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The Ethics of Perinatal Care for Black Women

Dismantling the Structural Racism in “Mother Blame” Narratives

Scott, Karen A., MD, MPH; Britton, Laura, PhD, RN; McLemore, Monica R., PhD, MPH, RN

The Journal of Perinatal & Neonatal Nursing: April/June 2019 - Volume 33 - Issue 2 - p 108–115
doi: 10.1097/JPN.0000000000000394
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Perinatal and neonatal nurses have a critical role to play in effectively addressing the disproportionate prevalence of adverse pregnancy outcomes experienced by black childbearing families. Upstream inequities in maternal health must be better understood and addressed to achieve this goal. The importance of maternal health before, during, and after pregnancy is illustrated with the growing and inequitable prevalence of 2 common illnesses, pregestational diabetes and chronic hypertension, and 2 common conditions during and after pregnancy, gestational diabetes and preterm birth. New care models are needed and must be structured on appropriate ethical principles for serving black families in partnership with nurses. The overarching purpose of this article is to describe the ethics of perinatal care for black women; to discuss how social determinants of health, health disparities, and health inequities affecting women contribute to poor outcomes among their children; and to provide tools to dismantle structural racism specific to “mother blame” narratives.” Finally, strategies are presented to enhance the provision of ethical perinatal care for black women by nurses.

Public Health & Health Equity Program, Mills College, Oakland, California (Dr Scott); School of Nursing, University of North Carolina at Chapel Hill (Dr Britton); and Family Health Care Nursing Department, University of California, San Francisco (Dr McLemore).

Corresponding Author: Monica R. McLemore, PhD, MPH, RN, Family Health Care Nursing Department, University of California San Francisco, 2 Koret Way, N431H, San Francisco, CA 94117 (monica.mclemore@ucsf.edu).

The authors acknowledge the Preterm Birth Initiative-California, the San Francisco Department of Public Health, Maternal Child Health Branch, and the Centers for Disease Control for permission to use modified Figure 1.

Data reported in this manuscript serve as part of the master's thesis of Dr Karen A. Scott. While producing the manuscript, Dr Britton was supported as a Hillman Scholar in Nursing Innovation and by National Institute of Nursing Research of the National Institutes of Health under Awards No. F31NR017320-01.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funders had no role in the conduct of the research or preparation of the manuscript.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Each author has indicated that he or she has met the journal's requirements for Authorship.

Submitted for publication: November 6, 2018; accepted for publication: January 7, 2019.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.