Degree

Doctor of Philosophy (PhD)

Department

Social Work

Document Type

Dissertation

Abstract

Black women in the United States, particularly in Louisiana, face some of the highest rates of adverse maternal health outcomes—outcomes shaped by systemic racism, historical neglect, and policy failures. This mixed-methods dissertation examines how Black women assess and navigate maternal health risks, using the Health Belief Model and Reproductive Justice framework to understand their reproductive decision-making. The study follows an exploratory sequential design (QUAL → QUANT) with distinct methods and findings sections.

The qualitative phase began with an autoethnography of the author’s own pregnancy experience, which informed the development of semi-structured interviews conducted with 13 Black women. These narratives reveal how knowledge of disparities, early reproductive experiences, social support, and perceived discrimination shape decisions around timing of care and provider selection. The subsequent quantitative phase, a cross-sectional survey of 187 participants, assesses how identity (e.g., disability, body size), structural access (e.g., insurance), and temporal context (e.g., year of pregnancy) predict perceived risk, respect in care, and provider choice

By integrating qualitative and quantitative data, the study demonstrates that Black women’s maternal decisions are rational responses to unjust systems—not cultural deficiencies. These findings have critical implications for healthcare policy and practice, including the need for culturally responsive care, transparent communication, and social work engagement across reproductive health settings. Black women’s lived experiences are more than anecdotes—they are evidence, and they deserve to be treated as such.

Date

4-23-2025

Committee Chair

Jennifer Scott

Available for download on Thursday, April 01, 2032

Included in

Social Work Commons

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