Background/Purpose: The purpose of this paper is to critically examine scholarly writings to understand the history and current manifestations of racism in maternal and perinatal outcomes and reproductive health care and to provide insight on how midwives can be impactful to the health disparities that impact Black women and infants. Theoretical Framework: Dr. David Williams created a framework for understanding the relationship between race and health. Understanding the differential distribution of adverse health consequences within racial groups is essential to developing effective solutions to these problems. Race is constructed of biological factors, social, and economic structures by which groups live and can shape values and behaviors that have health consequences. This framework is relevant due to racism experienced by African-American women, which creates adverse birth outcomes. Methods: Twenty research articles were critically reviewed with the purpose of evaluating the relationship between birth outcomes for African-American pregnant woman and low-birthweight infants, and the impact of midwifery care for this patient population. Results/Findings: The literature review shows that within African-American populations there is a health disparity of maternal mortality and infant mortality within the United States. This health disparity in African-American women can be broken up into three causal categories: racism, implicit bias, and stress. The articles support that midwives have the ability to lower the incidence of low birth weight in African-American infants through the quality care that they provide to women. Some articles support birth centers as a place where African-American women can go and receive quality care from midwives in a safe and comfortable environment; this is one of the ways that midwives are able to address the racism and stress that African- Americans experience which, in-turn, leads to negative birth outcomes. Implications for Research and Practice: The literature review consistently demonstrated that additional research is needed to enhance the understanding between the complex relationship of racism and birth outcomes. Literature demonstrates that birth weight has decreased in recent years, and reductions were greater in infants born to African-American women. It is therefore important to continue to assess why this disparity is growing, so that preventative interventions can be put into place. The support women receive during pregnancy is correlated with improved outcomes, and ongoing research that identifies the impact of public health interventions on Black maternal and infant health is necessary.
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Englund, M. G., & Estis, A. R. (2019). The Impact of Midwifery Care on Racial Disparities in African American Women and Infants [Masterʼs thesis, Bethel University]. Spark Repository. https://spark.bethel.edu/etd/193