Written by: Jess Kimball
Rates of maternal mortality and perinatal mood and anxiety disorder are rising worldwide, increasing the fear of birthing people. Trust between provider and patient plays a major role in the birth and postpartum outcomes that are seen. Trust between provider and patient can reduce stress and lead to lower rates of anxiety disorders. It also leads to an increase in communication from the patient, helping the provider catch health problems and treat them earlier. Cultural competency is an important aspect of providing care for birthing individuals and building that trust. The birthing population worldwide is made up of different gender identities, ages, ethnicities, and religious backgrounds. There is no “one size fits all” approach to supporting birthing families. Providers must practice humility, empathy, and curiosity; key parts of culturally attentive care.
When providing recommendations, providers should be aware of the population they are speaking with. Information should be provided in a way that the patient can process. When information is provided, space should be given to ask clarifying questions and discuss the pros and cons. It should never be expected that a patient would just agree with everything the provider said and it should not be expected that the patient has the same access to information that the provider does. The community they grew up in may not be one that openly discussed medical interventions or even used many medical interventions. On the other hand, it might be a community that is used to Western medicine and the patient may want to learn about more natural alternatives. Trust allows the patient to feel comfortable asking questions and have an open discussion with the provider.
Another important aspect of culturally attentive care is recognizing and assessing bias. The provider can engage in implicit bias assessments to delve deeper into their individual subconscious biases. Improving this self-awareness leads to fewer medical errors and better healthcare outcomes.
Studies have found that interventions to provide culturally competent care lead to better birth and postpartum outcomes. Interventions could include person-centered care, accessibility increase initiatives, and community-based models. Individuals who do not have access to transportation or live in rural areas may struggle to access care. Telehealth may work for some, but not if they do not have internet access. Understanding these barriers can help providers make the most out of the appointment time they do have with a patient and also influence community programs and public policies to help meet the needs of these individuals, who may be more likely to not receive adequate care. Person-centered care is an effective approach for increasing trust between provider and patient. This approach builds the self-esteem of birthing folks and creates a nonjudgmental, culturally sensitive, and respectful environment.
As maternal mortality rises worldwide we must change our approach to care to meet the needs of the population we are serving and improve outcomes for birthing individuals and infants. Recognizing and understanding bias, building trust, and practicing cultural humility are key components in improving healthcare outcomes.
At Global Foundation for Girls (GFG), we are active thought partners, serving global communities of birthing persons in order to advance and support the advocacy movement. We lead webinars and trainings for providers including doulas, social workers, childbirth educators, and more! To learn more about our upcoming trainings click here!
Jess Kimball, AS, CLC, CD, PCD, PMH-C