The Role of Counseling Psychology in Reducing Maternal Health Disparities: A Call to Action & Pilot Intervention

Abstract

There is a maternal mortality crisis affecting Black women in the U.S. Counseling psychologists are called to be active participants in promoting health equity and social justice, including engagement in reproductive justice, and are uniquely positioned to help mitigate this crisis by promoting the mental, sexual, and reproductive health of Black women. The field of counseling psychology specifically is well-suited to address this crisis because of the field's promotion of well-being through advocacy, practice, training, and research. The purpose of this article is to (a) provide an overview of maternal health inequities experienced by Black women in the U.S., (b) describe factors contributing to these inequities, and (c) recommend approaches for counseling psychologists to reduce maternal health inequities of Black women. This article also aimed to pilot a psychoeducational intervention combining Respectful Maternity Care (RMC) and Multicultural Competence (MCC) to train nursing students to provide equitable maternal care to Black women. 37 undergraduate nursing students from a large Southeastern university attended a single 120-minute EMPOWER (Educating Maternal Providers on Optimizing Wellness, Equity, & Respect for Black Mothers) group intervention session. Students completed measures of RMC perceptions, intentions to perform RMC practice recommendations, MCC awareness, maternal health disparities knowledge, and intentions to perform MCC skills at pre-intervention, post-intervention, and four-week follow-up. Feasibility and acceptability were assessed post-intervention. EMPOWER was feasible to deliver in 2 hours and acceptable. Generalized Estimating Equations (GEE) showed significant increases in MCC awareness (Cohen's d = 1.42), maternal health disparities knowledge (d = 3.20), RMC perceptions (OR = 7.53), RMC practices intentions (OR = 4.64), and MCC skills intentions (OR = 2.85) from pre- to post-intervention. Pre- to post-intervention changes were largely maintained at four-week follow-up. A brief, integrated RMC and MCC psychoeducational intervention is feasible, acceptable, and has preliminary efficacy for improving nursing students' knowledge, perceptions, and intentions to provide equitable maternal care to Black women.