All ETDs from UAB

Advisory Committee Chair

Janet Turan

Advisory Committee Members

Martha Wingate

Document Type

Dissertation

Date of Award

2024

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

Racism in maternity care has been identified as one of the major contributors to the persistent racial disparities in maternal health outcomes in the United States (US). Antiracism is a term used to describe the practice of actively identifying and opposing racism with the goal of changing policies, attitudes, behaviors, and beliefs that continue to foster racist ideas and actions. The results of this convergent mixed method research study reveal that racism and other forms of racial discrimination during maternity care may lead to adverse pregnancy outcomes in Non-Hispanic Black (NHB) pregnant patients in Southern US. In the first aim, I examined anti-racist attitudes in maternity workers through an online survey. Antiracist attitudes examined included their endorsement of the impact of racism in healthcare and society, and their likelihood of intervening in the case of hypothetical or actual racist incident scenarios. In the second aim, I explored the maternity care experiences of NHB women and family members of NHB decedents using qualitative research methods. This aim also elucidated their experiences with racial and other discrimination during maternity care and their preferred manner of treatment during maternity care. Findings from the first aim indicate that certain sociodemographic characteristics are associated with perception of bias training as beneficial and antiracist attitudes. The perception of bias training as beneficial was associated with race, place of highest education, and number of exposures to bias training. Antiracist attitudes were associated with job role, number of exposures to bias training, observing/witnessing a racist incident, place of education, age, and gender. Qualitatively, three main themes emerged including experiences with the quality of maternity care, perceptions of racial and other discrimination during maternity care, and preferred manner of treatment in maternity services. Integrated results of the quantitative and qualitative aims to address the study research questions provided an overall interpretation. Major recommendations include the need to incorporate bystander intervention training into bias training and to ensure that non-clinical maternity staff are included in bias training.

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