Exploring the Lived Experience of Healthcare Discrimination and Resilience among Postpartum African American Women: A Qualitative Study.

African American women are at higher risk of adverse pregnancy outcomes (APOs) than women in other racial and ethnic groups in the United States, which can lead to an increased risk of maternal mortality and morbidity. These disparities have been attributed to inequities in social determinants of health. This study explores the experiences of healthcare discrimination and resilience among African American women. From December 2023 to August 2024, we conducted 30 semi-structured interviews with African American/Black (AA/BL) postpartum women in Milwaukee, Wisconsin, USA. The interviews included the following content domains: life experiences of pregnancy, adverse pregnancy outcomes, healthcare racism or discrimination during pregnancy, stress, and resilience. Interviews were transcribed verbatim and coded using MAXQDA 2024 qualitative software. Themes were generated using thematic analysis to understand how AA/BL women experience discrimination during pregnancy and childbirth and how resilience manifests in their lives. Two themes were identified: 1. Perceived healthcare discrimination during pregnancy and childbirth, and 2. Leveraging resilience to mitigate experiences of healthcare discrimination and life stressors. The results highlight that AA/BL women experience healthcare discrimination during pregnancy and childbirth, including poor quality care, and mitigate these experiences by seeking Black OBGYN providers. It is evident from the stories in our study that AA/BL women are highly resilient and display positive coping mechanisms to overcome challenges in their lives. While resilience can help to buffer against adversity, systems and policies should be in place to protect against stressors.