Beyond “patient‐provider race matching.” Black midwives clarify a vision for race‐concordant care to achieve equity in Black perinatal health: A commentary on “Do Black birthing persons prefer a Black health care provider during birth? Race concordance in birth”

Abstract

Racial concordance has been identified as a potential strategy to improve the perinatal health of Black women and birthing people by mitigating implicit bias and improving mutual trust, healthy communication, and satisfaction. In a recent article published in BIRTH: Issues in Perinatal Care, Bogdan‐Lovis et al. surveyed 200 Black women to determine whether they possessed a race and gender practitioner preference for their birth practitioner and examined whether race and gender concordance was associated with greater birth satisfaction and perceived respect, trust, practitioner competence, empathy, and use of inclusive communication. In this commentary, written by a group of Black midwives, we respond to the study and offer a vision for race‐concordant care that encompasses cultural safety provided in a community‐based setting.

Communication Between Pregnant People of Color and Prenatal Care Providers in the United States: An Integrative Review

“…66 Additional recommendations are to increase education on racism, implicit bias, and respectful perinatal care. 61,62 Drawing from our findings, the concept of intersectionality, which involves the combined impact of various social categories in shaping systems, must also be incorporated into professional health care education. 34 Improvements in communication and information exchange are needed to address unmet information needs of pregnant people of color and empower them in decisions.…”

“…26,34 Thus supporting and building models of care that are led by Black midwives who prioritize racial concordance are essential. 61 Central to this strategy is providing support for student midwives of color through scholarships and mentoring, particularly as racism can deter the initiation and completion of midwifery education, as found in a crosssectional survey of 799 midwifery students of color by Mehra et al 62 When racially and culturally concordant prenatal care is unavailable, doulas who look like or have shared lived experiences with their clients can improve patient-provider communication. 69 Doulas improve the pregnancy experience and facilitate self-advocacy and communication with perinatal care providers.…”

Response to commentary Beyond “patient‐provider race matching.” Black midwives clarify a vision for race‐concordant care to achieve equity in Black perinatal health: A commentary on “Do Black birthing persons prefer a Black health care provider during birth? Race concordance in birth”

“…As educators and practitioners, opposing and working to end historic and social drivers of inequity and obstetric racism is our deep, enduring commitment that has underscored our respective research, the recruitment and education of health care and health care communication faculty and students, and many years of Black midwifery clinical service. Perhaps it goes without saying but allow us to say it anyway: We and the authors of the commentary 1 share the same goals. Like them, we want to create a just, fair, and culturally safe maternity care system.…”

“…As the commentators observe, the extant social climate "is characterized by racism, violence, gaslighting, mistreatment and disrespect." 1 Effective change, however, can unfortunately arrive in tandem with clandestine, undesirable consequences. It takes little imagination to envision how, in the name of concordant relationship-centered care, the desirable expansion of the Black medical workforce might too easily be "flipped" by those who would embrace the argument as a reason to refuse care from Black providers.…”

“…Elizabeth Bogdan-Lovis MA 1 Mary Bresnahan PhD 2 Jie Zhuang PhD 3 Joanne Goldbort PhD 4 Sameerah Shareef CNM 5 Karen Kelly-Blake PhD 1 Kendra Elam MSN 4…”