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Patient and Provider Breastfeeding Discourse
Cooke, Tiffany Anise
Cooke, Tiffany Anise
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Thesis/Dissertation
Date
2024-08
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Urban Bioethics
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http://dx.doi.org/10.34944/dspace/10622
Abstract
Disparities in breastfeeding are increasing for Black women in the United States despite initiatives aimed at improving breastfeeding outcomes. As a result, Black communities are not being protected, which is reflected in the disproportionate rates of mortality and morbidity for the Black dyad. Much of the qualitative studies in the literature have focused on the patient experience through focus groups or interviews. However, this information typically is not communicated to the same physicians providing the care in a study. This study aims to change that by obtaining the breastfeeding experiences and perspectives of patients and medical providers in a low-risk prenatal clinic in urban North Philadelphia. The secondary aim is to disseminate patient feedback to providers to develop a realistic call to action specific to that community. Work obligations and perceived necessary lifestyle changes were the patients' most significant barriers to breastfeeding. Patients desire more education from the medical community, but at the same time, providers lack the knowledge, comfort, and time to counsel. What is clear is that the medical system contributes to these poor outcomes; institutionalized barriers add to existing disparities and ultimately worsen the crisis for everyone, with long-term effects on the economy and productivity of the surrounding community and the population. Providers cannot create change by themselves, as breastfeeding disparities have roots in much larger policies and systems, but providers must examine what is in their scope of influence. Future research is needed to explore the effects of empowering Black communities with education regarding workplace laws and addressing myths that reinforce breastfeeding barriers. Medical education must incorporate breastfeeding into its curriculum as the consequences are dire and intersect with many areas of medicine. This research offers hope for change and has led to providers developing proposals for timely and realistic interventions based on community feedback and narratives.
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