Improving communication could promote positive birth experiences for Black birthing people

This study explored the perspectives of Black birthing people on how better communication with care teams may have improved their birth experiences. Researchers interviewed 30 non-Hispanic Black, English-language–proficient, low-income birthing people in the Philadelphia, Pennsylvania, area, all of whom were insured by Medicaid. All gave birth to preterm infants before 34 weeks gestation, or before 36 weeks gestation to birthing people with a modifiable risk factor such as high blood pressure. The interviews uncovered three main themes regarding the quality of communication with their care teams and the effect on their experiences: 1) communication gaps during urgent or emergent intrapartum procedures contributed to negative birth experiences; 2) postpartum opportunities to share birth experiences, particularly with peers, sometimes mitigated the psychological consequences of negative birth experiences; and 3) interviewees did not consistently discuss concerns about future pregnancy risk related to negative birth experiences with their clinical teams.

What we know: Physically or psychologically distressing birth experiences can influence postpartum health, parenting efficacy, and future pregnancy plans. Obstetric racism, in the form of interpersonal racism (e.g.,the effect of clinician bias on relationships and communication with patients) and/or structural racism (underfunded and/or understaffed facilities serving predominantly Black populations), may create negative birth experiences for Black birthing people.

What this study adds: This study adds an important patient perspective on racial inequities in maternal health care in the U.S. The findings suggest that health systems could promote positive birth experiences for Black birthing people by improving communication during emergency intrapartum procedures, fostering a welcoming environment for sharing their birth experiences, and promoting ongoing conversations with care teams about future pregnancy risks they may face.