This book uniquely explores American cultural values as a factor in maternal health. It looks beyond the social determinants of health as primarily contributing to the escalating maternal morbidity and mortality in the United States.
The United States is an outlier with poor maternal health outcomes and high morbidity/mortality in comparison to other high-resource and many mid-level resource nations. While the social determinants of health identify social and environmental conditions affecting maternal health, they do not answer the broader underlying question of why many American women, in a high-resource environment, experience poor maternal health outcomes. Frequent near-misses, high levels of severe childbearing-related morbidity, and high maternal mortality are comparable to those of lower-resource nations.
This book includes contributions from recognized medical and cultural anthropologists, and diverse clinical and public health professionals. The authors examine American patterns of decision-making from the perspectives of intersecting social, cultural, and medical values influencing maternal health outcomes. Using an interdisciplinary critical analysis approach, the work draws upon decision-making theory and life course theory. Topics explored include:
- Cultural values as a basis for decision-making
- Social regard for motherhood
- Immigrants, refugees and undocumented mothers
- Cultural conflicts and maternal autonomy
- Health outcomes among justice-involved mothers
Maternal Health and American Cultural Values: Beyond the Social Determinants is an essential resource for clinical and public health practitioners and their students, providing a framework for graduate-level courses in public health, the health sciences, women’s studies, and the social sciences. The book also targets anthropologists, sociologists, and women studies scholars seeking to explain the links between American cultural decision-making and health outcomes. Policy-makers, ethicists, journalists, and advocates for reproductive health justice also would find the text a useful resource.
Author(s): Barbara A. Anderson, Lisa R. Roberts
Series: Global Maternal and Child Health
Publisher: Springer
Year: 2023
Language: English
Pages: 219
City: Cham
Series Editorial Advisory Board
Preface
Acknowledgments
About the Book
Contents
Contributors
About the Editors
List of Abbreviations and Acronyms
List of Boxes
Part I: Maternal Health, American Cultural Values, and the Social Determinants of Health
Chapter 1: The Health of American Mothers in the Context of Cultural Values
1.1 The Current State of Maternal Health in the USA
1.2 Social and Environmental Conditions Affecting Maternal Health
1.2.1 The Social Determinants of Health
1.2.2 The Social Determinants of Maternal Health
1.3 Cultural Values and Maternal Health Outcomes
1.3.1 American Cultural Values
1.3.2 Personal Control
1.3.3 Individualism
1.3.4 Action-Orientation
1.3.5 Practicality
1.3.6 Self-Reliance
1.4 Summary
References
Chapter 2: Cultural Values as a Basis for Decision-Making
2.1 Maternal Health Outcomes: A Reflection of Decisions
2.2 Theoretical Foundations of Decision-Making
2.2.1 The Study of Decision-Making
2.2.2 Cultural Alternatives in Decision-Making
2.3 Cultural Models: Guide to Decision-Making
2.3.1 Norms and Values
2.3.2 Decisions and Cultural Values
2.4 American Cultural Values
2.4.1 Personal Control
2.4.2 Individualism
2.4.3 Action-Orientation
2.4.4 Practicality
2.4.5 Self-Reliance
2.5 Summary
References
Part II: The Lived Experience of American Mothers
Chapter 3: Social Regard for Motherhood
3.1 Motherhood in the USA
3.2 Experiences Across Life
3.2.1 Life Course Theory
