Browsing by Subject "Maternal health"
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Item At the mouth of my grave while tending my garden : fear of death and hope for life in Black Women's conversations about reproductive and maternal health(2023-04-20) Woods Bennett, Joy Melody; Donovan-Kicken, Erin E.; Ballard, Dawna; Nash, Jennifer C.; Treem, JeffreyBlack women are dying at higher rates that their white counterparts during childbirth. They are also facing more severe symptoms when diagnosed with endometriosis, fibroids, or other gynecological health issues. The purpose of this study is to investigate the ways in which Black women are discussing amongst themselves their reproductive and maternal health—their decisions, diagnoses, and overall conversations. The following dissertation combines auto ethnographic and qualitative interviews to investigate communicative practices utilized by Black women in their personal conversations. By rooting this investigation in Critical Race Theory, Endarkened Feminist Epistemology, and temporality, I can illuminate how Black women navigate through racists medical systems to seek holistic and safe reproductive and maternal healthcare. This study also highlighted how Black women lean on each other, their faith, and hope to continue to yearn for motherhood despite the devastating numbers of mortality that they face. Also, this dissertation revealed that Black women consider multiple things a part of their reproductive health decision making police brutality, historic racist experimentation, their spirituality, time and temporality, and much more.Item Belly : blackness and reproduction in the Lone Star State(2014-05) Cole, Haile Eshe; Vargas, João Helion CostaThis dissertation begins with the finding that in the United States Black women are four times as likely to die due to pregnancy related complications than their white counterparts as well as the finding that Black children are 2 to 2.5 times as likely to die before their first birthday. Given this, the project examines the intersections between Black women’s reproductive experiences and the condition of reproductive health and access in the state of Texas. In order to accomplish this, the research situates the grassroots organizing work of a collective of mothers of color alongside national and state level legislation and data about maternal and infant health disparities. The work not only situates ethnographic experiences within the larger repertoire of quantitative health literature on disparities but it also historicizes the work alongside Black Feminist theories of the body, history, and Black women’s reproduction. Drawing from extended participant observations, interviews, focus groups, policy research, statistics, and archival work, this project unpacks the large disparity that exists in maternal and infant health outcomes for African-American women and the ways in which policy, community organizing, and other geo-political factors contribute to, mediate, or remedy this phenomenon. Given the data presented, this projects suggests that (re)creating supportive communities and support networks may be an effective way of mediating stress caused by long-term exposures to racism and ultimately healing the negative maternal health outcomes for black women.Item Comparison of receipt of postpartum care and pregnancy-related risk factors among Texas Medicaid pregnant enrollees(2022-04-21) Gugala, Emma; Barner, Jamie C.; Lawson, Kenneth A; Brown, Carolyn MWomen in the United States (US) experience the highest rate of maternal mortality of similar countries and a high prevalence of pregnancy-related complications. Postpartum care (PPC) focused on chronic disease management is potentially lifesaving, especially among pregnancies complicated by risk factors such as diabetes, hypertension, and mental health conditions (MHCs). The objective of this study was to determine if there is a relationship between maternal mortality risk factors and receipt of PPC among Texas Medicaid enrollees. Pregnant women (ages 12-55) continuously enrolled in Texas Medicaid with a delivery between 3/25/2014-10/31/2019 were followed 84 days pre-delivery to 60 days post-delivery. PPC was defined as ≥1 visit within 60 days of delivery associated with postpartum services identified using ICD-9, ICD-10, and procedure codes. Maternal mortality risk factors (diabetes, hypertension, and MHCs) during and after pregnancy were identified using ICD-9/ICD-10 codes and medication utilization. Age, race/ethnicity, cesarean delivery, and preterm birth served as covariates. Multivariable logistic regression was used to address the study objective. The sample (N=617,010) was 26.5±5.7 years old, primarily Hispanic (52.8%), with 33.0% having cesarean deliveries and 9.3% having preterm births. Risk factor prevalence included: diabetes (14.0%), hypertension (14.3%), MHCs during pregnancy (6.3%), and MHCs after pregnancy (9.1%). A majority (77.9%) had a PPC visit within 60 days of delivery. The odds of receiving PPC were 1.2 times higher for patients with diabetes (OR=1.183, 95% CI=1.161-1.206; p<.0001), 1.1 times higher for patients with hypertension (OR=1.109, 95% CI=1.089-1.130; p<.0001), and 1.1 times higher for patients with MHCs (OR=1.138, 95% CI=1.108-1.170; p<.0001) than patients without the