the systems external to the community that create the current realities of racial inequities in birth outcomes in Baltimore City. Focus groups were recorded, transcribed, and coded to identify themes. Methods: A variety of systems were identified as playing a role in the health of pregnant and postpartum people and infants including: medical, justice, government, neighborhood environment, schools, and commercial/retail. For most systems, racism was described as acting by way of: the quality and availability of goods and services; bias, stereotyping, and racial profiling; and power imbalance. Within the health care system, participants commonly reported experiencing disrespectful medical care and described the ways in which it impacts their health. Discussion: Midwives, nurses, and other health care professionals have a role to play in undoing systemic racism. Understanding the sources and mechanisms by which systemic racism affects the lives of childbearing families is foundational to that work.