Abstract FR583: Patient Journey Mapping To Understand Black Women's Experiences With Hypertensive Disorders Of Pregnancy: Insights From Patients, Healthcare Providers, And Perinatal Support Workers

Background: Black women with hypertension in pregnancy face increased risks of adverse pregnancy, birth, and postpartum outcomes as well as long-term cardiovascular complications. These risks are compounded by negative social determinants of health and structural barriers to timely diagnosis, treatment, and comprehensive follow-up care. Objective: To understand key touchpoints, barriers, and facilitators that influence experiences of care and clinical outcomes for Black women with hypertensive disorders in pregnancy. Methods: We conducted qualitative focus groups and semi-structured interviews with patients, healthcare providers, and perinatal support workers. We asked patients about their healthcare encounters and the broader life circumstances and contexts surrounding their care, to gain a comprehensive understanding of their journey. Healthcare providers, doulas, and perinatal support workers shared their experiences in treating and supporting patients, highlighting both facilitators that enable positive care pathways and challenges to deliver optimal support. Participants used mixed media to create physical storyboards and timelines to visually depict their experiences. Results: 26 participants participated in focus groups or interviews (n=7 patients; n=6 healthcare providers; n=6 doulas; n=6 family support specialists; and n=5 lactation consultants). The findings indicate that there are six primary unmet needs Black women have to effect a positive care pathway after a diagnosis of hypertension in pregnancy: 1) early and continuous care to surveil and manage blood pressure through one year postpartum; 2) comprehensive understanding of health risks and early warning signs of hypertension; 3) bi-directional and timely communication regarding urgent concerns; 4) culturally congruent and culturally-sensitive support grounded in mutual trust; 5) holistic support that addresses sources of chronic stress, including racism and negative social determinants of health; and 6) facilitated transition to primary care. Conclusion: This study offers critical insights into the experiences of Black women managing hypertension during pregnancy, birth, and postpartum. The use of journey maps can inform the development of culturally responsive, person-centered interventions to improve perinatal hypertension management and outcomes.