Hannah Degge

Pregnancy during the COVID‐19 pandemic presented unique challenges for all women; however, the experiences of Black women were particularly affected by intersecting processes and systems such as race, class, gender, socioeconomic status, and healthcare access. The objective of this study was to explore the perinatal experiences of Black women amidst the COVID‐19 pandemic. This was a qualitative study. Inclusion criteria were self‐identification as a Black woman aged 18–49; experienced at least one pregnancy from March 2020 to May 2023; received at least one dose of COVID‐19 vaccine during the perinatal period; and residence in Greater Philadelphia. Interviews (n = 22) were conducted by trained researchers and were audio‐recorded and transcribed verbatim, and analyzed inductively. Participants were incentivized for their time. The average age of the participants was 33.5 (±6.2) years. Of 28 pregnancies, 22 resulted in live births, two ended in miscarriages, two in abortions, and two participants were pregnant during data collection. Three main themes were identified: (1) emotional impact of COVID‐19; (2) experiences of COVID‐19 illness during pregnancy and postpartum; and (3) impact of COVID‐19 mitigation measures on perinatal experiences. The perinatal experiences of Black women during the COVID‐19 pandemic revealed critical gaps in our maternal healthcare system. Hence, culturally sensitive and targeted crisis preparedness and readiness strategies, such as community‐led response teams, for minority groups during health crises like the COVID‐19 pandemic, are warranted.

Obstetric Fistula is an abnormal opening between the vagina and rectum resulting from prolonged and obstructed labour. Studies indicate that delays in accessing maternal care and home birth contribute to the development of fistula. Survivors are usually women of low socioeconomic status residing in rural locations. This study explores the birthing experiences of 15 fistula survivors through a narrative inquiry approach at a repair centre in North‐central Nigeria. Using structural violence as a lens, it describes the role of social, political and health systems in the inequitable access to care for women. For women opting for home births, preference for home delivery was mainly due to lack of finances, poor health systems and cultural practices. Rural location inhibited access as women seeking facility delivery faced transfer delays to referral centres when complications developed. Inequitable maternal health services in rural locations in Nigeria are inherently linked to access to health care, and these contribute to the increased incidence of fistulae. Structural intervention is a health policy priority to address poor health systems and achieve universal health coverage to address maternal health issues in Nigeria.