Deep care: a qualitative analysis of black community midwifery

BACKGROUND: Black community midwifery has historically offered holistic, culturally grounded care for Black birthing people, yet remains marginalized within modern maternity systems. As disparities in Black maternal health outcomes persist, this qualitative study explored the values, services, and impacts of Black community midwifery across multiple U.S. regions. METHODS: Using in-depth interviews with five midwives and 53 clients, family members, providers, and community stakeholders, we conducted inductive and deductive coding to identify core themes. RESULTS: Analysis revealed 11 primary midwifery services-including family integration, social-emotional support, and dietary counseling-and five guiding values: deep care, patient autonomy, patient safety, lived experience, and spirituality. Deep care, a model that integrates clinical, emotional, cultural, and spiritual dimensions, emerged as the most persistent and defining value across participant narratives. Midwives were described as educators, advocates, and system navigators who fostered client autonomy while balancing clinical safety. Family and spiritual integration were critical components of care, particularly during birth and pregnancy loss. Clients reported greater self-efficacy, trust, and emotional wellbeing compared to conventional healthcare settings. CONCLUSION: Our findings underscore Black community midwifery as a vital strategy for advancing maternal health equity. We theorize that deep care extends beyond contemporary frameworks in the care scholarship, being informed by history, spirituality, and justice. We recommend expanded investment in midwifery education, community-based birth infrastructure, and supportive policy reforms.