Objectives:  Significant racial inequities exist in infant and maternal health. A growing body of research identifies structural racism as an important factor in generating and reinforcing these inequities. However, few studies have examined whether clinicians recognize the role that structural racism plays in impacting birth outcomes. This study assessed the extent to which certified nurse-midwives named structural racism as a factor that impacts the health of their patients. The secondary aim was to identify what strategies, if any, nurse-midwives used to address health inequities.

Methods: Semi-structured interviews were conducted with eight hospital-based certified nurse-midwives in the Minneapolis-St. Paul metropolitan area.

Results:  Only three participants explicitly named structural racism.  Four major themes were identified. Overall, participants implicitly understood the downstream effects and causal pathways of structural racism, but lacked a clear vocabulary for discussing issues of race and racism. Though they identified significant organizational barriers, they strongly believed that the midwifery model of maternity care was well-suited to address health inequities and structural racism.

Conclusion: Though this study is limited by the small sample size and non-random sampling method, the results suggest several import areas for future research and for policymaking.