3.2.2 Context
3.2.3 Developmental Stage
3.2.4 Timing
3.2.5 Agency
3.2.6 Linked Lives
3.3 American Cultural Values Shaping Motherhood
3.4 Summary
References
Chapter 4: Fertility and Reproductive Health
4.1 Fertility and Reproductive Health in the USA
4.2 Influence of American Cultural Values
4.2.1 Women of Diverse Backgrounds
4.2.2 Negative Birth Experience
4.2.3 Expectations of Family Structure
4.3 Distress and Ambivalence about Motherhood
4.4 Infertility
4.4.1 Assisted Reproductive Technology
4.4.2 Social Response to Infertility
4.5 Family Building Alternatives
4.6 Summary
References
Chapter 5: Maternal Mental Health and Illness
5.1 Current State of Maternal Mental Health Inequities in the USA
5.2 Social Determinants of Health: Social and Community Context
5.3 Personal Control: An American Cultural Value Affecting Maternal Mental Health
5.4 Summary
References
Chapter 6: The Lived Experience of American Mothers in the Military
6.1 Mothers in the Military Culture
6.2 Maternal Health Care in the Military Community
6.3 The Evolving Family Culture in the Military
6.3.1 The Historical Expectations of Mothers in the Military Community
6.3.2 Contemporary Expectations of Mothers in the Military Community
6.3.3 Conflicts for Working Mothers in the Military Community
6.3.4 Self-Reliance in the Military Community
6.4 The Military Community and the Social Determinants of Health
6.4.1 Promoting Family Readiness for Mothers in the Military Community
6.4.2 Promoting Self-Reliance for Mothers in the Military Community
6.4.2.1 Economic Stability
6.4.2.2 Education
6.4.2.3 Neighborhood and Community
6.5 Summary
References
Part III: Mothers in a Divided Nation
Chapter 7: Immigrants, Refugees, and Undocumented Mothers
7.1 Privilege of Place
7.2 Motherhood and Place
7.3 Exemplars of the Lived Experience
7.3.1 Exemplar: An Immigrant Mother from South Asia
7.3.2 Exemplar: An Immigrant Mother from the Middle East
7.3.3 Exemplar: A Refugee Mother from Southeast Asia
7.3.4 Exemplar: A Second-Generation Mother from Central America
7.4 Undocumented: The Shadow World of the 70-Mile Rio Grande Valley
7.4.1 The Path to Personal Control
7.4.2 The Pathway to Inclusion
7.5 Summary
References
Chapter 8: Maternal Health Outcomes and Othering: The Impact of Ethnicity and Race
8.1 Historical Impact of Othering
8.2 Loss of Personal Control: The Lived Experience of Black Mothers
8.2.1 Ambivalence About Conception
8.2.2 Ambivalence About Abortion
8.2.3 Ambivalence About Childrearing
8.3 Breastfeeding Exploitation Among Black Mothers: Historical and Contemporary Effects
8.4 Othered Women and the Social Determinants of Health
8.4.1 SDoH Domain: Health Care Access and Quality
8.4.2 SDoH Domain: Neighborhood and Built Environment
8.5 The Impact of Othering on Maternal Health Outcomes
8.5.1 Allostatic Load
8.5.2 Invisibility
8.6 Racial and Cultural Concordance in Black Mothers
8.7 Summary
References
Chapter 9: Cultural Conflicts and Maternal Autonomy
9.1 The Autonomy of American Mothers
9.2 Individualism and Autonomy Among American Women
9.2.1 Legalization and Subsequent Threats to Autonomy in Pregnancy Continuation
9.2.2 Social Determinants of Health and Restricted Access to Abortion Services
9.2.3 Social Determinants of Health and Access to Fertility Control
9.2.4 Autonomy in Decisions about Birth Practices
9.3 Exemplar: Autonomy Among American Indian and Alaska Native Mothers
9.3.1 Health Outcomes Among American Indian/Alaska Native Mothers
9.3.2 Examples of Collectivism as Supportive to Maternal Health
9.4 Summary
References
Chapter 10: The National Conversation on Maternal Health
10.1 Information Dissemination on Maternal Health
