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Women’s Perspectives of Needs Surrounding Adverse Birth Outcomes: A Qualitative Assessment of the Neighborhood Impact of Adverse Birth Outcomes

Abstract

Objectives African Americans are two times more likely to suffer adverse birth outcomes (i.e., low birth weight, preterm birth, and infant mortality) when compared to all other ethnic groups and this pattern is no different for Douglas County, Nebraska, where the majority of African Americans in Nebraska reside. Our goal was to identify factors, as described by local women, that contribute to adverse birth outcomes in the predominantly African American community of Northeast Douglas County in Omaha, NE, to ensure that these women’s voices were included in the development of interventions to improve their neighborhood’s birth outcomes. The paper describes the results of a qualitative needs assessment of these women which will aid in the design and implementation of neighborhood-based solutions. Methods We brought together a group of women with varying levels of birthing experience, time spent living in the neighborhood, and overall community involvement. Individual in-depth, in person, and telephone interviews were used to collect participants’ perceptions of birth outcomes, neighborhood resources for pregnant women, and neighborhood strengths and weaknesses. Results The needs assessment identified that, although women in this neighborhood have experience with adverse birth outcomes, these experiences are not discussed resulting in a lack of awareness of the wide spread racial disparities in birth outcomes and the efforts and resources to address this public health problem. Conclusions for Practice This study reveals the power of direct conversations with women impacted by adverse birth outcomes, as they must be primary partners in any efforts to improve birth outcomes.

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Acknowledgements

This research was completed by the authors during their employment at the University of Nebraska Medical Center.

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Correspondence to K. Harper-Hanigan.

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No competing financial interests exist.

Appendix

Appendix

Birth Outcomes

  1. 1.

    Do you know people in your community that have experienced adverse birth outcomes? (Infant mortality; preterm birth; low birth rate; still born; miscarriage)

  2. 2.

    How do these adverse birth outcomes impact your neighborhood or community?

  3. 3.

    What do you think contributes to these adverse birth outcomes?

These questions intended to assess perceived susceptibility and severity of adverse birth outcomes within the community and investigate thoughts on contributing factors as identified by the neighborhood.

Community Resources for Pregnant Women

  1. 4.

    What services are available in your community to help with these problems?

  2. 5.

    What gets in your way to accessing these services?

  3. 6.

    What is needed in your community to resolve these access problems?

These questions intended to assess perceived barriers and cues to action.

Community Strengths and Areas of Improvement

  1. 7.

    What concerns you most about your community?

  2. 8.

    What do you think are the biggest health problems in your community?

  3. 9.

    What are your community’s strengths and assets?

These questions intended to assess perceived barriers, cues to action, and self-efficacy.

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Harper-Hanigan, K., Ross, G., Sims, T. et al. Women’s Perspectives of Needs Surrounding Adverse Birth Outcomes: A Qualitative Assessment of the Neighborhood Impact of Adverse Birth Outcomes. Matern Child Health J 21, 2219–2228 (2017). https://doi.org/10.1007/s10995-017-2343-7

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  • DOI: https://doi.org/10.1007/s10995-017-2343-7

Keywords

  • Birth outcomes
  • African American
  • Needs assessment