In the U.S., infant mortality and health outcomes during and after pregnancy for black women are poor and, in some areas, dip to levels below that of developing countries. One way to improve the health of black women and their babies is to strengthen the interpersonal relationship and cultural understanding between providers and patients. 

A new study led by researchers at the School of Public Health recently identified key culturally sensitive values and practices among providers at a successful freestanding birth center serving a diverse urban community. The study, led by PhD student J’Mag Karbeah and co-authored by Assistant Professor Rachel Hardeman and Associate Professor Katy Kozhimannil, was recently published in the Journal of Midwifery & Women’s Health. 

The researchers conducted semistructured interviews with midwives, student midwives and doulas who either worked at or worked closely with an African American‐owned birth center in north Minneapolis, Minnesota.

The interviews revealed four key themes in the ways the providers support their patients with racially concordant care:

• Providers recognize that it’s important to understand a mother’s culturally specific identity and needs, such as adhering to a special ethnic diet during pregnancy.
• Providers see offering high-quality pregnancy care to minority populations as a way to uphold reproductive and racial justice.
• Providers empower patients by letting them know they trust their judgement and believe their patients usually know what is best for them. 
• Providers practice cultural humility by acknowledging differences between themselves and their patients — such as ethnicity or economic status — and take time to understand what a mother feels is important to know about their particular cultural background.

 “These practices allow providers to engage in the patient’s cultural identity, which allows everyone to be a decision-maker and play an active role in the pregnancy,” says Karbeah.

According to the researchers, the study also highlights the necessity to increase racial and ethnic diversity among the nation’s midwifery workforce due to changing demographics in many states, including Minnesota.

In the meantime, Karbeah encourages all providers to view their patient’s cultural identity as an asset and work collaboratively to incorporate it into their care. “If they do that, the provider-patient relationship becomes stronger, patients trust their providers more, which improves the health of black mothers and their babies.”

This study is part of a larger research project funded by the Robert Wood Johnson Foundation’s Interdisciplinary Research Leaders (IRL) program. The goal of the project is to investigate the ways that community-connected and culturally centered clinical and support services can address the social determinants of health and birth outcomes that have produced disparities for African American mothers and babies for more than a century.