Keywords

Black maternal health, rural healthcare access, reproductive justice, Black feminist anthropology, structural racism, epistemic resistance

Abstract

This dissertation uses semi-structured interviews (n=42), participant observation, archival research, and storytelling, it employs frameworks of structural violence, intersectionality, and reproductive justice to situate Black women’s maternal health within broader histories of racialized medical neglect and reproductive governance. The study explores two questions: (1) What obstacles do Black women in rural Alabama face in accessing perinatal healthcare? (2) How do they navigate these barriers, and what strategies do they employ? A mixed-methods approach—including ethnography, quantitative analysis, and GIS—guides this research, with storytelling serving as both a methodological intervention and a challenge to dominant anthropological narratives. Findings highlight three major themes: cultural and historical mistrust, health literacy and language, and resilience. Black women rely on kinship networks, community-based support systems, and informal reproductive knowledge to counter institutional failures, forming alternative care infrastructures that preserve communal knowledge and enable adaptation in structurally constrained healthcare environments. The Barriers to Access Scale assesses transportation, provider availability, finances, health literacy, discrimination, and comfort in care, revealing that higher CIS scores (≥0.85) correlate with longer travel distances, greater discrimination, and lower financial resources, with provider shortages linked to medical mistrust. CIS strongly correlates with provider comprehension (r=0.80), discrimination (r=0.78), and financial barriers (r=0.51), underscoring racism and economic instability as primary obstacles. Grounded in Black feminist thought and womanist theology, it frames Black women’s lived experiences as epistemic resistance, asserting healthcare access as a moral imperative and contributing to medical anthropology, reproductive justice, and Black feminist theology while informing policy interventions that address racial and geographic maternal health disparities.

Completion Date

2025

Semester

Spring

Committee Chair

Reyes-Foster, Beatriz

Degree

Doctor of Philosophy (Ph.D.)

College

College of Sciences

Department

Anthropology

Identifier

DP0029329

Document Type

Dissertation/Thesis

Campus Location

Orlando (Main) Campus

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