Community-Led Solutions to Address Black Maternal and Infant Mortality Through the TNT-PISP Model: A Qualitative Study

OBJECTIVES: In both the U.S. and Wisconsin, Black women and infants experience significantly higher rates of morbidity and mortality than their white counterparts. Our research team set out to explore how a community-based and culturally informed perinatal support model could address the needs of Black mothers and their families. METHODS: We developed and implemented the Today Not Tomorrow Pregnancy and Infant Support Program (TNT-PISP), a community-based, culturally informed perinatal support model integrated with traditional obstetrical care. From October 2019 to August 2022, we held monthly support group sessions facilitated by Black community-based doulas, Black physicians, and community partners. Twenty-five participants engaged in topic-focused and freeform sessions to discuss mental health, breastfeeding, peripartum care, and medical racism. Data were collected through semi-structured interviews and focus groups and analyzed using the Daughtering Method and reflexive thematic analysis. RESULTS: Participants emphasized the importance of shared Black identity and culture in fostering connection and trust. The group's open, judgment-free environment allowed for meaningful conversations and emotional support. Participants valued the exchange of parenting knowledge and community resources. The program's flexible structure and child-friendly setting were key strengths, enabling consistent participation despite busy schedules. CONCLUSIONS FOR PRACTICE: This study highlights the potential of community-based, culturally informed perinatal support programs to promote health equity for Black women and infants. Future research should explore such programs' long-term impacts and scalability in diverse settings. Continued efforts to integrate culturally relevant care models into traditional healthcare systems may help promote health inequities in Black communities.