A community engaged approach to understanding Black fathers' experiences with perinatal care

ABSTRACT: Maternal mortality (MM) and severe maternal morbidity (SMM) have been on the rise, and racial
disparities are widening. Rochester is the city with the highest Black MM/SMM rates in the state of New York,
and Black women are 2 to 3 times more likely to die and to have severe morbidities associated with pregnancy.
Researchers continue work towards assessing these disparities and identifying modifiable structural and social
factors to improve pregnancy outcomes for Black women and birthing persons, while communities are called to
action to address disparities in MM/SMM. Our local community efforts include the initiatives of the Consortium
to End Black Maternal Mortality, created in 2019 (PCORI funded project) to engage multiple stakeholders in the
quest to understand local disparities and create a research agenda to inform local programs. Our initial project
consisted of conducting listening sessions with Black women in Rochester to understand their experiences with
the perinatal care system (Alio et al, 2022). Mothers identified their partners/infants’ fathers’ support as an
important factor influencing their experiences with perinatal care. In the literature, the emotional, physical and
financial support of fathers during pregnancy has been associated with improved birth outcomes, especially
among Black women. However, little is known about the role of fathers in helping to reduce MMM/SMM.
Fathers/partners are an untapped source of emotional and logistical support during perinatal care, and their
involvement may have indirect impact on MM/SMM, and longer-term benefits for the family. Furthermore, fathers
can serve as advocates for their birthing partner, and allies in the care of women during the perinatal period. We
build upon the work of our community Consortium to continue our efforts to understand the experiences of Black
parents and identify specific areas for intervention. Supplementing our data on Black women, this study aims to
explore Black fathers’ experiences with perinatal care, and their potential role in mitigating these dire outcomes.
Like our study with Black women (N=44), we will conduct listening sessions with 40 Black fathers and individual
interviews with 20 Black fathers in Rochester, NY, to explore their group and individual experiences with perinatal
care and understand their potential role as advocates for mothers and allies in perinatal care (AIM 1). We will
then merge results of LS with existing data from Black women for an integrated, group dyadic analysis (AIM 2).
Additionally, we will compare data from LS with fathers with results from induvial interviews to assess differences
in themes from the two methods. Findings will provide a comprehensive picture of Black parents’/co-parents’
experiences with perinatal care. The socio ecological model will guide the identification of multi-level elements
of Black fathers’ experiences and allow for comparisons with women’s data, and for assessing couple’s
experiences. The patient experience framework will guide analysis of themes from both groups. Results will
inform local efforts to identify and address specific elements of perinatal care to increase equitable care for Black
women and to reduce MM /SMM.

Grant Number: 1R03HD113972-01A1
NIH Institute/Center: NIH
Principal Investigator: PAULA ALIO