Perceived Discrimination During Prenatal Care at a Community Health Center

• Published in: Journal of racial and ethnic health disparities 2023-06, Vol.10 (3), p.1304-1309
• Main Authors: Prater, Christopher, Cohen, Lily, Chau, Edward, Carter, Ebony B., Kuebee, Blessing, Tepe, Melissa, Keegan, Mary
• Format: Article
• Language: English
• Subjects: Black people; Clinical outcomes; Community based action research; Community Health Centers; Community health services; Community involvement; Community participation; Community research; COVID-19; Discrimination; Epidemiology; Ethnic factors; Ethnic groups; Ethnicity; Female; Fetal growth; Fetuses; Health behavior; Health care; Health care facilities; Health care industry; Health disparities; Health facilities; Health insurance; Health services; Humans; Infant, Newborn; Locus of control; Male; Marginality; Medicine; Medicine & Public Health; Mental depression; Older women; Participatory research; Patient satisfaction; Perceived control; Perceived Discrimination; Polls & surveys; Postpartum depression; Postpartum period; Postpartum women; Pregnancy; Premature Birth; Prenatal Care; Quality of care; Quality of Life Research; Questions; Race; Racial groups; Racism; Social Inequality; Social Structure; Surveys; Telephone surveys; Women; Womens health
• ISSN: 2197-3792; 2196-8837
• DOI: 10.1007/s40615-022-01315-5

Introduction Discrimination in healthcare is associated with fetal growth restriction, preterm birth, and postpartum depression. A community-based participatory research study was designed to measure perceived discrimination and healthcare quality during prenatal care and delivery by a community health center, where the majority of patients served belong to historically marginalized ethnic and racial groups. Methods A 34-question phone survey was administered to women 18 years and older who received prenatal care at the study site during 2020–2021. The primary outcome was perceived discrimination during obstetric care, measured by the 7-question Discrimination in the Medical Setting (DMS) survey. Secondary outcomes included the association of race with perceived discrimination, quality of care, trust of healthcare providers, and perceived control over medical choices. Results Ninety-seven women completed the survey, 95 of whom were women of color. The sample was dichotomized into Black ( n  = 49) and non-Black ( n  = 46). Perceived discrimination for all participants was 21% (20/95), with 31% (15/49) of Black women reporting any discrimination during prenatal care and delivery. Compared to other women of color, Black women reported higher rates of perceived discrimination (31% vs 11%, aOR 3.9 [1.2–12.1], p