Research Project
Obstetric Disruptions: How COVID19 has exacerbated structural violence and maternal stress for the Black birthing community in Chicago and implications for future public health crises
The COVID19 pandemic may exacerbate maternal health inequities by disrupting obstetric care, increasing maternal stress and amplifying structural violence against Black women. In Chicago, maternal morbidity and mortality is 6 times more likely among Black birthing people than white, despite policy initiatives to promote maternal health equity. Disparities in maternal morbidity and mortality reflect experiences of structural violence in health care -- including limited patient-centered care, insufficient coordination and continuity of care, and implicit bias resulting patient mistrust in the health care system, low engagement, and attendance in perinatal care...
- Principal Investigator
- Liese, Kylea Laina
- Start Date
- 2021-07-01
- End Date
- 2024-06-30
- Funding Source
- Center for Health Equity Research Chicago
Abstract
The COVID19 pandemic may exacerbate maternal health inequities by disrupting obstetric care, increasing maternal stress and amplifying structural violence against Black women. In Chicago, maternal morbidity and mortality is 6 times more likely among Black birthing people than white, despite policy initiatives to promote maternal health equity. Disparities in maternal morbidity and mortality reflect experiences of structural violence in health care -- including limited patient-centered care, insufficient coordination and continuity of care, and implicit bias resulting patient mistrust in the health care system, low engagement, and attendance in perinatal care. In our preliminary study, we found that pregnant people who experienced multiple disruptions in their obstetric care (e.g., changes in high-risk monitoring, restrictions on support people in labor, transitions to telehealth for prenatal visits) experienced higher levels of stress. These obstetric disruptions, defined as disruptions in obstetric and social experiences and expectations related to pregnancy, sustained throughout and beyond the COVID-19 pandemic, may amplify existing maternal health disparities. It is essential to understand how obstetric disruptions – whether caused by the current pandemic or other sociopolitical and public health crises - affect access to high quality perinatal care, maternal stress, and perinatal outcomes in Chicago’s Black birthing community. In this study, we will use validated psychometric instruments, semi-structured interviews, and a biomarker of chronic stress in maternal hair samples to capture how stressors related to obstetric disruptions impact maternal stress and perinatal outcomes as the pandemic unfolds for a sample of 60 Black pregnant people seeking care at the University of Illinois Hospital and Health Sciences System (UIHHSS). Using these data, we will pilot a postnatal support group led by our community partner, Melanated Midwives, to examine the feasibility and acceptability of an intervention aimed at buffering the impacts of structural violence and obstetric disruptions in the Black birthing community. We expect to inform future policy initiatives that seek to improve health care system responses to public health crises among minority communities in Chicago.