Findings from A Transdisciplinary Conceptual Framework of Contextualized Resilience for Reducing Adverse Birth Outcomes are described by the author and PTBi researcher, Tijen Sumbul. Additional authors include Solaire Spellen and Monica McLemore.
Please describe your research findings.
Our study used a scoping review of literature from many different fields of knowledge to develop a conceptual resilience framework and better understand how resilience is lived, created and transformed by Black, Hispanic and Latina women to increase healthy birth outcomes and reduce disproportionately high preterm births and low birth rates. Our resilience framework focuses on centering the strengths of Black, Hispanic and Latina women while also putting in context the everyday experiences of stress, discrimination, historically inequitable circumstances and contemporary structural forces that influence negative birth outcomes.
Are there any “first(s),” “biggest(s), or “only(s)” with this study – i.e., first study to quantify or examine something, the largest study of its kind, etc?
Our resilience framework is the first developed to be strengths-based and woman-centered while also incorporating the context of historical racism, oppression, trauma, structural vulnerabilities, and gender roles. Instead of only identifying how stress and adverse experiences such as discrimination and structural violence are experienced in the body, we are also looking at how resilience is created and experienced in the body to create health and wellness. Our framework provides a tool to view how Black, Hispanic and Latina women create and embody resilience to create healthier pregnancies, births, and resulting wellness for their infants.
What is already known about this topic, and how do your findings add to or change this existing knowledge?
In the public health field, many research studies have shown how stress, discrimination, segregation, individual traits, and social supports influence women’s health and birth outcomes. Numerous resilience studies in anthropology, social work, psychology, and many other fields demonstrate how healthy individuals benefit from their resilient character traits and relationships to family and community. Our resilience framework builds on the knowledge and research already established in studies on adverse birth outcomes and overall health resilience, while also seeking to shift the focus to see women’s experiences as the starting point of “resilience” by understanding how women are already creating healthier birth outcomes.
Our framework adds to the existing knowledge by contributing to the definition of resilience as a strength-based, multi-leveled process that involves an ebb and flow of positive and sometimes “negative” or survival-based ways of dealing with and maneuvering stressors, discriminations, traumas and often-unequal access to resources and privileges.
How does your research impact current clinical practice? How does your research impact patients?
Black women experience the highest and disparate rate of preterm birth and adverse birth outcomes. Hispanic and Latina women also experience high rates of adverse birth outcomes compared to White women. Our resilience framework provides a dynamic lens to understand how Black, Hispanic and Latina women create and negotiate resilience in many contexts and environments to increase healthy birth outcomes. Our framework provides a deeper understanding of resilience not just as an individual’s ability to think positive thoughts or rely on their family or community supports, but to also recognize how women deal with and actively navigate stressors and unequal access to resources and privileges.
Our framework of resilience can be applied to improve women’s birth outcomes via understanding the ways resilience is increased while using that knowledge to expand upon resilient practices and center women in their own healthy birthing experiences.
What should researchers/providers/patients/public health workers/etc. do as a result of these findings?
Practitioners can use our framework to center the strengths and resilient practices of Black, Hispanic and Latina women through applying examples of strategies that increase resilience in multi-level environments. This framework can also be used to move away from an individualistic focus and understand resilience as existing in many contexts while being a lived experience that influences the health of women, birthing people, and their children.
