Obstetrics
General Articles
Snapshot of Maternal Health Inequity, Advisory Board, Quick resource guide with an overview of maternal health inequity based on race in the US.
Social Determinants of Pregnancy-Related Mortality and Morbidity in the United States:A Systematic Review (2020), In this systematic review 58/67 studies found an association between minority race or ethnicity with pregnancy-related mortality and severe maternal morbidity (also associated with insurance status and education).
Reduction of Peripartum Racial and Ethnic Disparities: A Conceptual Framework and Maternal Safety Consensus Bundle, This concept article was created by a multidisciplinary workgroup as background material for the “Reduction of Peripartum Racial and Ethnic Disparities Patient Safety Bundle” .
Social Cases
NEJM case studies: Reproductive (In)justice
NEJM Case Studies: Social Distance and Mobility- a 39 year old pregnant migrant farmworker
Podcasts and Videos
How Racism Kills Black Americans
COVID-19 and Public Health, AAMC, Podcast
Black Voices in Healthcare, the Nocturnists
Lecture (EFA OBGYN) Incarceration and Health
How Racism Makes us Sick, a TEDMED2016 Talk by David Williams
The PRAXIS Examining Racism in Medicine Podcast
Arch Beat: Dr. Rachel Hardman Talks Birth and Race Outcomes Podcast
History and Social Sciences of Motherhood and Slavery
(Recommendations by African American Intellectual History Society)
The Nameless and Forgotten: Maternal Grief (2017)
Maternal Struggles and the Politics of Childlessness Under Pronatalist Caribbean Slavery, 2017
Naming Institutionalized Racism in the Public Health Literature: A Systematic Literature Review
Medical Violence, Obstetric Racism, and the Limits of Informed Consent for Black Women
Indigenous and Black Birth Stories
Severe Maternal Morbidity and Mortality Among Indigenous Women in the United States The incidence of severe maternal morbidity and mortality was elevated among indigenous women compared with white women. Incidence was highest among rural indigenous residents. Efforts to improve maternal health should focus on populations at greatest risk, including rural indigenous populations.
American Indian and Alaska Native Women’s Maternal Health: Addressing the Crisis This article describes the predominant barriers to care for American Indian and Alaska Native women during pregnancy and childbirth. It also highlights several national and state level policy changes that could improve outcomes for American Indian and Alaska Native women.
Tapping Tribal Wisdom: Providing Collaborative Care for Native Pregnant Women with Substance Use Disorders and Their Infants This article reviews the main results from a listening tour conducted with five tribal sites in Minnesota that received the In-Depth Technical Assistance grant to address substance abuse during pregnancy and the postpartum period.
Racial Differences in Birth Outcomes: The Role of General, Pregnancy, and Racism Stress,2010, These were among the first findings indicating the significance of psychosocial factors that occur early in the life course for birth outcomes. Experiencing perceived racism was a significant predictor of low birth weight in African Americans, but not in non-Hispanic Whites.
Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization, Khiara M Bridges (2011), This book explores the role of race in the medical setting, based on a large NYC public hospital. Khiara M. Bridges investigates how race―commonly seen as biological in the medical world―is socially constructed among women dependent on public OB care.
Medical Bondage: Race, Gender, and the Origins of American Gynecology, Deirdre Cooper Owens (2017), This book examines a wide range of literature to show how gynecologists created and disseminated medical fictions about black patients, such as their belief that black enslaved women could withstand pain better than white "ladies”.
Black maternal and infant health: historical legacies of slavery, 2019, This article describes how the legacies of slavery are seen today in structural racism that has resulted in disproportionate maternal and infant death among African Americans. The authors describe how disparities are rooted in the commodification of enslaved Black women’s childbearing and physicians’ investment in serving the interests of slaveowners. They argue that public health initiatives must address institutionalized racism and implicit bias in medicine to decrease health disparities, and that doctors must decolonize obstetrics and gynecology specifically.
VBAC calculator (now changed as of May 2021 to no longer include race variables), the article associated with the change, and an article on issues with race-based medicine.
Examining the Lived Experience of Care: Voices Seldom Heard - Dr Saraswati Vedam - YouTube
Associate Providers and Birth Centers for Racially Concordant Care
All my babies...a midwife's own story’, preserved in the National Film Registry; full-length, 1 hour long movie online in the Library of Congress film archive: https://www.loc.gov/item/2017604960
Where did the Granny Midwives Go? documentary courtesy of Timeline (from Medium) https://timeline.com/granny-midwives-rural-south-87a27ba13dd1
The Experience and Motivations of Midwives of Color in Minnesota: Nothing for Us Without Us, This article focuses on midwives who identify as African American.
Experiences of Community Doulas Working with Low-Income, African American Mothers, This is a qualitative study involving thematic analysis of interviews with Doulas to determine the components of their services that might best serve low-income, African American women.
