Date of Award

Summer 2021

Document Type

Open Access Dissertation


College of Nursing

First Advisor

Tisha Felder


Maternal health outcomes are worst for racial and ethnic minority patients in the United States. There are disparities in pregnancy-related death and severe maternal morbidities where Black women suffer the most disparate outcomes. However, much of the previous scholarly work in this arena has charged that race is a risk factor for adverse maternal outcomes in which this dissertation refutes.

To better understand this phenomenon, we first conducted a scoping review of literature. Our aim was to examine the current state of literature on group prenatal care and its impact on maternal outcomes and racial disparities in adverse maternal outcomes. We then conducted two data-based studies using the Medical Expenditures Panel Survey (MEPS). In Chapter 3, we examine the association of the patient-centered medical home (PCMH) model on severe maternal morbidity (SMM) outcomes among women who gave birth using the MEPS. Secondarily, we examine the association between the PCMH model among racial groups on the prevalence of SMM among women who gave birth using the MEPS. In Chapter 4, we examine the relationship between race and SMM outcomes during the childbirth period among Black and White women. We also examine one aspect of personally mediated racism (i.e., provider discrimination) on SMM outcomes and explore its association with SMM.

The findings from our study indicate that implementing models like group prenatal care and patient-centered medical homes have the potential to improve maternal outcomes and create equitable healthcare for all, however more research is necessary to test this hypothesis. Findings from our study also indicate that there are innovative ways for measuring aspects of racism in large datasets such as the MEPS; however, more research is necessary to test the reliability and validity of these measures.


© 2021, Curisa Mae Tucker

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Nursing Commons