163 lines
5.6 KiB
YAML
163 lines
5.6 KiB
YAML
abstract: 'Health inequities are not caused by personal failings or shortcomings
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within disadvantaged groups, which can be erased with behavioral
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interventions. The scope of the problem is much greater and will only
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fully be addressed with the examination of the systems, structures, and
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policies that perpetuate racism, classism, and an economic, class, race,
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or gender divide between patients and the people who care for them.
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Solution-oriented strategies to achieve health equity will remain
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elusive if researchers continue to focus on behavior modification in
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patients while failing to do harder work that includes focusing on the
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institutions, community, and societal contexts in which pregnant women
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are living; addressing social determinants of health; considering racism
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in study design, analysis, and reporting; valuing the voices of
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patients, practitioners, and researchers from historically disadvantaged
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groups; disseminating research findings back to the community; and
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developing policy and reimbursement structures to support care delivery
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change that advances equitable outcomes. A case study shows us how group
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prenatal care may be one viable vehicle through which to affect this
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change. Group prenatal care is one of the few interventions shown to
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improve pregnancy outcomes for black women. Studies of group prenatal
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care have predominantly focused on the patient, but here we propose that
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the intervention may exert its greatest impact on clinicians and the
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systems in which they work. The underlying mechanism through which group
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prenatal care works may be through increased quantity and quality of
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patient and practitioner time together and communication. We hypothesize
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that this, in turn, fosters greater opportunity for cross-cultural
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exposure and decreases clinician implicit bias, explicit bias, and
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racism, thus increasing the likelihood that practitioners advocate for
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systems-level changes that directly benefit patients and improve
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perinatal outcomes.
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taged groups, which can be erased with behavioral interventions. The
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scope of the problem is much greater and will only fully be addressed
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with the examination of the systems, structures, and policies that
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perpetuate racism, classism, and an economic, class, race, or gender
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divide between patients and the people who care for them.
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Solution-oriented strategies to achieve health equity will remain
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elusive if researchers continue to focus on behavior modification in
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patients while failing to do harder work that includes focusing on the
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institutions, community, and societal contexts in which pregnant women
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are living; addressing social determinants of health; considering racism
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in study design, analysis, and reporting; valuing the voices of
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patients, practitioners, and researchers from historically disadvantaged
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groups; disseminating research findings back to the community; and
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developing policy and reimbursement structures to support care delivery
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change that advances equitable outcomes. A case study shows us how group
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prenatal care may be one viable vehicle through which to affect this
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change. Group prenatal care is one of the few interventions shown to
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improve pregnancy outcomes for black women. Studies of group prenatal
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care have predominantly focused on the patient, but here we propose that
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the intervention may exert its greatest impact on clinicians and the
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systems in which they work. The underlying mechanism through which group
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prenatal care works may be through increased quantity and quality of
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patient and practitioner time together and communication. We hypothesize
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that this, in turn, fosters greater opportunity for cross-cultural
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exposure and decreases clinician implicit bias, explicit bias, and
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racism, thus increasing the likelihood that practitioners advocate for
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systems-level changes that directly benefit patients and improve
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perinatal outcomes. Key words: centering pregnancy, group prenatal care,
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health equity, racism'
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affiliation: 'Carter, EB (Corresponding Author), Washington Univ, Sch Med, Dept Obstet
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\& Gynecol, Div Maternal Fetal Med, St Louis, MO 63110 USA.
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Carter, Ebony B., Washington Univ, Sch Med, Dept Obstet \& Gynecol, Div Maternal
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Fetal Med, St Louis, MO 63110 USA.
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EleVATE Women Collaborative, St Louis Integrated Hlth Network, St Louis, MO USA.
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Mazzoni, Sara E., Univ Washington, Sch Med, Dept Obstet \& Gynecol, Div Gen Obstet
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\& Gynecol, Seattle, WA 98195 USA.'
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author: Carter, Ebony B. and Mazzoni, Sara E. and Collaborative, EleVATE Women
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author-email: ebcarter@wustl.edu
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author_list:
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- family: Carter
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given: Ebony B.
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- family: Mazzoni
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given: Sara E.
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- family: Collaborative
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given: EleVATE Women
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da: '2023-09-28'
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doi: 10.1016/j.ajog.2020.11.040
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earlyaccessdate: MAR 2021
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eissn: 1097-6868
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files: []
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issn: 0002-9378
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journal: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
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keywords: centering pregnancy; group prenatal care; health equity; racism
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keywords-plus: 'GROUP PRENATAL-CARE; PRETERM BIRTH; UNITED-STATES; DISPARITIES; EQUITY;
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CENTERINGPREGNANCY; STUDENTS; IMPACT; BIAS'
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language: English
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month: APR
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number: '4'
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number-of-cited-references: '29'
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orcid-numbers: Carter, Ebony/0000-0002-7620-4929
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pages: 359-361
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papis_id: 5ac7e48161aade1390dfceafe6dab3fd
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ref: Carter2021paradigmshift
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times-cited: '17'
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title: A paradigm shift to address racial inequities in perinatal healthcare
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type: article
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unique-id: WOS:000637866800003
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usage-count-last-180-days: '0'
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usage-count-since-2013: '15'
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volume: '224'
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web-of-science-categories: Obstetrics \& Gynecology
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year: '2021'
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