The Birth Sisters Program: A Model of Hospital- Based Doula Support to Promote Health Equity, This article describes an innovative, hospital-based doula model serving a racially diverse, low-income population. The program’s history, model, administration requirements, training, and evaluations are described.
Advancing Birth Justice: Community-Based Doula Models as a Standard of Care for Ending Racial Disparities, This document outlines the ways in which community-based doula programs in New York State have been developed to serve families most at risk for poor maternal and infant health outcomes. It also outlines successful elements of community-based doula trainings and practices that help to reduce disparities.
Race and Health, and Doulas for Social Justice, This is a blogpost in Nonprofit Quarterly as a part of their Equity, Diversity and Inclusion Project written by a Doula who discusses the difficulties of providing equitable doula care in the United States.
Birth Settings in the United States, This national report describes the ongoing inequities surrounding childbirth in the U.S. For the report, the authors examined hundreds of articles documenting birth outcomes in three settings: hospitals, birthing centers and home births, and compared them with the medical literature from other countries whose birth outcomes are better than in the U.S.
Roots Community Birth Center: A culturally-centered care model for improving value and equity in childbirth, This article describes the development and organizational structure of Roots Community Birth Center, an African American-owned, midwife-led freestanding birth center in North Minneapolis.
Meet The Midwife Starting The First Native American Birth Center, This is an article describing the first Native American Birth Center in the U.S, founded with the goal of providing Native American women with prenatal education and modern medical support, while also preserving traditional teachings and practices. Changing Women Initiative: Birth Center for Navajo Women and an article on its foundation.
Identifying the Key Elements of Racially Concordant Care in a Freestanding Birth Center, This study utilized individual interviews to identify the aspects of care that are the most important for African American clinicians providing care for African American patients at a birth center in Minneapolis
Breastfeeding (Courtesy of TheBlackOBGYN project)
DeVane-Johnson et al. (2018). A Qualitative Study of Social, Cultural, and Historical Influences on African American Women's Infant-Feeding Practices. The Journal of perinatal education, 27(2), 71–85. https://doi.org/10.1891/1058-1243.27.2.71 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388681/
Johnson et al. (2015). Enhancing breastfeeding rates among African American women: a systematic review of current psychosocial interventions. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 10(1), 45–62. https://doi.org/10.1089/bfm.2014.0023 ; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307211/
Racial and Geographic Differences in Breastfeeding in the United States, 2011–2015 (2017) https://www.cdc.gov/mmwr/volumes/66/wr/mm6627a3.htm
Chocolate Milk: The Documentary PROMO
Postpartum Care
Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women, Suboptimal treatment was prevalent among all low-income women in the study. However, racial and ethnic disparities in the initiation and continuation of postpartum depression care were predominant and according to the authors warrant clinical and policy attention.
Racial and Ethnic Differences in Factors Associated With Early Postpartum Depressive Symptoms, African-American and Hispanic women more commonly reported postpartum depressive symptoms (43.9% and 46.8%, respectively) than white women (31.3%, P < .001).
Immigration, Race/Ethnicity, and Social and Economic Factors as Predictors of Breastfeeding Initiation,. The researchers found that immigration status was strongly associated with increased breastfeeding initiation in this cohort, as immigrants of all races/ethnicities initiated breastfeeding more often than their US-born counterparts. This result implies that cultural factors are important in the decision to breastfeed.
Racism, Bias, and Discrimination as Modifiable Barriers to Breastfeeding for African American Women: A Scoping Review of the Literature, Health care providers' biased assumption that African American women would not breastfeed affected the quality of breastfeeding support provided to them.
Racial and Geographic Differences in Breastfeeding — United States, 2011–2015, This national report from the CDC examines rates of breastfeeding in each state.
Skimmed: Breastfeeding, Race and Injustice, The book uses the story of America's first surviving set of identical quadruplets, born into a poor Black family in North Carolina in 1946, to illustrate how companies selling baby formula and pediatricians of that era pushed black mothers away from breastfeeding.
Racial Disparities in Postpartum Pain Management: Original Research, 2019,A retrospective chart review of a single tertiary care medical center that looked at racial and ethnic disparities in postpartum pain management, specifically looking at perceived pain scale at discharge, inpatient opioid use, and prescription for opioids for home. The conclusion was that there were notable differences for women of color not explained by just increased perceived pain.
Birthing While Black, A narrative piece in Harper’s that explores a mother’s story about her delivery at a major institution and her mixed emotions around her new bundle of joy and the journey to delivery.
Impact of breastfeeding interventions among United States minority women on breastfeeding outcomes: a systematic review : This systematic review (SR) was designed to answer the question: What is the impact of breastfeeding interventions targeting ethnic/racial minority women in the U.S. on improving BF initiation, duration and exclusivity rates?
Resource list from LOOM, a wellbeing platform, by Dr. Erica Cahill nad Erica Chidi. LOOM Antiracist Birth Preferences - Neutral (mcusercontent.com)