Community based organizations’ perspectives on structural racism and systemic failures’ impact on black birthing people: “This system is cracked”
Tiwaladeoluwa B. Adekunle, Nicollette Moore, LaToshia Rouse, Savannah Graziano, Marissa R. Cisneros, Margaret S. Butler, Kiarri N. KershawPurpose
Structural racism and systemic failures contribute to disparities in obstetric outcomes for Black birthing people (BBP). Community Based Organizations (CBOs) play an important role in mitigating barriers in access to critical resources for BBP. However, little is known about these organizations’ perspectives on BBP’s reproductive health or their strategies to improve health and wellbeing in their communities. The purpose of this study was to explore CBOs’ perspectives on i)the impact of systemic failures and structural racism on Black birthing people across levels of the Socio-Ecological Model ii) the actions and activities CBOs engage in to mitigate this impact and iii) how, if at all, CBOs might themselves inadvertently uphold structural racism.
Methods
In-depth interviews were conducted with 14 CBO staff and leadership.
Results
A thematic analysis of qualitative data found that structural racism and systemic failures impact Black birthing people through prejudice, inequitable care, neighborhood disinvestment, poorly designed programs and housing and food insecurity and a complex and disjointed benefits system at the policy level. Furthermore, CBOs revealed nuanced strategies to promote wellbeing for Black birthing people.
Conclusion
Findings from this study shed light on perspectives of often-underrepresented constituents in maternal health, can help strengthen capacity building for CBOs and offer important insights for new and emerging CBOs interested in advancing equitable outcomes for Black birthing people.