Doctor of Philosophy, University of Toledo, 2023, Health Education

Introduction: Increasing evidence demonstrates that the Black reproducing community in the U.S. has to navigate anti-Black gendered racism, in and out of the healthcare setting, during the perinatal period. This dissertation conducts an independent qualitative and quantitative secondary analysis of the Giving Voice to Mothers (GVtM) survey dataset to examine and explain Black women's care experiences of anti-Black gendered racism during the provision of perinatal care. There is a lack of research utilizing Black women-defined theories to examine their experiences. This dissertation is grounded in three conceptual frameworks that encapsulate the lived experience of Black women and birthing people during the perinatal period. Purpose: Study One will aim to evaluate a relationship between obstetric racism, other forms of structural racism, and Black pregnant and birthing persons' concerns about their individual and community's experiences of pregnancy and giving birth. Study Two is a qualitative text analysis that will use obstetric racism and the Black Birthing Bill of Rights as a conceptual framework to describe pregnancy, birthing, and postpartum care experiences among Black women and birthing people in the United States. Methods: Both studies are a secondary data analysis of the Giving Voice to Mothers (GVtM) survey dataset. GVtM is the first U.S. study to use indicators created by service users to describe pregnancy and birthing care among those who had a community or hospital birth. Both studies exclusively analyzed data from respondents identifying as Black women, which comprised 14% of the total sample (N=380). After removing missing variables, Study One yielded a sample size of n=260. Descriptive analyses and logistic regression models were conducted to explore how concern about pregnancy and birth for themselves and the Black reproducing community varies based on exposure to mistreatment or pressure during care and within the context of structural raci (open full item for complete abstract)

Committee: Erica Czaja (Committee Chair); Saraswathi Vedam (Committee Member); Na'Tasha Evans (Committee Member); Barbara Saltzman (Committee Member); Karen A. Scott (Committee Member) Subjects: Health Education; Health Sciences; Public Health; Public Health Education

Doctor of Philosophy, The Ohio State University, 2015, Germanic Languages and Literatures

The end of the nineteenth century marked the slow shift from home births towards an increased hospitalization of birthing, which became a firmly established practice in twentieth-century German-speaking countries. In this project, I analyze and contextualize representations of birthing, birthing assistants, and the medicalization of the female body in the late nineteenth and early twentieth centuries in Helene Boehlau's Halbtier! (1899), Ilse Frapan's Arbeit (1903), and Gabriele Reuter's Das Traenenhaus (1908). Boehlau, Frapan, and Reuter wrote their novels at the cusp of a new approach to birthing, and their protagonists grapple with the transition from giving birth at home with minimal medical intervention to viewing birth as a pathological condition that requires support from medical personnel. By bringing together theoretical discourses on the body and on medicalization, I examine what effect the restructuring of birthing assistance, and later the development of the medical specialty of obstetrics, had on women in the late nineteenth and early twentieth centuries, and how women perceived these changed birthing conditions. I argue that each of these literary works challenges the medical history narratives that have portrayed medical advances in obstetrics as a positive change for women across the world. Rather, these works take up questions of female agency and the human cost resulting from medical advancements. I identify the three authors' preoccupation with unwed mothers' birthing experiences and the socio-economic and moral factors that influence their patient care and access to health care as a crucial commonality between the works examined. The project begins with a historical overview of the medicalization of birthing in German-speaking countries and of the changing discourses about the female procreative body from the 1750s onwards. The subsequent three literature chapters focus on the portrayal of women's perceptions of the birthing experience, the loc (open full item for complete abstract)

Committee: Barbara Becker-Cantarino PhD (Committee Co-Chair); Katra Byram PhD (Committee Co-Chair); Anna Grotans PhD (Committee Member) Subjects: Germanic Literature

Ph.D., Antioch University, 2024, Antioch Seattle: Counselor Education & Supervision

This study examines the lived experience of the perinatal population to understand how they can be supported from the lens of different ecological systems and what counselors can do to better serve people with uteruses during their perinatal experience. Furthermore, this study aims to utilize an inclusive framework for capturing the perinatal experience of people with uteruses and to explore barriers and facilitators to care through an ecological systems framework. Fifteen participants who have experienced infertility, conception, pregnancy, miscarriage, childbirth, stillbirth, and postpartum were recruited through various means throughout the United States. Thematic analysis was used, with semi-structured interviews and photovoice, to gather and analyze participant narratives through oral and visual means in two phases. The first phase resulted in eight themes: (1) social and cultural influences, (2) navigating transitions and changes, (3) support networks and resources, (4) discrimination and stigma, (5) advocacy and empowerment, (6) mental health and well-being, (7) interactions with medical systems, and (8) impact of systems and policies. The themes identified in phase two were: (1) meaning making, (2) the emotional impact of perinatal experiences, (3) navigating roles and identities, (4) pressure and expectations, (5) advocacy and empowerment, (6) social support and community, (7) prevalence of infertility and miscarriage, and (8) challenges in healthcare. Implications of this study indicate a need for collaborative, interdisciplinary communication among providers interacting with the perinatal population and perinatal mental health competency training. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

Committee: Stephanie Thorson-Olesen (Committee Member); Angela Mensink (Committee Member); Katherine Fort (Committee Chair) Subjects: Counseling Education; Counseling Psychology; Developmental Psychology; Education; Gender; Health; Health Care; Higher Education; Mental Health; Minority and Ethnic Groups; Psychology; Psychotherapy; Public Health; Public Policy; Therapy