The Psychology of Black Reproductive Healthcare: Understanding and Transforming Black maternity experiences and maternal health inequities

在过去的二十年里，医学科学的技术进步大大减少了孕产妇和婴儿的死亡。尽管取得了这些进展，黑人和白人母亲在分娩过程中的存活率仍然存在很大差异(Knight等人，2021年)。黑人或黑人-英国婴儿经历围产期死亡的可能性超过50%(《国家母性评论》，2017)。至关重要的是，尽管种族主义被认为是一种公共健康危机，但现有研究往往忽略了种族和种族主义的影响(Devakumar等人，2020年)。更复杂的是，关于黑人跨性别者和非双性恋者的怀孕之旅以及他们的医疗保健经验和与医疗保健服务的互动的研究有限(Greenfield&Darwin，2020)。围产期服务提供者，虽然高度反式和非二元积极，但分享顺式-异型护理模式有助于易性恐惧症和排他性做法(Pezaro等人，2022年)。了解黑人生殖保健的心理学是公共卫生和心理学中一个研究不足的领域，是转变保健制度和做法的关键一步，以解决保健制度经验中存在的不平等问题，并最终减少黑人分娩者(包括顺式妇女、跨性别者和非双亲生育的人)可避免的死亡人数。然而，为了避免个人化的西方白人心理立场根植于这一领域(Malherbe等人，2021年)，拟议的研究采用了跨学科、心理社会、非殖民主义和反种族主义的框架。作为一名可能获得生殖医疗服务的英国黑人女性，考虑到我作为NHS临床研究从业者的经验，她意识到这些种族主义的差异，这个项目对我个人和职业都很重要。此外，黑人妇女的工作经常被排除在对社会问题的学术理解以及学术理论之外(Reddy&Amer，2022；Thomas，2020)。作为一名服务使用者和服务提供者，以及作为一名未来的黑人学者，我寻求为我自己和我的社区呼吁改变临床护理的标准。

Technological advancements in medical science in the last two decades have significantly reduced maternal and infant deaths. Despite these advancements, large discrepancies between Black and white mothers' survival of the birthing process exists (Knight et al., 2021). Black or Black-British babies have more than a 50% chance of experiencing perinatal mortality (National Maternity Review, 2017). Crucially, the influence of race and racism is often missing in the existing research, even as racism is argued to be a public health crisis (Devakumar et al., 2020). To add another layer of complexity, there is limited research on the pregnancy journey of Black trans and non-binary individuals and their experiences of medical care and interaction with healthcare services (Greenfield & Darwin, 2020). Perinatal service providers, whilst highly trans and nonbinary positive, shared that a cis-heteronormative model of care contributes to transphobia and exclusionary practices (Pezaro et al., 2022). Understanding the psychology of Black reproductive healthcare, an under-studied area in public health and psychology, is an essential key step in transforming health care systems and practices, to address the inequalities present in the experiences of the health care system, and ultimately reduce the number of avoidable deaths of Black birthing people (including cis-women, trans men and non-binary individuals who birth). However, to avoid the individualised, white Western psychological stance embedded in the field (Malherbe et al., 2021), the proposed study adopts a transdisciplinary, psychosocial, decolonial and anti-racist framework. As a Black-British woman who is likely to access reproductive healthcare services, and who is aware of these racialised disparities given my experience as a Clinical Research practitioner in the NHS, this project is both personally and professionally important to me. Furthermore, the work of Black women is often excluded from academic understandings of social issues, as well as academic theorising (Reddy & Amer, 2022; Thomas, 2020). As both a service user and a service provider, and as a future Black academic, I seek to invoke changes to the standard of clinical care for myself and for my community.