Communication and Birth Experiences Among Black Birthing People Who Experienced Preterm Birth

PURPOSE Physically or psychologically distressing birth experiences can influence postpar-tum health, parenting efficacy, and future pregnancy plans. Communication deficits contrib-ute to negative birth experiences. This qualitative analysis explored themes related to com-munication and negative birth experiences among Black birthing people who experienced preterm birth. METHODS We conducted qualitative interviews with non-Hispanic Black, English language- proficient birthing people with Medicaid-insured preterm infants. Interviews were designed to explore experiences with health care access and well-being after birth. Interviews were audio recorded, transcribed, and coded following an integrated approach where we applied a priori codes and captured emergent themes from the data. RESULTS We interviewed 30 participants from October 2018 to July 2021. Median gesta-tional age at birth was 30 weeks (range 22-36 weeks). Interviews occurred a median of 7 months postpartum (range 2-34 months). Themes emerged related to negative birth experi-ences and communication: (1) communication gaps during urgent or emergent intrapartum procedures contributed to negative birth experiences; (2) postpartum opportunities to share birth experiences, particularly with peers, sometimes mitigated the psychological conse-quences of negative birth experiences; (3) participants did not consistently discuss concerns about future pregnancy risk related to negative birth experiences with clinical teams. CONCLUSIONS Themes from this sample of Black birthing people who experienced preterm birth suggest 3 ways health systems might intervene to improve communication to mitigate the consequences of negative birth experiences. Improvement efforts in these areas may improve postpartum health, future pregnancy outcomes, and long-term health.