Date of Award
8-16-2024
Document Type
Open Access Dissertation
Department
Health Promotion, Education and Behavior
First Advisor
Daniela Friedman
Abstract
The United States is experiencing a maternal health crisis, which disproportionately affects Black women. Black women die from pregnancy-related causes two to three times as often as their White counter parts, and the majority of maternal death are preventable. In recent years, public health and national governing authorities have devoted resources to monitoring the health crisis and raising the public’s knowledge of warning signs; however, maternal mortality rates continue to rise. Noted contributors to Black maternal mortality include, but are not limited to, racism, delayed treatment and response to health emergencies, and lack of social and emotional support during childbirth, suggesting needed improvements in healthcare quality.
When COVID-19 emerged as a global threat to public health, managing the virus’ transmission took precedence. In response to SARS-CoV-2 (COVID-19) public health expert authorities recommended policy and practice changes on labor and delivery units in order to mitigate the spread of COVID-19. Recommendations ranged from restrictions to visitors, support people, and doulas, to requirements for additional personal protective equipment, all of which potentially impacted social support for women birthing amidst the pandemic. In addition, healthcare providers modified their practices to maintain personal and patient safety. The degree to which changes in policy and practice affected Black birthing patients’ social support is not yet fully understood. Therefore, a qualitative evaluation of the impacts, from patient and provider perspectives, could offer insights useful to inform future healthcare policy developments efforts.
This study utilized a phenomenological, qualitative research design in which 14 Black women who had given birth before and during year 2020 (March-December) and 25 perinatal care providers who attended births during the same period were interviewed via semi-structured in-depth interviews. Participants were recruited by way of purposeful criterion and snowball sampling using social media and key informants. Interviews were conducted online, recorded, transcribed verbatim and analyzed using open coding and thematic analysis.
Several policy- and practice- related themes emerged from the analysis. Themes included: 1) policies impacting human physical interaction and support, (2) policies influencing patient autonomy, (3) policies impacting healthcare delivery, (4) practices impacting patient-provider relationship, and (5) practices impacting healthcare delivery. Themes related to patient perceptions of the impacts of policy and practice changes on their social support during their COVID-19 childbirth as compared to a previous birth included: (1) family missing out, (2) lock down and (3) desired changes in support.
Study findings suggest the need for exceptions to visitor policies for laboring patients, especially given the association between social support and maternal and infant health outcomes. Additionally, findings lend support for enhancing training and education for labor and delivery staff about how to safely deliver social support in times when physical supports may be contraindicated or deemed unsafe. Future research efforts should explore the feasibility and appropriateness of virtual technologies to aid in support and ensure that healthcare systems are equipped to provide equitable access to patients most at risk to adverse health outcomes resulting from diminished social support.
Rights
© 2024, Tiffany Eva Byrd
Recommended Citation
Byrd, T. E.(2024). The Effect of COVID-19 Restrictions on the Social Support Experiences of Black Women Giving Birth in South Carolina Hospitals During the First Year of the COVID-19 Pandemic (2020) As Compared to a Previous Birth. (Doctoral dissertation). Retrieved from https://scholarcommons.sc.edu/etd/7822