Institute of Translational Health Sciences

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I. Project Summary: A Qualitative Study of Bisexual Women of Color's Perinatal HealthCare Experiences Both women of color (WOC) and sexual minority women (SMW) experience striking inequities in maternal health and healthcare in the United States. Most notably, bisexual women have the highest rates of pregnancy among SMW, while childbearing rates in bisexual adolescents and young adults significantly exceed that of their heterosexual counterparts. However, maternal health research commonly aggregates bisexual women with lesbians and assumes heterosexuality among WOC, despite the distinctive health and healthcare disparities faced by bisexual WOC. These imprecise groupings at the intersection of maternal healthcare for WOC and SMW obscure the perinatal health needs of bisexual WOC within maternal health research and clinical practice. Adequate perinatal care is crucial for optimizing maternal and birth outcomes, yet no maternal health studies have examined the perinatal healthcare experiences of bisexual WOC. It is urgent to engage bisexual WOC in translational health research to understand their perinatal healthcare needs and identify gaps in care to develop effective maternal health interventions for this population. This application proposes to develop community-driven approaches to engaging bisexual WOC in translational health research. Using qualitative methods, the secondary goals of this proposed study are to: 1) improve the understanding of lived experiences with perinatal healthcare in bisexual WOC using an intersectional, reproductive justice lens, and 2) identify recommendations for improving perinatal care for bisexual WOC. A community steering committee (n=10), comprised of a majority of bisexual WOC, will regularly convene throughout the study to develop equitable and affirming strategies for engaging bisexual WOC in translational health research. Interviews will be conducted with bisexual WOC (n=31) to identify their preferences, needs, and experiences while they are seeking and utilizing perinatal care. Finally, three focus groups will be held with perinatal providers and medical staff, birth workers, and healthcare administrators (n=24) to characterize healthcare system perceptions and perspectives on perinatal care for bisexual WOC and identify recommendations for improving perinatal care practices. This study will address key knowledge gaps in our current understanding of bisexual WOC's perinatal encounters, following evidenced-based community engagement (CE) methods and through the innovative lens of reproductive justice. The new strategies developed for engaging bisexual WOC in research will be adaptable to other clinical areas, serving as a valuable resource for the wider scientific community. The proposed study is also expected to inform the future development of effective clinical interventions and care delivery models to improve maternal and birth outcomes for bisexual WOC and other historically disadvantaged populations in the long term, thus advancing maternal health equity for all. With the support of a two-year Diversity Supplement, the candidate will further develop her translational health research skills, preparing her to submit a K application based on the findings from this award to support her in attaining her long-term research goals.