Judge Me Not: Exploring Black Mothers' Perceptions of Maternal Health Care Services and Structural Racism in South Carolina.

Black women in the United States face disproportionately high rates of maternal mortality, driven by structural racism, patient-provider mistreatment, and gendered and racial discrimination. However, little research has explored Black mothers’ perceptions of maternal health care services and structural racism in the Southeastern U.S. This study aims to address this gap by examining Black mothers’ maternal health care experiences in South Carolina. Using semi-structured interviews conducted during the summer of 2023 with Black mothers who had given birth within the previous five years, this qualitative study employed grounded theory to analyze recurring themes in their maternal health care experiences. The study utilized Critical Race Theory and Black Feminist Thought to frame and interpret these experiences. Three major themes emerged: navigating health care access and quality, engaging interpersonal dynamics and support systems, and confronting structural racism and systemic barriers. Participants described communication delays, impersonal interactions, and frustrations with limited access to culturally competent care. Racial concordance with health care providers was preferred but often unavailable. Community-based support, such as doulas and midwives, particularly those racially concordant, improved experiences, while racial discrimination in health care settings remained prevalent. This study highlights the need for culturally competent care, greater racial concordance in provider selection, and systemic reforms to address structural racism. These findings contribute to a deeper understanding of racial disparities in maternal health and provide insights for future research and policy reform aimed at improving outcomes for Black mothers.