Cross-Cultural Care in Perinatal Nursing

Persistent racial and ethnic disparities in perinatal outcomes in the United States demand attention to the relational dynamics that shape cross-cultural care experiences. This dissertation examined patient-clinician interactions for Black birthing people in perinatal care, examined the concept of nurse cultural humility, and explored OB nurses’ experiences delivering cross-cultural care. This was first accomplished by conducting an integrative review of the literature that reported on patient-clinician interactions during the perinatal period for Black birthing people. Next, a concept analysis was completed on nurse cultural humility using descriptive statements from the literature. Finally, a hermeneutic phenomenological study was completed exploring the lived experience of OB nurses delivering care to diverse patient populations. Major findings of the integrative review reveal a patient-clinician relationship characterized by mistrust, ineffective communication, lack of established relationship, and unequal power dynamics. The concept analysis provided a conceptual definition of nurse cultural humility that included the attributes of a lifelong process of reflexivity, engaging in active listening to learn from patients, an understanding and appreciation that the cultural background of both nurse and patient influences health care encounters, and a commitment to redress and mitigate power imbalances in the patient-clinician relationship. Major findings of the hermeneutic phenomenological study revealed five interrelated patterns: (1) Relational Openness: Attending to the Other with Curiosity and Care; (2) Moving Beyond the Tasks: The Art of Nursing; (3) Navigating Ethical Crossroads: When Values Collide in Care; (4) Reframing Cultural Knowing: From Preconception to Patient Presence; and (5) Becoming Aware: The Clinician as a Work in Progress. This dissertation study further illuminates how cultural humility can be enacted in practice and developed through relational experience and reflection. Together, this work offers a foundation for reimagining perinatal nursing through the lens of cultural humility, with the goal of honoring the full humanity of every birthing person.