Exploring Black Women’s Pathways to Motherhood Within a Reproductive Justice Framework

Amidst the increasing push to address racial disparities in maternal health equity, fewer studies have considered Black women’s perspectives on their needs, concerns, and priorities regarding family planning care. Such evidence might help address the lack of support and information that many Black women report in patient–provider encounters, and broaden empirical knowledge on the contextual factors that influence Black women’s reproductive decisions. In the present qualitative study, we explored Black women’s pathways to motherhood within a reproductive justice framework. We drew on individual, semi-structured interview data from 31 Black mothers (25–50 years, Mage = 35 years) across the United States. Using consensual qualitative research methods, we elaborated on three themes: (1) intentional family planning, (2) unintended pregnancy, and (3) othermothering. The findings challenge deficit-based stereotypes of Black mothers’ reproductive choices and illuminate how health practitioners can facilitate humanizing conversations that prioritize Black women’s family planning goals and decision-making.

Screening for Substance Use Disorders during Pregnancy: A Decision at the Intersection of Racial and Reproductive Justice

Objective: Improve racial equity with routine universal drug screening / Study Design: Commentary on the medicolegal and social history of the United States and the field of obstetrics and gynecology regarding drug screening policy / Results: Critical aspects to inform an equitable drug screening policy include (1) racial bias and stigma related to substance use, (2) the legislative history surrounding substance use during pregnancy, (3) the relationship between substance use and mass incarceration which disproportionately affects persons of color, (4) propensity toward punitive measures for Black mothers with substance use, including termination of parental rights, (5) the role of the medical field in fostering mistrust among our patients / Conclusion: new practices in screening for substance use during pregnancy are needed. Key Points

“I Thanked God Right Then and There”

This chapter tells the stories of the Black parents and children who challenged school segregation in the five cases decided by the Supreme Court in 1954 under the caption Brown v. Board of Education of Topeka, Kansas. The first case, chosen by Thurgood Marshall to show the unequal facilities for Black and White students, came from the small town of Summerton, South Carolina, in which Black children walked to schools in former sharecroppers’ cabins while White children rode buses to schools with four times the funding of Black schools. The next case, in rural Prince Edward County, Virginia, began with a strike by Black high school students to protest conditions at their overcrowded schools, where classes were held in unheated tar-paper shacks. The third case challenged segregation in the nation’s capital, led by a Black parent whose daughter was turned away from the all-White junior high nearest her home and sent to an overcrowded all-Black school. The fourth case, from New Castle County, Delaware, began when two Black mothers each protested the inferior schools their children were forced to attend. The final, and most famous, case began in Topeka, Kansas, whose four elementary schools were the only ones segregated in the state, when a father tried to enroll his nine-year-old daughter in the all-White school nearest her home rather than the Black school, a long walk and bus ride away. A federal appeals court cited the Plessy case as binding precedent but almost invited the Supreme Court to overrule it.

The Interplay of Race/Ethnicity and Education in Fertility Patterns

This study examines the racial/ethnic and educational disparities in fertility for U.S. women born during 1960–80. Using data from the National Survey of Family Growth from 2006 to 2017, we apply a regression-based approach to estimate 1) cohort total fertility rates, 2) parity progression ratios, and 3) parity-specific probability of having a birth by age, for non-Hispanic Whites, non-Hispanic Blacks, and Hispanics by educational attainments. We find that compared to their White counterparts, Black and Hispanic women with less than a high school education have higher fertility. However, among college educated women, Blacks have the lowest fertility levels, whereas Hispanics have the highest. The difference in fertility between Black and White college educated women is mainly driven by the smaller proportion of Black mothers having second births. We find little evidence that the observed racial disparities in fertility levels across educational levels are driven by differences in fertility timing.

Perceptions of Postpartum Teaching and Knowledge of Warning Signs among Black Mothers

The postpartum period is the time of highest risk for maternal death. Quality postpartum education is important to minimize risk. We assessed the postpartum education given to Black mothers on post-birth warning signs by conducting a cross-sectional survey of 80 Black women who had given birth in the previous 12 months. Participants completed an electronic questionnaire, and data were analyzed using descriptive and regression models. On average, educational needs were reported by 20 participants as being unmet, 27 as being met, and 30 as being more than met. Only 54.4% of the participants reported receiving education about postpartum warning signs. The percentage of participants able to identify each sign ranged from 11.4% to 35.4%. No participants identified more than five of the nine warning signs, and 25% identified none. Knowledge of post-birth warning signs was significantly associated with the delivery hospital, household income, and education on warning signs before discharge.

