The Black communitys perspectives on the Black maternal health crisis

Many Black people in the United States have responded to their excessively high risk for maternal mortality and morbidity by moving childbirth from hospital settings to community homes and birth centers. Black perinatal health leaders are increasingly advocating for investments in community strategies such as birth centers and community midwifery. Despite the excess burden of death and disease carried by that community, few studies have sought to investigate community solutions. This qualitative study was conducted between January and October of 2023 to explore how the Black community was responding to the maternal health crisis. It consisted of structured and unstructured conversations with fifty-seven experts, leaders, artists, and practitioners who were deeply knowledgeable about community approaches and an observation of one Black midwife caring for two Black postpartum clients in their homes. Participants perceived that the overemphasis on the negative mortality and morbidity statistics on Black birthing people in the media, without a concomitant attention to the solutions, is harmful to that community and discourages childbearing. They described significant yet often ignored positive contributions of Black women and identified Black community midwifery as an important yet under-resourced strategy. Direct observation of community midwifery care illustrated dominant themes of spirituality, support, and rest. These findings suggest that Black community midwifery is an important model of care that offers protective factors during the times that Black birthing people --postpartum--are most vulnerable to death and disease and warrant further investments and study.