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Research Project

Melanated Maternity Care

Principal Investigator
Pearson, Pamela
Start Date
End Date
Funding Source
Rita & Alex Hillman Foundation


National maternal death rates for Black women are 3-4 times higher than for white women; in Chicago they are six times higher, with more than half of these deaths deemed preventable. These disparities hold for Black women regardless of age, income, and education. Black women also experience more severe maternal morbidity, life-threatening complications that are caused or exacerbated by pregnancy, at every point along the pregnancy continuum. More than ⅔ of all pregnancy related deaths take place in the postpartum period. The leading causes of preventable death in the postpartum period are suicide, drug use, and cardiomyopathy. In addition, 54% to 78% of pregnant Black women report disrespectful and racist treatment in maternity care, which exacerbates maternal risk through mistrust the healthcare system and delays in diagnosis and treatment. Interventions that provide non-discriminatory postpartum care for Black mothers are necessary to decrease maternal death. After birth, standard postpartum care fails to provide sufficient coordination with mental health, specialty care and wrap-around services. Melanated Maternal Community Caregivers (MMCC) is a nurse-driven, community-based model of postpartum care that expands the roles of certified nursing assistants (CNAs) to provide Black mothers with racially concordant in-home postpartum support and linkages to wrap-around services and the health care system. Racial concordance between the CNAs and mothers is supported by studies demonstrating Black women feeling safe and more connected with providers of color and/or fearful of receiving judgement from white providers. Black women rarely have this option during pregnancy since less than 6% of nurse-midwives and 11% of obstetricians identify as Black. Incorporating Black CNAs promotes health equity by providing an innovative pathway for CNAs, who represent more racial diversity than nurse-midwives, to gain experience, training and connection with the midwifery model of care – thereby supporting future diversification of midwifery. MMCC has strong potential for scale-up since Illinois is the first state to provide continuity of full Medicaid benefit coverage for mothers by offering extended eligibility for a woman during the entire first year after delivery. A second bill has been signed into law and is awaiting appropriation that will allow in-home postpartum doula support to be covered under Medicaid. Research Objective: Our goal is to determine the feasibility and acceptability of training Black CNAs to provide racial concordant in-home postpartum care for Black mothers. Building on strong community partnerships and guided by social models of behavior change, outcomes of this study will support a clinical trial to test the benefit of MMCC for improving maternal and infant outcomes among Black families in the first year postpartum.