For birthing persons of color, culturally-centered care enhances feelings of respect and autonomy.
Pregnancy-related problems kill up to three times as many black and indigenous birthing persons as they do white counterparts. Alternative care models centered on the birthing person’s culture and relationships, according to University of Minnesota (U of M) researchers working with Roots Community Birth Clinic (Roots) in Minneapolis, may be able to improve the birthing person’s experiences and health during pregnancy.
The study, led by former University of Minnesota Medical School researcher Jennifer Almanza, drew data from a larger project with Roots led by senior author, School of Public Health Associate Professor, and Blue Cross Endowed Professor of Health and Racial Equity Rachel Hardeman, and predoctoral trainee J’Mag Karbeah, which was published in the Maternal and Child Health Journal.
«The results of this study strongly imply that investing in culturally-centered practices like those utilized at Roots Community Birth Center could result in better outcomes for BIPOC birthing people,» Karbeah stated.
Abuse in health care settings may be one cause of reproductive health disparities among birthing individuals, with Black, Indigenous, and People of Color (BIPOC) people reporting instances of mistreatment in hospitals two to three times as often as white peers. More than 98 percent of births in the United States take place in hospitals, yet Roots demonstrates that community clinics can be a better option for birth outcomes.
«This study extends earlier findings that community birth center care provides greater experiences in autonomy and respect by claiming that when that care is delivered with a culturally-centered manner, BIPOC experiences are even better,» Almanza said. «It also reveals that, regardless of ethnicity, birthing people have higher levels of autonomy and respect when they are given care that is centered on their cultural values.»
The study compared sentiments of autonomy and respect during delivering experiences from persons who received care from Roots to the national Giving Voice to Mothers study, which primarily examines women giving birth at hospitals where this type of care is not emphasized.
The study found that:
When compared to participants in the national survey, BIPOC clients reported experiencing more autonomy and respect when they got culturally-centered care at the Roots clinic.
Reduced disparities in how BIPOC clients feel about autonomy and respect could improve their overall prenatal care experience.
When compared to treatment in the dominant, hospital-based system, the findings reflect earlier research findings demonstrating that giving birth at a community birth center protects against prejudice.
«What this study supports is what those of us working in reproductive and sexual health already know: culture is therapeutic, not a risk factor for poor health outcomes,» Almanza said. «As we realign medical practices to recognize that race should not be factored into risk-factor algorithms—and that modern epidemiology and public health can provide a more comprehensive understanding of disparate outcomes—we must also amplify solutions that are rooted in culture and created by those who are most impacted.»
The researchers suggest that reimbursement policies for maternal health care should include an emphasis on making community births more sustainable, particularly for BIPOC provider-owners who deliver culturally-centered care.
They also believe that future trials of culturally-matched care as an intervention to improve client experiences and perinatal outcomes should take into account baseline disparities between those who receive culturally-matched care and those who do not.