OBJECTIVE: National studies report that birth center care is associated with reduced racial and ethnic disparities and reduced experiences of mistreatment. In the US, there are very few BIPOC-owned birth centers. This study examines the impact of culturally-centered care delivered at Roots, a Black-owned birth center, on the experience of client autonomy and respect.
METHODS: To investigate if there was an association between experiences of autonomy and respect for Roots versus the national Giving Voice to Mothers (GVtM) participants, we applied Wilcoxon rank-sum tests for the overall sample and stratified by race.
RESULTS: Among BIPOC clients in the national GVtM sample and the Roots sample, MADM and MORi scores were statistically higher for clients receiving culturally-centered care at Roots (MADM p < 0.001, MORi p = 0.011). No statistical significance was found in scores between BIPOC and white clients at Roots Birth Center, however there was a tighter range among BIPOC individuals receiving care at Roots showing less variance in their experience of care.
CONCLUSIONS FOR PRACTICE: Our study confirms previous findings suggesting that giving birth at a community birth center is protective against experiences of discrimination when compared to care in the dominant, hospital-based system. Culturally-centered care might enhance the experience of perinatal care even further, by decreasing variance in BIPOC experience of autonomy and respect. Policies on maternal health care reimbursement should add focus on making community birth sustainable, especially for BIPOC provider-owners offering culturally-centered care.
|Original language||English (US)|
|Number of pages||10|
|Journal||Maternal and child health journal|
|State||Published - Apr 2022|
Bibliographical noteFunding Information:
The authors would like to acknowledge the Indigenous Nations whose land the University of Minnesota and the University of British Columbia are occupying. These lands are the traditional and unceded territory of the Musqueam, Squamish and Tsleil’waututh of the Coast Salish Nations in British Columbia and the Wahpekute, Anishinaabe, and Očeti Šakówiŋ (Sioux) in Minnesota. We are also grateful to the Steering Council and participants in the Changing Childbirth in BC study who informed the development of the MADM and MORi measures. A special thank you to Dr. Katy Kozhimannil for her incredible partnership and guidance in the Birth Equity study. We are indebted to Rebecca Polston, CPM and Roots Community Birth Center staff for their incredible work, against all odds.
Support for the Roots Birth Center (RBC) study was provided by a grant from the Robert Wood Johnson Foundation’s Interdisciplinary Research Leaders Program. Research reported in this publication was supported by NIH grant P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR002494. The Giving Voice to Mothers (GVtM) study team was supported by grants from the Transforming Birth Fund of the New Hampshire Charitable Foundation award Numbers 100156 and 105661, Groundswell Fund award number BJF21019, and a Michael Smith Foundation for Health Research – Health Professional Investigator award number 17020. Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) under Award Number T32HD095134 (Warren and Osypuk, PIs). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This project also benefited from support provided by the Minnesota Population Center, (P2CHD041023) which receives funding from NICHD. Research reported in this publication was supported by NIH grant P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors of this study have no conflicts of interest to report. Ethics approval for RBC was provided by the University of Minnesota Institutional Review Board and by The Behavioural Research Ethics Board at University of British Columbia (#H15-01524). RBC project consent for publication was obtained upon the general project consent form. All information within this publication is de-identified. In the GVtM study participants reviewed a consent form prior to completing the survey. A minimum dataset was de-identified and shared for linkage with the RBC dataset. The full linked RBC data are stored in the University of Minnesota Red Cap system and are available through University of Minnesota IRB approval. Coding from the RBC project are stored in the RedCap system at the University of Minnesota and are available with IRB approval. All authors were responsible for and made significant contributions to the development, writing and review of the content of this manuscript. Individuals wishing to access supplemental information such as study protocol, raw data or programming codes may contact the lead author.
© 2021, The Author(s).
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