189 - Patient-Provider Allyship as a Mitigating Factor for Maternal Fears around Pregnancy and Childbirth: A Critical Qualitative Study

Publication Number: 189.5623

Oseme P. Okoruwa, Indiana University School of Medicine, Indianapolis, IN, United States; Jasmine Johnson, Indiana University School of Medicine, Carmel, IN, United States; Sacha Sharp, Indiana University School of Medicine, Indianapolis, IN, United States; India R.. Johnson, Indiana University, Indianapolis, Indianapolis, IN, United States; Veronica Derricks, University of colorado boulder, Boulder, CO, United States; Francesca A.. Williamson, University of Michigan Medical School, Ann Arbor, MI, United States; Melissa D. Klitzman, Indiana University School of Medicine, Indianapolis, IN, United States; Taylor E. Smith, Emory University School of Medicine, Atlanta, GA, United States

Background: Black women have increased morbidity and mortality during childbirth, and Black infants have an increased risk of mortality in the United States. These findings are true despite trends of decreasing overall infant mortality. As a result of these trends, Black women have increased fear and anxiety around the childbirth process paired with the added stressors of experiencing discrimination and bias when engaging with healthcare providers. These maternal stressors, originating from racism, can lead to adverse birth outcomes as well as lasting health impacts for infants throughout childhood.

Objective: The study aimed to identify intervenable targets related to interpersonal barriers Black mothers experience when attempting to access quality maternal healthcare. Our focus was on examining how Black mothers interpret the behaviors of their obstetric providers as signaling allyship.

Design/Methods: We recruited 16 Black or African American women over the age of 18 from Marion County, Indiana to participate in focus groups and individual interviews about their pregnancy experiences. Participants were asked several questions, including the types of behaviors they believed would convey or undermine allyship. The interview data was transcribed and coded into themes using data visualization software to help draw conclusions about relationships in the data. To analyze the thematic relationships, we used Black Feminist Epistemology as a framework for understanding how the social standing of Black women affects their treatment within the healthcare system.

Results: The main theme revealed in this analysis was that Black women seek allyship with their providers and look for behaviors or language from providers to indicate that they are entering a safe space. These behaviors included allowing the mother to have a voice in medical decisions, demonstrating knowledge about Black maternal and infant health, and being responsive to patient needs – whether that is alone or with the help of a support person.

Conclusion(s): Many fears Black mothers hold around childbirth are rooted in historically poor maternal outcomes due to obstetric racism. To protect themselves and their children, Black mothers seek providers who display actions and language that indicate the provider wants to be an ally in the birthing process. This study is important for providers who play a role in obstetric and pediatric care of Black patients as it helps to understand the needs of this specific patient population to feel safe and adequately cared for during pregnancy, childbirth, and in the postnatal period.