10.2 Individualism and the Rhetoric on Maternal Health
10.2.1 Individualism and Polarization
10.2.2 Language in a Divided Nation
10.2.3 Information, Misinformation, and Disinformation
10.3 Motherhood According to the Media
10.3.1 Conformity
10.3.2 Deviance
10.3.2.1 “Absent Mothers”: The Media Profile
10.3.2.2 “Non-traditional Mothers”: Media Conversations
10.3.3 “Fitness for Motherhood”
10.3.3.1 Disability and Fitness for Motherhood
10.3.3.2 Race, Ethnicity, and Fitness for Motherhood
10.4 Summary
References
Part IV: Community Forces Influencing Maternal Health
Chapter 11: Healthcare Providers: Leadership for Optimal Maternal Health
11.1 Influencing Decisions for Safe Maternal Outcomes
11.2 Action to Protect Maternal Health During COVID-19
11.2.1 Provision of Maternal HealthCare Access during COVID-19
11.2.2 Management of Vaccine Hesitancy and Misinformation
11.3 Action to Protect Mothers at Especially High Risk
11.3.1 Guarding Mothers at High Risk
11.3.2 Exemplar: American Indian/Alaskan Native Mothers at Risk
11.4 Action to Support Conditions for Optimal Birth
11.4.1 Public Advocacy for Healthcare System Action
11.4.2 The Healthcare System Response
11.5 Summary
References
Chapter 12: Survival Services for American Mothers
12.1 Meeting Basic Needs for Maternal Health
12.2 Basic Necessities for Survival
12.2.1 Food
12.2.2 Water
12.2.2.1 Exemplar: Water in Flint, Michigan
12.2.2.2 Exemplar: Water in Pearl Harbor, Hawaii
12.2.3 Air
12.2.4 Shelter
12.3 Cultural Values and Survival
12.3.1 Citizen Action in Flint
12.3.2 Action of Citizen Soldiers and Military Families in Honolulu
12.3.3 Citizen Response to Food Deserts and Food Waste
12.3.4 Barriers to Reaping the Benefits of Citizen Action
12.3.5 Practicality: Necessary But Not Sufficient
12.4 Summary
References
Chapter 13: Community Influences on Maternal Safety
13.1 Individualism and Maternal Safety
13.2 Intimate Partner Violence and Maternal Safety
13.2.1 Withholding Resources
13.2.2 Threatening with Weapons
13.2.3 Sexual Violence
13.2.4 Taking Pets Hostage
13.3 Neighborhood Security
13.3.1 Individualism and Gun Safety in the Neighborhood
13.3.2 Maternal Mental Health in Unsafe Environments
13.3.3 Project Safe Neighborhoods
13.4 Human Trafficking and Maternal Safety
13.4.1 Impact of Sex Trafficking on Maternal Health
13.4.2 Missing and Murdered American-Indian and Alaska Native Mothers
13.5 Summary
References
Chapter 14: Substance Use and Maternal Health
14.1 Substance Use and Maternal Health Outcomes
14.2 The Influence of Self-Reliance
14.3 Complexities of Receiving Prenatal Care
14.3.1 Stigmatization and Discrimination
14.3.2 Legal Ramifications
14.4 Adverse Social Determinants of Health
14.4.1 Low Socioeconomic Status
14.4.2 Inadequate Insurance Coverage
14.4.3 Unstable Housing and Limited Transportation
14.4.4 Community Response to Substance-Abusing Mothers
14.5 The Means to Overcome
14.6 Summary
References
Chapter 15: Health Outcomes Among Justice-Involved Mothers
15.1 Surveillance and Incarceration in the USA
15.2 Maternal Health Outcomes in Jails and Prisons
15.3 The Framework of Reproductive Justice
15.4 Self-Reliance: An American Cultural Value
15.4.1 The Myth of Self-Reliance
15.4.2 Criminalizing Non-Adherence to Self-Reliance
15.4.2.1 Exemplar: Self-Reliance and Healthcare
15.4.2.2 Exemplar: Self-Reliance and Substance Abuse
15.4.2.3 Exemplar: Self-Reliance and Reproductive Violence in Prison
15.4.3 Policies and Programs to Support Self-Reliance
15.5 Summary
References
Part V: Reflections in the Cultural Mirror
Chapter 16: Conclusions
16.1 Reflections on History, Values, and Decisions
16.2 Advancing Maternal Health in America: The Path Forward
References
Index