Black Mothering Legacies: Theorizing Lament as a Form of Justice Research

I feel compelled by the moment to take up these questions: What does it mean to mother a Black child within/against this historical moment within/against the (carceral) United States? What does it mean to mother a Black child when the legacy of enslavement in the United States is still the basis for assessing the “worth” of you and your children? How do I determine justice for my/a/the Black child in this historical moment? How does this justice come to matter? My approach to critical qualitative research is best understood through Cynthia Dillard’s (2006) notion of “endarkened feminist epistemology” (p. 3). Here I trace a lineage of Black mothering praxis that has been enacted in response to injustice across different historical moments and geographical locations in the United States. This lineage focuses on Black mothers who have lost their children to state violence, when that violence is perpetrated by the state or when the state fails to mete out justice for the taking of Black life.

Conditional cash transfer program and child mortality: A cross-sectional analysis nested within the 100 Million Brazilian Cohort

Background Brazil has made great progress in reducing child mortality over the past decades, and a parcel of this achievement has been credited to the Bolsa Família program (BFP). We examined the association between being a BFP beneficiary and child mortality (1–4 years of age), also examining how this association differs by maternal race/skin color, gestational age at birth (term versus preterm), municipality income level, and index of quality of BFP management. Methods and findings This is a cross-sectional analysis nested within the 100 Million Brazilian Cohort, a population-based cohort primarily built from Brazil’s Unified Registry for Social Programs (Cadastro Único). We analyzed data from 6,309,366 children under 5 years of age whose families enrolled between 2006 and 2015. Through deterministic linkage with the BFP payroll datasets, and similarity linkage with the Brazilian Mortality Information System, 4,858,253 children were identified as beneficiaries (77%) and 1,451,113 (23%) were not. Our analysis consisted of a combination of kernel matching and weighted logistic regressions. After kernel matching, 5,308,989 (84.1%) children were included in the final weighted logistic analysis, with 4,107,920 (77.4%) of those being beneficiaries and 1,201,069 (22.6%) not, with a total of 14,897 linked deaths. Overall, BFP participation was associated with a reduction in child mortality (weighted odds ratio [OR] = 0.83; 95% CI: 0.79 to 0.88; p < 0.001). This association was stronger for preterm children (weighted OR = 0.78; 95% CI: 0.68 to 0.90; p < 0.001), children of Black mothers (weighted OR = 0.74; 95% CI: 0.57 to 0.97; p < 0.001), children living in municipalities in the lowest income quintile (first quintile of municipal income: weighted OR = 0.72; 95% CI: 0.62 to 0.82; p < 0.001), and municipalities with better index of BFP management (5th quintile of the Decentralized Management Index: weighted OR = 0.76; 95% CI: 0.66 to 0.88; p < 0.001). The main limitation of our methodology is that our propensity score approach does not account for possible unmeasured confounders. Furthermore, sensitivity analysis showed that loss of nameless death records before linkage may have resulted in overestimation of the associations between BFP participation and mortality, with loss of statistical significance in municipalities with greater losses of data and change in the direction of the association in municipalities with no losses. Conclusions In this study, we observed a significant association between BFP participation and child mortality in children aged 1–4 years and found that this association was stronger for children living in municipalities in the lowest quintile of wealth, in municipalities with better index of program management, and also in preterm children and children of Black mothers. These findings reinforce the evidence that programs like BFP, already proven effective in poverty reduction, have a great potential to improve child health and survival. Subgroup analysis revealed heterogeneous results, useful for policy improvement and better targeting of BFP.

I Can't Sleep At Night, Praying He Returns Home Alive: The Experiences Of Black Mothers Raising Black Sons In The Greater Toronto Area

<div>This is a qualitative narrative study of how self-identified Black mothers raising Black sons in the Greater Toronto area respond to the everyday likelihood that their sons may be killed by the police. The goal of this research is to shed light, create space, and give voice to Black mothers to share their personal experiences of police brutality in the Greater Toronto Area, and some ideas for how to better support these women. Additionally, it is meant to create an understanding that behind every murdered, incarcerated or racially profiled Black male, there is a Black mother suffering in silence. This research is grounded in Critical Race Feminism and Anti-Black Racism.</div><div><br></div><div>KEY WORDS: Constant fear, Parental responsibility, Lack of resources in Black communities/criminality, and Powerlessness/systemic change.</div>

I Can't Sleep At Night, Praying He Returns Home Alive: The Experiences Of Black Mothers Raising Black Sons In The Greater Toronto Area

<div>This is a qualitative narrative study of how self-identified Black mothers raising Black sons in the Greater Toronto area respond to the everyday likelihood that their sons may be killed by the police. The goal of this research is to shed light, create space, and give voice to Black mothers to share their personal experiences of police brutality in the Greater Toronto Area, and some ideas for how to better support these women. Additionally, it is meant to create an understanding that behind every murdered, incarcerated or racially profiled Black male, there is a Black mother suffering in silence. This research is grounded in Critical Race Feminism and Anti-Black Racism.</div><div><br></div><div>KEY WORDS: Constant fear, Parental responsibility, Lack of resources in Black communities/criminality, and Powerlessness/systemic change.</div>