Pregnancy and Postpartum Experiences in Chicago Neighborhoods With Increased Adverse Maternal Outcomes: A Qualitative Study

Abstract: Background: Black birthing people are three to four times more likely to die from pregnancy-related causes than White birthing people. Objective: We aimed to better understand the pregnancy and postpartum experiences with health care, support, and maternal morbidity and mortality (MMM) of Black pregnant and parenting people living in neighborhoods with increased rates of MMM in Chicago, Illinois. Methods: This was a rapid qualitative analysis in Chicago, Illinois based on principles of community-based participa-tory research. Community partners recruited Black pregnant and parenting individuals living in neighborhoods with higher rates of MMM. Four focus groups from February 2021 to October 2021 were led by community health workers and covered pregnancy and postpartum experiences. Transcripts were deductively and inductively coded by paired-analyst teams and thematically analyzed. Results: This study included 31 participants from eight neighborhoods. Key themes related to pregnancy and the postpartum period included the: (1) a need for social and mental health support during and after pregnancy, (2) a preference for multiple sources of health information, (3) a need for strengthened connection with medical providers and health care systems, (4) a lack of clarity regarding MMM and the postpartum period, and (5) a difference in language between patients and health care providers. Conclusions: Further research and interventions are needed to evaluate how to best support pregnant and postpartum people, to implement patient-centered language when communicating about pregnancy and postpartum complications, and to demonstrate investment by health care workers in Black birthing people. Crucial to further research and interventions is communication with and input from communities most affected by MMM.