Desirable Weather: Relational Approaches for Studying Black Birthing Outcomes

Deficit framing of Black reproductive health isolates problems into individual instead of structural problems, often placing blame on Black people for their own health outcomes rather than concentrating on the histories, policies, and environments that Black individuals experience that result in these negative outcomes. My dissertation addresses this pitfall and aims to answer the question: how does the usage of multiple epistemologies expand our knowledge of Black birthing beyond a deficit or damage-centered model? To do so, I develop and demonstrate a framework for studying Black birthing outcomes that opposes prevalent deficit framing within health sciences research, where conclusions often blame racial minorities for their negative health outcomes. The framework employs the concept of relationality – a way of knowing the world that presumes relation and interdependence – to show the necessity of breaking down disciplinary boundaries and using interdisciplinary theories, methods, and data sources to understand a phenomenon more holistically. I use mixed-methodologies including semi-structured interviews, archival research, theory construction, data visualization, and statistical modeling while engaging with scholarship across the physical, social, and health sciences to understand how Black birthing outcomes exist as a product of relations between these interconnected arenas of life, or environments. My desire-based framework (DBF) rejects deficit as a requirement or condition that must be considered when doing research. The ‘desire’ in the DBF is achieved by not only centering Black birthing individuals' desire for healthy births but also promoting self-determination by allowing subjects to see how they are differently and uniquely impacted on their own terms, rather than only being discussed in deficit to another group or set of outcomes. Beyond just creating the theoretical framework, this dissertation illustrates its praxis in chapters two and three, which 1) qualitatively reveal existing practices that center Black birthing individuals' desire for healthy births and 2) apply the framework in a quantitative environmental epidemiology study. Together, these chapters show not only the utility of the desire-based framework but also lead me to conclusions and solutions that work to achieve Black individuals' desires for healthy births and avoid individual-based solutions that do not address structural issues.