Traversing traditions: Prenatal care and birthing practice preferences among black women in North Florida

Abstract

Objectives: Our goal was to explore prenatal practices and birthing experiences among Black women living in an urban North Florida community. Design: Non-random qualitative study. Setting: Private spaces at a convenient location selected by the participant. Participants: Eleven Black women, aged 25-36 years, who were either pregnant or had given birth at least once in the past five years in North Florida. Methods: Semi-structured interviews were completed in July 2017, followed by thematic analysis of interview transcripts. Results: Four main themes emerged: a) decision-making strategies for employing alternative childbirth preparation (ie, midwives, birthing centers, and doulas); b) having access to formal community resources to support their desired approaches to perinatal care; c) seeking advice from women with similar perspectives on birthing and parenting; and d) being confident in one’s decisions. Despite seeking to incorporate “alternative” methods into their birthing plans, the majority of our participants ultimately delivered in-hospital. Conclusions: Preliminary results suggest that culturally relevant and patient-centered decision-making might enhance Black women’s perinatal experience although further research is needed to see if these findings are generalizable to a heterogenous US Black population. Implications for childbirth educators and health care professionals include: 1) recognizing the importance of racially and professionally diverse staffing in obstetric care practices; 2) empowering patients to communicate and achieve their childbirth desires; 3) ensuring an environment that is not only free of discrimination and disrespect, but that embodies respect (as perceived by patients of varied racial backgrounds) and cultural competence; and, 4) providing access to education and care outside of traditional work hours.