research PRECARIOUS PARENTHOOD Portland State researchers investigate how to support the most vulnerable parents WHEN ROBERTA HUNTE, social work faculty, talks to Black people who have given birth she hears about painful and alienating experiences with healthcare providers and worries about deliveries. “That was one of my biggest fears,” one woman told her. “You know, dying while giving birth.” Hunte is one of a slate of Portland State researchers working to identify factors—from racism to inadequate parental leave—that can make pregnancy, birth and parenting extra tough—and what can be done about it. Together these researchers highlight how tackling hard societal issues like structural racism, parental leave, child care and affordable housing may help pull the most vulnerable parents away from the brink and set up the next generation for a thriving future. HUNTE and fellow social work faculty member Susanne Klawetter are examining the Healthy Birth Initiatives (HBI), a Multnomah County home-visit program that provides individualized care to Black families during pregnancy and for 18 months after birth. If you’re Black in the United States, delivering a child is a dangerous proposition. According to the Centers for Disease Control and Prevention, Black women are three times more likely to die from pregnancy-related causes than white women—a gap that widens with age and education. “What is incredibly important to note about HBI is that it is a program of Black birth workers. I think that’s its key intervention,” says Hunte, who was also a participant in the program. “It’s run by Black people, it’s for Black people, and it is engaging with the broader medical system and asking it to be better.” The study found that racism-related stress was a chronic experience for participants with a direct impact on their parenting. In focus groups, they described traumatic birth experiences, struggles paying for housing and worries about the safety of their children in school and around police. As a result, the program focuses on well-being within and beyond medical appointments, offering conversation, transportation, child care, housing assistance and even intervening if Child Protective Services gets involved. Data shows the approach is working. Black mothers who go through the program are less likely to encounter unexpected health complications following delivery than Portland mothers of any other racial group. KLAWETTER is also researching how to support parents with children in the neonatal intensive care unit, or NICU, which she experienced first-hand when her triplets were born 15 years ago. Roughly 10-15% of babies require this high level of medical care after birth.Their parents often deal with multiple additional stressors—from caring for older children to juggling jobs so they can maintain employment and housing—and show increased rates of depression, anxiety and post-traumatic disorder. Klawetter has identified several ways to better support them, for example by screening for depression and anxiety throughout their babies’ NICU stay and at discharge. But there’s one intervention the healthcare system alone can’t provide, Klawetter says. SEVENTYFOUR, ADOBE STOCK 12 // PORTLAND STATE MAGAZINE
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