Background Black women in the United States face maternal mortality rates three to four times higher than their White counterparts despite advancements in obstetric care. Structural racism, gendered stereotypes, psychosocial stressors, and intersecting oppressions amplify the risk of adverse maternal health outcomes. This is part of a broader " dual burden” or stigma of being both Black and a woman. To further explain this dual burden, this study introduces the concept of “Black Tears” as an analytical framework that synthesizes the intersecting crises shaping Black maternal health. Objectives This qualitative study examines how psychosocial stressors, and institutional inequities intersect to shape Black maternal experiences. Design This study employed an interpretive (hermeneutic) phenomenological approach to explore the lived experiences of Black mothers. Methods Five Black and one Black Hispanic woman (aged 18–32) who had given birth in Kansas or Missouri participated in in-depth semi-structured interviews. Guided by an integrated framework of Critical Race Theory (CRT), the SBW schema, and interpretive phenomenology, transcripts were analyzed to uncover the essential themes of their maternal healthcare encounters. Results Three interrelated themes emerged: [<CitationRef CitationID="CR1">1</CitationRef>] the invalidation of embodied knowledge: dismissal of pain and concerns [<CitationRef CitationID="CR2">2</CitationRef>], the performance of strength: suppressing vulnerability to be heard, and [<CitationRef CitationID="CR3">3</CitationRef>] the weight of systemic bias: navigating a hostile environment. These findings reveal the persistent “tears” of Black women’s maternal health concerns and the normalization of their suffering within medical contexts. Conclusion Black women’s maternal experiences are shaped by historical inequities, racialized stereotypes, and institutional neglect. The endorsement of the SBW stereotype has been shown to lead to coping strategies like “identity shifting,” where Black women alter their behaviors to mitigate discrimination. Culturally responsive care models, provider training, and policy reforms centered on Black maternal voices are urgently needed to disrupt systemic harms.

Running Head: Dismissed and Ignored: Confronting the Trauma of Black Women Maternal Healthcare

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2025年12月15日

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Sharla Smith,
Traci N. Johnson,
Patricia J. Kelly

摘要

Background

Black women in the United States face maternal mortality rates three to four times higher than their White counterparts despite advancements in obstetric care. Structural racism, gendered stereotypes, psychosocial stressors, and intersecting oppressions amplify the risk of adverse maternal health outcomes. This is part of a broader " dual burden” or stigma of being both Black and a woman. To further explain this dual burden, this study introduces the concept of “Black Tears” as an analytical framework that synthesizes the intersecting crises shaping Black maternal health.

Objectives

This qualitative study examines how psychosocial stressors, and institutional inequities intersect to shape Black maternal experiences.

Design

This study employed an interpretive (hermeneutic) phenomenological approach to explore the lived experiences of Black mothers.

Methods

Five Black and one Black Hispanic woman (aged 18–32) who had given birth in Kansas or Missouri participated in in-depth semi-structured interviews. Guided by an integrated framework of Critical Race Theory (CRT), the SBW schema, and interpretive phenomenology, transcripts were analyzed to uncover the essential themes of their maternal healthcare encounters.

Results

Three interrelated themes emerged: [1] the invalidation of embodied knowledge: dismissal of pain and concerns [2], the performance of strength: suppressing vulnerability to be heard, and [3] the weight of systemic bias: navigating a hostile environment. These findings reveal the persistent “tears” of Black women’s maternal health concerns and the normalization of their suffering within medical contexts.

Conclusion

Black women’s maternal experiences are shaped by historical inequities, racialized stereotypes, and institutional neglect. The endorsement of the SBW stereotype has been shown to lead to coping strategies like “identity shifting,” where Black women alter their behaviors to mitigate discrimination. Culturally responsive care models, provider training, and policy reforms centered on Black maternal voices are urgently needed to disrupt systemic harms.