Listen to me: The communicative exchange and unconscious bias in a maternity setting.

点击翻译按钮获取中文摘要

This PhD seeks to use conversation analysis (CA) to respond to the urgent real-world issue of racial health inequality in maternal health outcomes. Racial health inequalities in the UK pregnancy-post-partum journey are stark. MBRRACE-UK's November 2021 report identifies a more than four-fold difference in maternal mortality rates between Black and white women in the period 2017-2019. The Royal College of Midwives has acknowledged systemic racism and unconscious bias, launching a 'Race Matters' strategy. Midwives identify that unconscious bias negatively impacts practice (Chitongo et al, 2021) and research shows how pervasive cultural myths, e.g., Black women are less susceptible to pain (Saluja & Bryant, 2021) and more aggressive (e.g., Ashley, 2014), are enacted on the ward. Despite communication being crucial to a mother-midwife relationship (Heys et al, 2021, Nicholls & Webb 2006) and in supporting safe outcomes for mother and baby (Dickson 1997) and despite Black women reporting feeling they are not listened to (Jomeen & Redshaw 2012, MBRRACE-UK, 2021), there is little empirical research in this area. This PhD will examine communication between Black mothers and white midwives, aiming to understand if unconscious bias operates through language use in the maternity setting and whether communication plays a role in sustaining racial health inequality. The primary research question is 'How do Black women experience not being listened to?' with secondary questions of 'If there are presentations of unconscious bias in the data, by what mechanisms does it manifest?' and 'Does communication maintain inequality in this setting for Black women'? I will record perinatal appointments of Black mothers with white midwives for conversation analysis. CA recognises communication as joint activity (Sacks, 1984) and 'is more concerned with perlocutions than with illocutions' (Stubbe et al, 2003, p354). This will allow emphasis on listening, characterised as lacking by Black mothers.