Experiences of racial Trauma among perinatal women of color in seeking healthcare services.

OBJECTIVE: To describe the experiences of perinatal Black, Indigenous, and other People of Color (BIPOC) women in healthcare interactions. METHODS: We conducted eight virtual focus groups with perinatal BIPOC women across the USA from November 2021 to March 2022. A semi-structured interview protocol was used, and focus groups were audio recorded and transcribed verbatim. Our team used reflexive thematic analysis to analyze the qualitative data and describe our findings. RESULTS: Three latent themes emerged related to racial trauma in healthcare interactions: (1) observations and experiences of anti-Black bias, (2) experiences of dismissal of pain and withholding of care, particularly among Black and Latinx patients, and (3) common race-based traumatic experiences across all BIPOC women, including a consistent lack of bodily autonomy and deferral to White people for decision-making. Recommendations from participants included more transparent communication and greater empathic care for all patients, with calls to specifically address anti-Black bias in healthcare treatment. CONCLUSION: The study's findings suggest that perinatal healthcare needs to reduce mental stress and exposure to racial trauma for perinatal BIPOC women. This study offers a discussion of implications for future training for healthcare providers and implications for addressing systemic racial disparities in perinatal mental health.

Construction and validation of the Racially Biased Reasoning Scale: A measure of beliefs about police interactions with people of color.

OBJECTIVES: The purpose of this study was to develop and provide initial psychometric support for the Racially Biased Reasoning Scale-Police (RBias-Police). The vignette-based RBias-Police is designed to capture rigid racially biased beliefs. The items focus on police interactions with people of color as this is a particularly emotional-laden issue in the United States that signifies deeper racial and social intolerance. METHOD: Data from a combined sample of 1,156 participants were collected through Mechanical Turk for two interrelated studies. In the first study, we used matrix sampling and exploratory structural equation modeling to explore the factor structure of RBias-Police. In the second study, we conducted confirmatory factor analysis and explored the construct validity with theoretically relevant concepts. RESULTS: In Study 1, we found that 10 items with three factors solution captured the data across each of the six vignettes: (a) Minimization of Racism, (b) Target Apathy, and (c) Target Blaming. In Study 2, findings from confirmatory factor analysis supported that the three-factor model was a good fit to the data. The RBias-Police factors were positively related to color-blind racial ideology and the general belief in a just world in theoretically expected ways. CONCLUSIONS: Across two studies, our findings provide initial psychometric support for the RBias-Police; this new measure captures both affective and cognitive dimensions of biased reasoning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Navigating Pregnancy and the Healthcare System during COVID-19: A Qualitative Study with Perinatal Women of Color.

OBJECTIVE: To address health disparities in the perinatal period (i.e., during pregnancy and through one year after birth) by exploring the intersectional experiences of perinatal Black, Indigenous, and other People of Color (BIPOC) women during the COVID-19 pandemic. In this study, participants were asked if and how COVID-19 had impacted their experiences of receiving healthcare, whether they had faced any challenges during this time, how they had navigated these challenges, and what recommendations they had for improving perinatal healthcare. METHODS: Between November 2021 and March 2022 our team conducted eight virtual focus groups comprising perinatal BIPOC women. A semi-structured interview protocol was used, and interviews were voice recorded and transcribed verbatim. The data were analyzed using reflexive thematic analysis. RESULTS: Three major themes common in BIPOC perinatal healthcare experiences during COVID-19 were generated through engaging in reflexive thematic analysis: (1) an overwhelming lack of support from providers, (2) experiences of blame and shame, and (3) difficulties navigating institutional policies that were unclear or ever-changing during the COVID-19 pandemic. Recommendations from participants included greater empathic communication from providers in the face of uncertainty during COVID-19, greater access to information and guidance for caring for themselves and their babies, and an overall request for greater compassion while navigating an exciting and busy time. RELEVANCE: These findings have implications for trauma-informed and inclusive perinatal care that can reduce the impacts of systemic inequalities for perinatal BIPOC women. This study offers a discussion of implications for future training for maternal health providers and implications for community-based programs.

Exploring the Application of Intersectionality as a Path toward Equity in Perinatal Health: A Scoping Review.

OBJECTIVE: To conduct a scoping review to determine how past studies have applied the theory of intersectionality, a critical feminist research paradigm, to understand the physical health and mental health outcomes of perinatal people as a step toward addressing maternal health disparities and injustice. The study includes a review of existing research on maternal physical and mental health outcomes, presents the strengths and limitations of existing studies, and provides recommendations on best practices in applying intersectionality in research to address systemic issues and improve outcomes for the perinatal population. METHODS: We conducted an extensive literature search across four search engines, yielding 28 publications using the intersectionality framework that focused on the outcomes of perinatal people, with a total sample of 9,856,042 participants. We examined how these studies applied intersectionality and evaluated them based on three areas: conceptualization, research method, and interpretation/findings. RESULTS: Our findings indicate that maternal health researchers have provided good descriptions of the interaction of systemic inequalities and have used analysis that allows for the examination of interlocking and mutually reinforcing social positions or systems. We find that improvement is needed in the areas of conceptualization, reflexivity, and understanding of power structure. Recommendations are provided in the form of a checklist to guide future research toward an impactful approach to addressing perinatal health disparities. RELEVANCE: Our scoping review has implications for improving applied health research to address perinatal health disparities, mortality, and morbidity. Recommendations are given along with references to other tools, and a guidance checklist is provided to support scholars in creating an impactful approach to applying intersectionality in the goal of addressing maternal health disparities.