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Primary Submission Category: Health equity
“They Didn’t Expect Me to Be in There”: Black Fathers, the Birth Experience, Reproductive Health Systems, and the Cost of Exclusion
Authors: Diamond Cunningham, Darrell Creecy, Andre Apparacio,
Presenting Author: Diamond Cunningham*
Louisiana leads the nation in maternal mortality, with Black women dying from pregnancy-related causes at rates three to four times higher than white women. Nearly half of those deaths occur in the first postpartum year. Louisiana also leads the nation in incarceration, with Black men disproportionately impacted by structural racism limiting healthcare access. These crises happen in the same households, to the same families, during the same critical window.
The Reproductive Empowerment and Advocacy for Louisiana (R.E.A.L.) Fathers Study examines Black fathers’ reproductive health engagement during the first postpartum year in post-Dobbs New Orleans using a convergent mixed-methods design. Guided by Public Health Critical Race Praxis and reproductive justice, the study examines contraceptive knowledge, reproductive health self-efficacy, and partner communication through community-based surveys and focus groups conducted with Black father-led organizations including Fathers Matter NOLA and Dad-a-Port.
Preliminary findings from seven focus groups with 30 Black fathers reveal consistent experiences of structural exclusion within healthcare settings. Fathers described being rendered invisible by providers despite being physically present. One father said nurses looked at him like “they had never seen a Black father in the delivery room.” Another whose son spent 90 days in the NICU said: “I would have had a better experience with my babies.” Another said simply: “We actually care. Plain and simple.”
The maternal mortality crisis has largely asked Black women to solve it themselves. Black men make up approximately 80% of partners of Black women giving birth and are already present and motivated. Reimagining population health science to build trust requires finally turning to look at who is already in the room.