The Model Maternity Myth: An Exploration of AAPI Experiences in the U.S. Maternal Healthcare System

Abstract

Introduction and Background: Maternal mortality in the United States is a major national public health issue. While the majority of the states in the United States grapple with this issue, some states, like California, have found a way to reverse the trend, through toolkits developed by committees like the CMQCC. Maternal mortality and morbidity, however, have not ceased to exist, even in California. One particular area in need of improvement is that of continuing racial disparities in quality of healthcare, particularly for Black and Brown women. Despite extensive knowledge on racial disparities in particular segments of the population, however, there is a relative lack of information on how AAPI mothers experience healthcare. Existing research does provide a general overview of the issue and suggests a need for concern, but is insufficient due to regional constraints, outdatedness, and lack of causality.

Objectives: This research aims to address the issues not yet studied in Asian, Asian-American, and Pacific Islander maternal health research. The work will shed light on the experiences of AAPI women before, during, and after childbirth comprehensively, across different U.S. regions, racial subgroups, socioeconomic attainments, and age groups.

Methods: Data for this analysis was collected through qualitative phone and video interviews with Asian, Asian-American, and Pacific Islander women who had given birth within the last ten years. Interview contacts were obtained through personal contacts, alumni networks, and snowball sampling. The questions asked in these interviews spanned five major categories in order to comprehensively assess healthcare experience. In total, 25 people were interviewed for this study.

Results: Participants reported a wide range of experiences with the maternal healthcare system. Positive outcomes included high rates of positive patient-provider relationships, high appointment attendance, low c-section rates, and low rates of discrimination, as well as decreased likelihood of some physical complications (i.e. gestational diabetes, general vaginal tearing, pelvic floor trauma, postpartum preeclampsia, and mastitis). Outcomes in need of improvement included negative relationships with midwives, high rates of obstetric mistreatment, high rates of induction, increased risk of postpartum depression, and increased rates of other complications (i.e. preeclampsia, major third or fourth-degree tearing, infection, and hemorrhage).

Conclusion: This study provides a blueprint for providers and researchers to follow in addressing issues disproportionately impacting AAPI mothers, and provides some policy lessons that can be taken to improve healthcare for AAPI women and women of all backgrounds. Though this study provides a comprehensive look into the experiences of AAPI mothers in the healthcare system, some limitations include small sample size and lack of representativeness. Future studies aiming to assess AAPI maternal healthcare in the U.S. should address these limitations.