MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Applying a critical race lens to relationship-centered care in pregnancy and childbirth: An antidote to structural racism

Citation Type: Journal Article

Publication Year: 2020

DOI: 10.1111/birt.12462

Abstract: Achieving racial equity in childbirth care is critical to the health and well-being of our nation. Black infants are more than twice as likely as White infants to die before reaching their first birthday, and Black individuals who experience reproduction are 3-4 times more likely to experience a complication or death related to childbirth. 1 These inequities are one clear manifestation of structural racism-a form of racism that lacks an identifiable perpetrator but is instead the codification and legalization of society's unequal allocation of resources and opportunity based on an established racial hierarchy. 2,3 Clinical care during pregnancy and childbirth is an important determinant of perinatal-infant outcomes; however , for Black birthing people, care in the medical context does not consistently meet their clinical needs. 4 In addition, racial discrimination and experiences of interpersonal racism such as implicit racial bias and microaggressions during clinical encounters create disproportionate barriers to high-quality , respectful, patient-centered care experienced by Black people. 5-8 Perinatal care, as currently designed and delivered in most settings in the United States, has proven woefully inadequate for addressing structural and interpersonal racism in the day-today experiences of Black birthing people and in their encounters with the health care system. 8-11 Health care services that are grounded in relationships that acknowledge dynamics of power and that foster mutual respect may help shift pernicious patterns of racial inequity in perinatal care and childbirth. The patient-clinician relationship is central to achieving high-quality perinatal care. Indeed, relationships provide the context for many important functions and activities in health care. 12 Relationship-centered care-a theoretical concept introduced in 2006 by Beach and colleagues, can be defined as care in which all participants appreciate the importance of their relationships with one another. 12 To date, few scholars have explored this concept, and despite a considerable body of relationship-centered care literature devoted to prenatal and perinatal care, there is very little written about what constitutes relationship-centered care specifically for Black birthing people. 13 Racial identity and experiences of racism influence the care Black birthing people desire-this suggests that meaningful care for this population needs to incorporate not only a relationship-centered care approach, but also anti-racism-based theoretical approaches that focus specifically on the experiences of Black parenthood. 10,14 This call to action describes Beach and colleague's four principles of relationship-centered care through a critical race lens in the context of pregnancy and childbirth care. Taken together, the two concepts-relationship-centered care and critical race theory-have the potential to powerfully reduce racism's impact on childbirth outcomes for Black birth-ing individuals, infants, and families.

User Submitted?: No

Authors: Hardeman, Rachel; Karbeah, J’Mag; Kozhimannil, Katy B.

Periodical (Full): Birth

Issue:

Volume: 47

Pages: 3-7

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop