Racism and health care access: a dialogue with childbearing women.

The rates of low birth weight and preterm delivery are twice as high for African Americans as they are for Whites in the United States. Racism and health care access may be factors in this twofold disparity. To investigate this possibility, we conducted a qualitative study with African American prenatal and postpartum women (N = 14). In 1- to 2-hr interviews, we asked the participants to describe their ability to access health care and their experiences of racism. We then independently and collectively coded the data until consensus (95%) was obtained. Data categories included access to care, treatment, differences in care, stereotypes, and racism. Three themes emerged from the interviews: (a) the pervasiveness of the stereotype of pregnant African American women; (b) a care that is indifferent, inaccessible, and undignified; and (c) the totality of racism. These themes encompass social, political, and economic factors affecting the experiences of childbearing African American families and mandate the need for further investigation and intervention.