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Research ArticleOriginal ResearchA

Communication and Birth Experiences Among Black Birthing People Who Experienced Preterm Birth

Emily F. Gregory, Geminesse T. Johnson, Alejandra Barreto, Arthurine K. Zakama, Adya I. Maddox, Lisa D. Levine, Scott A. Lorch, Alexander G. Fiks and Peter F. Cronholm
The Annals of Family Medicine January 2024, 22 (1) 31-36; DOI: https://doi.org/10.1370/afm.3048
Emily F. Gregory
1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
2Clinical Futures, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
3PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
4Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
MD, MHS
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  • For correspondence: gregorye@email.chop.edu
Geminesse T. Johnson
3PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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Alejandra Barreto
3PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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Arthurine K. Zakama
4Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
MD
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Adya I. Maddox
2Clinical Futures, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
3PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
MPH
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Lisa D. Levine
4Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
5Maternal Fetal Medicine Research Program, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
MD, MSCE
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Scott A. Lorch
1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
2Clinical Futures, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
3PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
4Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
MD, MSCE
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Alexander G. Fiks
1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
2Clinical Futures, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
3PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
4Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
MD, MSCE
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Peter F. Cronholm
3PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
4Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
6Department of Family Medicine and Community Health, Center for Public Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
MD, MSCE
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Abstract

PURPOSE Physically or psychologically distressing birth experiences can influence postpartum health, parenting efficacy, and future pregnancy plans. Communication deficits contribute to negative birth experiences. This qualitative analysis explored themes related to communication and negative birth experiences among Black birthing people who experienced preterm birth.

METHODS We conducted qualitative interviews with non-Hispanic Black, English language–proficient birthing people with Medicaid-insured preterm infants. Interviews were designed to explore experiences with health care access and well-being after birth. Interviews were audio recorded, transcribed, and coded following an integrated approach where we applied a priori codes and captured emergent themes from the data.

RESULTS We interviewed 30 participants from October 2018 to July 2021. Median gestational age at birth was 30 weeks (range 22–36 weeks). Interviews occurred a median of 7 months postpartum (range 2–34 months). Themes emerged related to negative birth experiences and communication: (1) communication gaps during urgent or emergent intrapartum procedures contributed to negative birth experiences; (2) postpartum opportunities to share birth experiences, particularly with peers, sometimes mitigated the psychological consequences of negative birth experiences; (3) participants did not consistently discuss concerns about future pregnancy risk related to negative birth experiences with clinical teams.

CONCLUSIONS Themes from this sample of Black birthing people who experienced preterm birth suggest 3 ways health systems might intervene to improve communication to mitigate the consequences of negative birth experiences. Improvement efforts in these areas may improve postpartum health, future pregnancy outcomes, and long-term health.

Key words:
  • African American
  • birth trauma
  • Black
  • Black birthing people
  • interconception care
  • intrapartum care
  • negative birth experience
  • preconception care
  • reproductive justice
  • health communication
  • postpartum care
  • Received for publication February 16, 2023.
  • Revision received August 10, 2023.
  • Accepted for publication September 5, 2023.
  • © 2024 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 22 (1)
The Annals of Family Medicine: 22 (1)
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Communication and Birth Experiences Among Black Birthing People Who Experienced Preterm Birth
Emily F. Gregory, Geminesse T. Johnson, Alejandra Barreto, Arthurine K. Zakama, Adya I. Maddox, Lisa D. Levine, Scott A. Lorch, Alexander G. Fiks, Peter F. Cronholm
The Annals of Family Medicine Jan 2024, 22 (1) 31-36; DOI: 10.1370/afm.3048

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Communication and Birth Experiences Among Black Birthing People Who Experienced Preterm Birth
Emily F. Gregory, Geminesse T. Johnson, Alejandra Barreto, Arthurine K. Zakama, Adya I. Maddox, Lisa D. Levine, Scott A. Lorch, Alexander G. Fiks, Peter F. Cronholm
The Annals of Family Medicine Jan 2024, 22 (1) 31-36; DOI: 10.1370/afm.3048
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Subjects

  • Person groups:
    • Women's health
    • Vulnerable populations
  • Methods:
    • Qualitative methods
  • Other topics:
    • Communication / decision making
    • Disparities in health and health care

Keywords

  • African American
  • birth trauma
  • Black
  • Black birthing people
  • interconception care
  • intrapartum care
  • negative birth experience
  • preconception care
  • reproductive justice
  • health communication
  • postpartum care

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