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

该博士旨在使用对话分析（CA）来应对孕产妇健康结果中种族健康不平等的紧迫现实问题。英国怀孕-产后旅程中的种族健康不平等是显而易见的。MBRRACE-UK 2021年11月的报告确定了2017-2019年期间黑人和白色女性之间孕产妇死亡率的四倍多差异。皇家助产士学院承认存在系统性的种族主义和无意识的偏见，并启动了一项“种族问题”战略。助产士认为无意识的偏见会对实践产生负面影响（Chitongo et al，2021），研究表明文化神话是多么普遍，例如，黑人女性对疼痛不太敏感（Saluja & Bryant，2021），更具攻击性（例如，阿什利，2014年），在病房颁布。尽管沟通对母亲-助产士关系至关重要（Heys等人，2021，Nicholls & Webb 2006），并支持母亲和婴儿的安全结果（Dickson 1997），尽管黑人妇女报告说她们感觉自己没有被倾听（Jomeen & Redshaw 2012，MBRRACE-UK，2021），但这方面的实证研究很少。这个博士学位将研究黑人母亲和白色助产士之间的沟通，旨在了解无意识的偏见是否通过语言使用在产妇环境中运作，以及沟通是否在维持种族健康不平等中发挥作用。主要的研究问题是“黑人女性是如何体验不被倾听的？”附带的问题是，如果数据中存在无意识偏见的表现，它是通过什么机制表现出来的？”和“沟通是否维持了黑人女性在这种环境中的不平等？”我将记录黑人母亲与白色助产士的围产期预约，以进行对话分析。合作交际将交际视为共同活动（Sacks，1984），并且“更关注取效而不是施事”（Stubbe et al，2003，p354）。这将允许强调倾听，这是黑人母亲所缺乏的。

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.