conditions, respectively. This real-world study revealed that over three-quarters of Texas Medicaid pregnant enrollees received PPC within 60 days of delivery and that risk factors were prevalent. The prevalence of diabetes and hypertension in this study was similar to national estimates; however, mental health conditions were less prevalent than previously reported among Medicaid populations. Targeted interventions to provide comprehensive PPC for patients with chronic conditions may help lower the rate of maternal morbidity and mortality in Texas.Item Labor of love : Black women's birth work in the wake(2019-05-09) Brown, Nyesha; Rountree, Michele A.Black women in the United States are three to four times more likely to die due to pregnancy related deaths than white women. Research findings suggest race is a salient factor accounting for differences in maternal health and birth outcomes. As a consequence, Black women remain disproportionately impacted by inadequate maternal care. This project analyzes these maternal health disparities as inevitable outcomes of systemic and institutionalized racism and sexism—interlocking and cooperating systems of oppression that are detrimental drivers to Black women’s poor maternal health outcomes. Black maternal mortality, I argue, is not only an outcome of these systems, but is necessary for the maintenance of the United States’ hetero-patriarchal capitalist project — an endeavor dependent upon widespread state-endorsed violence and gendered anti-Blackness. Doula collectives organized by Black women, such the Mamas for Maternal Justice (MMJ) collective in Austin, TX, seek to improve pregnancy and birth outcomes by providing culturally congruent care to Black women in Travis County. This project is an ethnographic examination of the political implications of doula care provided by and for Black mothers in Austin, Texas. Analyzing an in-depth focus group conducted with the MMJ collective will identify the unique forms of resistance and maternal care that Black doulas have established to combat the racist and classist conditions that perpetuate negative birthing outcomes for Black women. The data suggests that doula care is an embodied labor that serves as a buffer against the cumulative effects of racism-related stress that Black women experience during childbirth. Their unique mode of caretaking relies on the formation of intimate relationships with mothers and their families, which challenges biomedical constructions of childbirth and hierarchical circulations of power in obstetric settings. Thus, this study presents doula care as a radical mode of maternal care that is deeply rooted in Black vernacular feminism.Item Maternal resilience : rethinking maternal health for the post-2015 sustainable development goals agenda(2015-05) Charles, Nkechi Ukwu; Weaver, Catherine, 1971-; Lentz, ErinSeptember 2015 signals the expiration of the Millennium Development Goals (MDGs) and the upcoming special summit on the post-2015 Sustainable Development Goals (SDGs). The fifth MDG (MDG 5), in particular, aims to improve maternal health by reducing maternal mortality rates by three-fourths and to achieve universal access to reproductive health care. MDG5 has progressed the least among the eight MDGs over the past 15 years. The 45% decline in global maternal mortality rates over the past two decades will not be sufficient to achieve MDG 5. With the summit on the post-2015 SDGs fast approaching, maternal health practitioners and researchers have a unique opportunity to rethink how we look at maternal health and the barriers to achieving progress. This professional report first explores some of limits and consequences of the MDG 5 framing of maternal health, critiquing the prominent use of maternal mortality as target and indicator. Then the report reviews extant literature that challenges us to consider the underlying cultural and behavioral drivers that affect maternal health. With no clear indication of the SDGs moving towards a better operationalization of maternal health, this report concludes by introducing maternal resilience as a new concept that can help foster a course correction towards a more comprehensive ecological-based framework to improve maternal health.Item This "court of mine" : an analysis of Black women athletes media use as a tool for advocacy, self-care, and activism(2023-08-15) Brown, Haley Marie; Davis, Amira RoseThis paper considers the ways in which Black women athletes have used media to disrupt and challenge dominant narratives and images about themselves. Black women- in and out of sports- have long been scrutinized and subjugated by media narratives and stereotypical images. Yet, in recent years, Black women in sports have found ways to successfully use their platforms and media engagement to offer counter narratives about their athletic participation. This paper uses media discourse analysis and Black feminist thought to examine six contemporary major professional Black women athletes and their personal uses of media. Ultimately, this study reveals how Black women have been able to use new forms of media engagement as tools for advocacy and activism, challenging racialized and gendered stereotypes while simultaneously addressing issues like self-care, mental health and wellness and political protest.