Implementing a community-partnered postpartum care model based in reproductive justice for black birthing people: protocol for a pilot mixed-methods intervention study
11 affiliations
- 1Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
- 2School of Public and International Affairs, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- 3Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- 4Department of Biostatistics and Health Data Science, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
- 5Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
- 6Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- 7Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- 8Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- 9Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- 10Department of Health Policy and Management, University of Pittsburgh School of Health, Pittsburgh, Pennsylvania, USA
- 11Healthy Start Inc, Pittsburgh, Pennsylvania, USA
Abstract
Introduction Postpartum care (PPC) in the USA remains largely inaccessible despite calls for community-driven care models to address poor birth outcomes and racial disparities. Fewer than 40% of US birthing people receive even one PPC visit within 6 weeks post-delivery. Lack of adequate/high-quality PPC exacerbates existing health inequities, with black birthing people more than two times as likely to die as white birthing people in the first year postpartum. PPC remains focused on individual biomedical risks and does not take into account social and structural determinants that shape US pregnancy-associated mortality and morbidity.Methods and analysis This paper describes a 6-year pilot mixed-methods intervention research protocol (fiscal years: 2025–2030) that draws on Reproductive Justice, Restoring Our Own Through Transformation and Public Health Critical Race Praxis frameworks to address gaps in current PPC models within the broader context of social justice. During years 1–2 (2025–2026), we assess baseline maternal health outcomes, including PPC completion, among pregnant individuals delivering at a single Pennsylvania hospital (n=~65 000) from 2016 to 2023. In year 3 (2027), we use qualitative data from focus group discussions and interviews with birthing people, clinicians and health centre staff to develop a community-informed PPC model tailored to the needs of black birthing people in Southwest Pennsylvania. We iteratively adapt the model in years 4–5 (2028–2029) based on community and clinician feedback, assessing both clinical and person-centred outcomes, including outcomes prioritised by black birthing people. To address key systemic and structural barriers of obstetric racism and economic insecurity, we include reproductive justice and anti-racism/anti-oppression training for perinatal clinicians, trainees and staff (with pre-training and post-training assessment) in year 3 (2027), and an unconditional cash transfer that mirrors paid family leave for postpartum people, piloted and assessed in years 4–5 (2028–2029), with overall final evaluation wrapping up in year 6 (2030).Ethics and dissemination The University of Pittsburgh Institutional Review Board approved this study (STUDY24050009). Findings will be disseminated through peer-reviewed publications, community forums and partnerships with the EMBRACE Center.
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BibTeX
@article{salter2026implementing,
title = {{Implementing a community-partnered postpartum care model based in reproductive justice for black birthing people: protocol for a pilot mixed-methods intervention study}},
author = {Cynthia L Salter and Cindy Pan and Mehret Birru Talabi and Jeanine M Buchanich and Andrea Casas and Emily Dauria and Natacha De Genna and Nikita Kubal and Olga V Kravchenko and Tamar Krishnamurti and Claire Lama and Emma Mairson and Dara D Mendez and Iris Ryn Olson and Jada Shirriel and Hyagriv N Simhan and Demia Tyler and Sade A Tukuru and Stacy Bartlett},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2026-122255},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122255},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Implementing a community-partnered postpartum care model based in reproductive justice for black birthing people: protocol for a pilot mixed-methods intervention study
AU - Cynthia L Salter
AU - Cindy Pan
AU - Mehret Birru Talabi
AU - Jeanine M Buchanich
AU - Andrea Casas
AU - Emily Dauria
AU - Natacha De Genna
AU - Nikita Kubal
AU - Olga V Kravchenko
AU - Tamar Krishnamurti
AU - Claire Lama
AU - Emma Mairson
AU - Dara D Mendez
AU - Iris Ryn Olson
AU - Jada Shirriel
AU - Hyagriv N Simhan
AU - Demia Tyler
AU - Sade A Tukuru
AU - Stacy Bartlett
PY - 2026
DA - 2026/10/22
JO - BMJ Open
DO - 10.1136/bmjopen-2026-122255
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-122255
AB - Introduction Postpartum care (PPC) in the USA remains largely inaccessible despite calls for community-driven care models to address poor birth outcomes and racial disparities. Fewer than 40% of US birthing people receive even one PPC visit within 6 weeks post-delivery. Lack of adequate/high-quality PPC exacerbates existing health inequities, with black birthing people more than two times as likely to die as white birthing people in the first year postpartum. PPC remains focused on individual biomedical risks and does not take into account social and structural determinants that shape US pregnancy-associated mortality and morbidity.Methods and analysis This paper describes a 6-year pilot mixed-methods intervention research protocol (fiscal years: 2025–2030) that draws on Reproductive Justice, Restoring Our Own Through Transformation and Public Health Critical Race Praxis frameworks to address gaps in current PPC models within the broader context of social justice. During years 1–2 (2025–2026), we assess baseline maternal health outcomes, including PPC completion, among pregnant individuals delivering at a single Pennsylvania hospital (n=~65 000) from 2016 to 2023. In year 3 (2027), we use qualitative data from focus group discussions and interviews with birthing people, clinicians and health centre staff to develop a community-informed PPC model tailored to the needs of black birthing people in Southwest Pennsylvania. We iteratively adapt the model in years 4–5 (2028–2029) based on community and clinician feedback, assessing both clinical and person-centred outcomes, including outcomes prioritised by black birthing people. To address key systemic and structural barriers of obstetric racism and economic insecurity, we include reproductive justice and anti-racism/anti-oppression training for perinatal clinicians, trainees and staff (with pre-training and post-training assessment) in year 3 (2027), and an unconditional cash transfer that mirrors paid family leave for postpartum people, piloted and assessed in years 4–5 (2028–2029), with overall final evaluation wrapping up in year 6 (2030).Ethics and dissemination The University of Pittsburgh Institutional Review Board approved this study (STUDY24050009). Findings will be disseminated through peer-reviewed publications, community forums and partnerships with the EMBRACE Center.
SN - 2044-6055
SN - 2044-6055
ER -