Experiences of Non-Hispanic Black and African American Women with Postpartum Healthcare

Abstract

Racial and ethnic disparities in maternal mortality and morbidity are stark in the United States, especially for non-Hispanic Black and African American women who experience elevated rates of pregnancy-related deaths and severe maternal morbidity. Effective postpartum healthcare is essential for preventing pregnancy-related deaths, successfully managing complications, and optimizing childbearing women’s health, yet little is known about non-Hispanic Black and African American women’s experiences with postpartum healthcare in the year following delivery. The purpose of this study was to describe non-Hispanic Black and African American women’s experiences with postpartum healthcare throughout the one-year postpartum period from their perspectives. Semi-structured interviews were conducted with 20 postpartum non-Hispanic Black and African American women in Indiana within 12 months of childbirth. The participant narratives were analyzed using qualitative content analysis. Participants identified eight types of positive experiences and eight types of negative experiences interacting with healthcare providers, nine types of healthcare facilitators and 12 types of healthcare barriers encountered during the one-year postpartum period, and eight recommendations for improving postpartum healthcare. The findings revealed (1) participants’ feelings about their postpartum healthcare were primarily influenced by relational experiences with providers (e.g. feeling attended to or dismissed) and whether their care needs were or were not met by providers, and (2) participants’ experiences accessing healthcare were primarily influenced by health system factors (e.g. having or not having enough appointments), resource and practical factors (e.g. childcare), and financial and insurance factors (e.g. having health insurance). The study results provide preliminary insights into non-Hispanic Black and African American women’s experiences with healthcare in Indiana during the one-year postpartum period and suggest there may be multiple opportunities throughout the postpartum year for healthcare providers and the health system to optimize this population’s healthcare experiences.