Keywords

maternal mortality, prenatal care adequacy, Black women, health disparities, racial disparities, severe maternal morbidity

Abstract

The United States continues to face a maternal health crisis marked by persistent racial disparities, with Black women experiencing pregnancy-related mortality rates three times higher than those of White women. Despite national efforts to expand access to prenatal services, inequities in maternal outcomes remain, indicating that the quality of prenatal care may be as critical as its timing and frequency. The purpose of this thesis is to examine whether adequate prenatal care, compared to inadequate prenatal care, is associated with reduced adverse maternal outcomes among Black and African American women in the United States. Guided by a PICO question, this study employed an integrative review methodology following PRISMA guidelines to synthesize quantitative and qualitative evidence from peer-reviewed literature. Prenatal care adequacy was conceptualized beyond visit count to include timely initiation, individualized and culturally responsive care, effective communication, and attention to social and structural determinants of health. Findings from the reviewed literature indicate that inadequate quality of prenatal care, provider bias, and fragmented care delivery contribute significantly to adverse maternal outcomes among Black women, while comprehensive, multidisciplinary, and patient-centered prenatal care models are associated with improved risk identification, management of chronic and pregnancy-related conditions, and enhanced trust in the healthcare system. This study is important because it highlights the role of prenatal care quality as a modifiable factor in reducing preventable adverse maternal outcomes and advancing birth equity, offering implications for nursing practice, healthcare policy, and future research focused on culturally responsive and structurally informed prenatal care interventions.

Thesis Completion Year

2026

Thesis Completion Semester

Spring

Thesis Chair

Navarro, Kimberly

College

College of Nursing

Department

College of Nursing

Thesis Discipline

Nursing

Language

English

Access Status

Open Access

Length of Campus Access

None

Campus Location

Orlando (Main) Campus

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Rights Statement

In Copyright