Respectful Maternity Care Collaborative
Background
The Patient-Centered Outcomes Research Institute (PCORI) and the Reproductive Health Impact (RH Impact) are thrilled to announce the awarding of major funding by PCORI to RH Impact in support of its efforts to build a Respectful Maternity Care Collaborative (RMCC).
While Black mothers and infants are the most impacted by adverse health outcomes in the United States, Black birthing people are often not included in leadership or partnership roles in research despite being included as subjects. RH Impact established the RMCC to address the absence of Black birthing people in maternity care research, and to ensure they are regarded as key partners in learning, as well as leaders and decision-makers.
What Is It?
The RMCC is a formalized partnership of stakeholders, dedicated to improving maternal outcomes for Black birthing people through Patient-Centered Outcomes Research (PCOR) and Comparative Effectiveness Research (CER). RH Impact has been awarded to establish a birth equity patient-centered research infrastructure that elevates the knowledge and experiences of Black birthing people and stakeholders.
RMCC’s primary activities will involve:
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Creating training tools and structured opportunities for individuals and organizations to engage in patient-centered research as critical stakeholders
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Building the confidence of members as they design and lead research and learn from one another
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Training stakeholders in fostering a safe space in which to do this work with Black birthing people
RMCC will also provide training to build knowledge of patient-centered outcomes research among membership, share resources to create a sustainable research infrastructure, build a community of stakeholders ready to be partners/leaders in research, and create a collaborative research agenda that will identify research priorities. This synergy will lead to a long-term to build-up of a Black maternal health research agenda that is led by Black birthing people.
Top 10 Research Priorities to Eliminate Black Maternal Health Disparities
The Reproductive Health Impact (RH Impact) has established the Respectful Maternity Care Collaborative (RMCC), a formalized partnership of stakeholders dedicated to improving maternal outcomes for Black birthing people through Patient Centered Outcome Research (PCOR) and Comparative Effectiveness Research (CER). This research agenda is based on results from The Future of Black Birthing Research, a survey RH Impact distributed in early 2022 on eradication strategies for Black maternal health disparities to RH Impact staff, Black pregnant/birthing people and their partners, birth equity activists and researchers, and birthworkers. The RMCC worked collaboratively to prioritize the survey themes and develop a national Black birthing research agenda that addresses the Black maternal health crisis. Our hope is that this agenda will guide future research priorities to direct funding, advocacy, and investment.
While all of these topics are important, the following list is in order from highest priority to lowest priority to identify where and how we should focus our initial efforts.
1. Systemic Change
Transformation of the structures, practices, customs, mindsets, power dynamics, and policies within systems of institutions and society that control and oppress Black birthing people and their villages (i.e., healthcare system, insurance companies, social services, political systems, hospital systems, and professional organizations) to antiracist systems that are uplifting and protective to people instead of the system itself.
2. Full Spectrum Perinatal Care Integration
The expansion, inclusion, and integration of all members of the perinatal care team for Black birthing people and their villages, including but not limited to doulas, lactation specialists, nutritionists, social workers, community support, mental health providers, pelvic floor therapists, doctors, nurses, and midwives.
3. Culturally Safe Care
Culturally-informed care that is in congruence with the birthing person’s social and cultural needs, respects their dignity, and fosters a sense of physical, mental, and emotional safety. This includes but is not limited to the perinatal care team taking a learning role in understanding each birthing person, addressing barriers that prevent access to care spaces, honoring language preferences, ensuring spiritual safety, and centering people who share the culture of the birthing person.
4. Personal Decision Making
Honoring the birthing person’s autonomy and ensuring that they have all information necessary to make a decision, enough time to make decisions, an option to discuss with their support system and/or patient advocate, and access to decision-making tools that aid the birthing person throughout the perinatal period.
5. Birth worker and Healthcare Professional Pipeline
To make and sustain the pathway into birth work and the healthcare profession more inclusive and accessible and ensure the education, wellbeing, and development of their staff, students, and leadership centers the needs of Black birthing people and their villages.
6. Investing and Funding
Public and private entities generously financially invest in Black birthing people and their villages and systems and programs that provide direct care and support them without restrictive grant processes, including but not limited to programs that provide unconditional cash transfers/stipends, food, housing, transportation, doula care, midwifery care, childcare, and other birth or reproductive care, with the goal of sustaining these programs over time.
7. Listening and Supporting Black Birthing People and their Villages
Perinatal care teams listening to Black birthing people and their advocates/birth partners in a compassionate way that acknowledges birthing people as experts of their own bodies and lived experiences for treatment and care that is responsive to their medical needs, self-reported symptoms, and trauma. This includes being accessible to the birthing person and their support team, not making assumptions about their experiences, giving them time and space to process information, and informing them of all options regardless of the perinatal care team’s care preferences.
8. Availability and Access to Respectful and Quality Perinatal Care
Interrogating and eliminating barriers that may prevent access to care, including but not limited to scheduling, costs, insurance coverage, transportation, language barriers, and availability of lactation specialists, midwives, doulas, clinicians, and other members of the perinatal care team.
9. Accessible and Respectful Education and Resources
Perinatal care systems, insurance companies, peer support systems, and other entities provide access to free, relevant, and accurate information in a non-threatening and respectful manner to Black birthing people and their villages from the preconception to postpartum period.
10. Professional Development
Assessment, continuous implementation, and evaluation of anti-bias and antiracism training for birthworkers, office staff, and other perinatal care workers that is grounded in cultural congruence, patient-centered care, and trauma-informed care.
