Prenatal racial discrimination associated with dissatisfaction with prenatal care

Abstract

Introduction: Maternal and infant racial and ethnic health disparities persist in Wisconsin. The Black infant mortality rate is 3 to 4 times that of White infants.

Objective: In this study, we used data from the Wisconsin Pregnancy Risk Assessment Monitoring System to examine women's experiences with racism and accessing pre- and postnatal care.

Methods: Data from the 2016-2018 Pregnancy Risk Assessment Monitoring System-an ongoing state-administered surveillance system of new mothers-were used. The total number of non-White respondents was n = 2,571. The data are weighted both for nonsampling and for nonresponse. The prevalence of late entry to prenatal care, inadequate prenatal care, and no postpartum visit in the population of non-White women were calculated. Multivariable logistic regression was used to model the association between racial discrimination in the year prior to birth and perinatal care utilization and satisfaction.

Results: Less-than-adequate prenatal care was significantly associated with racial discrimination in bivariate analysis (OR 1.4; 95% CI, 1.02-1.8), but this relationship became marginally significant after adjusting for maternal sociodemographic characteristics (OR 1.3; 95% CI, 0.9-1.7). In contrast, prenatal experience of racial discrimination was associated with about 1.5 times the odds of not receiving a postpartum visit both before and after adjusting for maternal characteristics (OR 1.6; 95% CI, 1.1-2.3).

Conclusions: Completing the postpartum visit has the potential to save mothers' lives; decreasing experiences of racial discrimination in health care settings may be one mechanism for decreasing maternal and infant mortality