The stories of Black women who experienced a high-risk pregnancy

Pregnancy related maternal deaths (PRMDS) in the United States (US) have been increasing for several decades. While the rate of maternal deaths in the US is higher than most other developed countries, the disparity in PRMDs for Black women is alarming. Black women are three times more likely to experience PRMD than white women. Black women also are at increased risk of experiencing severe maternal morbidity (SMM) during the perinatal period. Women most at risk for experiencing PRMD or SMM include those experiencing high-risk pregnancies. Little research exists exploring the pregnancy experiences of this population. Therefore, the purpose of this study was to examine the perinatal narratives constructed by Black women experiencing high-risk pregnancy. Narrative inquiry using Riessman’s approach to narrative analysis was utilized in this study. Purposive sampling was utilized. Participant recruitment occurred through personal networks, a religious institution, and social media. Snowball sampling was also utilized through participants sharing recruitment information with their networks. Ten women that self-identified as Black women and who experienced a high-risk pregnancy and delivery one to three years ago participated in this study. Interviews were conducted via Zoom or face-to-face using an interview guide. Interviews were audio recorded and transcribed verbatim. Thematic, structural, and performance analyses were conducted, and individual narratives were compared across participants for similarities and differences. Powerful and emotional narratives were created by Black women describing their high-risk pregnancy experiences. Fear in pregnancy was common across the narratives, particularly surrounding knowledge of negative outcomes for Black women. Women described balancing multiple factors during the pregnancy, including stressors and assets, and a desire for autonomy and holistic care. The desire to help others by sharing their story and providing advice to others also was present. Black women in high-risk pregnancies encounter both positive and traumatic experiences and often, the traumatic experiences overshadow the positives. Providers must deliver high-quality, holistic perinatal care to help reduce fears and support Black women. Black women also have a wealth of knowledge regarding their experiences and should be included as partners in their care and in future research aimed at decreasing the disparity in perinatal outcomes.