Home » Including the patient voice when addressing racial disparities in maternal health

Including the patient voice when addressing racial disparities in maternal health

Some recurring themes arose from responses posted in JAMA network openincluding the view that the inconvenience of appointments outweighed the perceived benefits and that the approach to prenatal care was too standardized to make sense.

As one participant said: “[the doctor] will only check the heartbeat and it will take about 10 minutes. No, I won’t waste my gas. I survived then.”

Another person described clinical care as a “cookie cutter” approach that did not address their specific concerns.

Prenatal care is an important goal to reduce maternal mortality and morbidity, Peahl says, but previous research suggests that blacks, particularly those of low socioeconomic status living in urban areas, face significant barriers to quality care. Challenges can include a lack of transportation, financial constraints, and structural racism.

“Prenatal care in its current form, which requires frequent in-person visits, can actually increase barriers for those who will benefit most from this important health service,” she said.

Peahl said she and her colleagues have already incorporated the new feedback into efforts to redesign prenatal care locally and nationally, reflected in new prenatal care recommendations that have emerged from the COVID-19 pandemic and greater use of Call for telemedicine and fewer in-person visits during pregnancy.

According to Peahl, the ideal prenatal care model outlined by the participants includes services tailored to each person’s comprehensive needs and preferences, including evaluation and treatment of existing health conditions that could lead to pregnancy complications, as well as counseling on pregnancy, childbirth, Childbirth and parenthood.

Participants also wanted help with non-medical factors affecting their ability to engage with the health care system during pregnancy, including resources such as housing and transportation, and social support.

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“We must listen to the voices of patients in our communities to develop new models of care that address persistent inequalities in prenatal care and outcomes,” said Peahl.

Additional authors include Michelle Moniz, MD, MSc.; Michele Heisler, MDMPA; Aalap Doshi, MS; Gwendolyn Daniels, DNP, MSN; Martina Caldwell, MD, MSc.; Vanessa Dalton, MD, MPH; Ana De Roo, MD, MSc.; Mary Byrnes, Ph.D.

Disclosures: Peahl is a consultant to the Maven Clinic.

Cited study: “Experiences with Prenatal Care Reported by Income and Health Workforce in the US, A Qualitative Study,” JAMA network open. DOI: 10.1001/jamanetworkopen.2022.38161

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