Experiences and Perceptions of Maternal Autonomy and Racism Among BIPOC Veterans Receiving Cesarean Sections

IF 2.8 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Womens Health Issues Pub Date : 2024-07-01 DOI:10.1016/j.whi.2024.04.001

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Abstract

Background

Previous studies of pregnant veterans enrolled in Department of Veterans Affairs (VA) care reveal high rates of cesarean sections among racial/ethnic minoritized groups, particularly in southern states. The purpose of this study was to better understand contributors to and veteran perceptions of maternal autonomy and racism among veterans receiving cesarean sections.

Methods

We conducted semi-structured interviews to understand perceptions of maternal autonomy and racism among 27 Black, Indigenous, People of Color (BIPOC) veterans who gave birth via cesarean section using VA maternity care benefits.

Results

Our study found that a substantial proportion (67%) of veterans had previous cesarean sections, ultimately placing them at risk for subsequent cesarean sections. More than 60% of veterans with a previous cesarean section requested a labor after cesarean (LAC) but were either refused by their provider or experienced complications that led to another cesarean section. Qualitative findings revealed the following: (1) differences in treatment by veterans’ race/ethnicity may reduce maternal agency, (2) many veterans felt unheard and uninformed regarding birthing decisions, (3) access to VA-paid doula care may improve maternal agency for BIPOC veterans during labor and birth, and (4) BIPOC veterans face substantial challenges related to social determinants of health.

Conclusion

Further research should examine veterans’ perceptions of racism in obstetrical care, and the possibility of VA-financed doula care to provide additional labor support to BIPOC veterans.

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接受剖腹产手术的黑人退伍军人对产妇自主权和种族主义的体验和看法。

背景：以前对退伍军人事务部（VA）护理的怀孕退伍军人进行的研究显示，少数种族/族裔群体的剖腹产率很高，尤其是在南部各州。本研究的目的是更好地了解在接受剖腹产手术的退伍军人中，产妇自主权和种族主义的促成因素和退伍军人的看法：我们进行了半结构化访谈，以了解 27 名使用退伍军人事务部产妇护理福利进行剖腹产的黑人、土著、有色人种（BIPOC）退伍军人对产妇自主权和种族主义的看法：我们的研究发现，很大一部分（67%）退伍军人曾进行过剖腹产，这最终使他们面临再次进行剖腹产的风险。超过 60% 曾进行过剖腹产的退伍军人要求进行剖腹产后分娩 (LAC)，但要么被医疗服务提供者拒绝，要么出现并发症，导致再次进行剖腹产。定性研究结果显示了以下几点：(1) 退伍军人种族/族裔待遇的差异可能会降低产妇的能动性，(2) 许多退伍军人在分娩决定方面感到被忽视和不知情，(3) 获得退伍军人协会支付的朵拉护理可能会提高 BIPOC 退伍军人在分娩和生产期间的产妇能动性，(4) BIPOC 退伍军人面临着与健康的社会决定因素相关的巨大挑战：进一步的研究应考察退伍军人对产科护理中的种族主义的看法，以及退伍军人事务部资助的朵拉护理为BIPOC退伍军人提供额外分娩支持的可能性。

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来源期刊

Womens Health Issues Multiple-

CiteScore

4.50

自引率

6.20%

发文量

审稿时长

32 days

期刊介绍： Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.