Striving for optimal care: Understanding the determinants and experiences of Black women after cesarean birth using a public health critical race praxis lens

In the United States (U.S.), Black women are more likely to undergo a cesarean birth in comparison to other racial and ethnic groups. Previous research has identified individual-level factors, such as health behaviors, comorbidities, and socioeconomic status to be associated with cesarean birth among Black women. However, those individual-level factors do not fully account for the variation in cesarean births. The three-manuscript dissertation explores factors that influence cesarean rates among Black women in the US. The first manuscript provided a scoping review of peer reviewed research on the risk and protective factors associated with cesarean birth among Black women in the U.S. In the second manuscript, logistic regression was utilized to examine the association between experiencing racial discrimination and delivery method using data from the 2016-2021 Pregnancy Risk Monitoring System (PRAMS). The third manuscript applied a qualitative, phenomenological approach to understand the experiences, perceptions, and needs of Black women following a cesarean birth. The findings contribute to the understanding of racial disparities in cesarean births and can inform evidence-based practice and research. There is opportunity to provide all women with the chance to receive optimal maternity care and Black women are no exception.