12 Reimagining postpartum care to advance health equity – A qualitative study with Black birthing people and health workers

Abstract

Objectives/Goals: 1. Examine structural, interpersonal, and health system factors that impact postpartum well-being for people who are racialized Black. 2. Differentiate components of postpartum well-being. 3. Design a model of postpartum care that addresses comprehensive well-being. Methods/Study Population: We conducted eight focus groups with participants in the Washington, D.C. area including four with Black birthing people who had given birth in the past two years (n = 23), and four with staff and providers from Community of Hope, a federally qualified health center, who provide care to birthing people (n = 19). We used an action-oriented qualitative approach informed by Black feminist theory. Our analysis was grounded in the 5D Cycle for Health Equity (reDefine, Discover, Dream, Design, and Deliver) and appreciative inquiry, which guide researchers to focus on strengths, be open to possibility, and engage radical imagination. Results/Anticipated Results: Participants reDefined postpartum health and wellness as physical, mental and social well-being, and material stability. Participants discovered that Black birthing people felt deeply unsupported navigating postpartum including difficulties with feeding, sleep, and mood and strongly believed that “postpartum” is at least a year, with different needs at different phases. Participants dreamed that postpartum care could be more accessible and trustworthy, have opportunities for social connection and creating a village, and have their basic needs (food, housing, clothing, and rest) met. Discussion/Significance of Impact: The participants’ conveyed that postpartum care must be designed and delivered to ensure that it is accessible, creates opportunities for connection, and promotes health, well-being, and joy. Postpartum care that can generate trust and engagement with healthcare, reduce morbidity and mortality, and increase thriving.