Equity in Maternal Journeys: Maternal Health Care Experiences Among Black Mothers in South Carolina

Black women in the United States experience disproportionately adverse maternal health outcomes, particularly in the Southeast. This dissertation examines the maternal health care experiences and resilience strategies of Black mothers in South Carolina through a qualitative study grounded in critical race theory, Black feminist thought, resilience theory, and ecological systems theory. It highlights the pervasive influence of structural racism while amplifying the resourcefulness and agency of Black mothers. The first manuscript develops a conceptual framework to explore the structural, social, and interpersonal mechanisms influencing Black maternal health care experiences. The second manuscript employs grounded theory to investigate Black mothers’ lived experiences, uncovering barriers to quality care, patient-provider biases, and the need for culturally responsive services. The third manuscript utilizes thematic analysis to identify resilience strategies Black mothers employ to navigate systemic barriers, including advocacy, knowledge-seeking, social support, and alternative care approaches. Findings reveal the profound impact of structural racism on maternal health care while underscoring the resilience strategies Black mothers employ to confront systemic challenges. This research emphasizes the urgent need for culturally competent care, anti-racism training for providers, and systemic interventions to address maternal health disparities. By centering Black mothers’ voices, this dissertation contributes to the development of equitable policies and practices aimed at improving maternal health outcomes for marginalized communities.