What is the research about?
In the United States, Black women are three to four times as likely to die from complications related to pregnancy or birth. These deaths are particularly tragic because an estimated two-thirds of deaths could be prevented. Due to racism embedded in health care and society, Black women have a harder time getting access to high-quality maternity care and support when they need it most. As a result, they also have less trust and engagement with the healthcare system.
This study compares the usual maternity care received by most women to a new model of maternity care that combines four effective strategies to improve Black women’s experiences and outcomes during pregnancy and postpartum. In Melanated Group Midwifery Care (MGMC), Black women will receive prenatal care from a Black midwife in groups with the same 8-10 other Black women throughout pregnancy. In pregnancy and into the first year postpartum, MGMC patients will stay connected to the health system through a proactive care coordinator, who is a Black licensed nurse. After having their babies, patients in MGMC will also be supported by a trained postpartum doula.
Who can this research help?
Policy makers, health systems, clinicians, and communities can draw on the findings when considering ways to improve maternity care for pregnant and postpartum women at high risk for maternal morbidity and mortality.
What is the research team doing?
The research team plans to enroll 432 Black women in their first trimester of pregnancy at the University of Chicago Medical Center on the Southside of Chicago. Half will be randomly assigned to Melanated Group Midwifery Care. The other half will have their usual one-on-one care with a midwife or obstetrician.
Women in MGMC will have prenatal care with a Black midwife and other Black women who have similar due dates. The groups will meet 10 times and participate in interactive learning discussions about pregnancy, birth, postpartum, and motherhood. The care coordinator will help facilitate these sessions and develop relationships with the pregnant women. If anyone in the group needs more care, such as a referral for a specialist for mental health or medical care or social services, like help with housing or transportation, the care coordinator will help them. During a third trimester prenatal care session, the group will be introduced to their community-based postpartum doula. The doula will meet with every woman individually at their home while they are still pregnant and then right after they give birth. The doula will be available during the entire first year after she has the baby to visit and support her.
Women will be completing surveys about their health and health care. The research team will look in the medical records for information about the health and outcomes of women in both groups. If any women experience complications during pregnancy or in the postpartum, the team will interview them about their care experiences. The research team will interview some of the MGMC women and all of the MGMC providers about their experience offering this innovative maternity care model at their clinic.
Mothers, maternal health professionals, clinicians, insurers, and policy makers are helping the research team plan, carry out, and evaluate the MGMC model and study.
*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.