Term of Award
Spring 2025
Degree Name
Doctor of Public Health in Public Health Leadership (Dr.P.H.)
Document Type and Release Option
Dissertation (restricted to Georgia Southern)
Copyright Statement / License for Reuse
This work is licensed under a Creative Commons Attribution 4.0 License.
Department
College of Public Health
Committee Chair
Joanne Chopak-Foss
Committee Member 1
Samuel Opoku
Committee Member 2
Linda Kimsey
Abstract
Among all developed countries, the U.S. has the highest maternal mortality rate and is the only one, out of the developed countries, where mortality rates are steadily rising. In addition, in the United States, there are significant disparities in maternal mortality rates based on race and ethnicity. During 2017–2019, the PRMR for non-Hispanic Black women was 39.9 deaths per 100,000 live births compared to non-Hispanic White women with 14.1 deaths per 100,000 live births. Much has been written about physical causes of maternal mortality such as cardiomyopathy, pre-eclampsia, and eclampsia as clinical indicators. However, there is limited research on non-clinical factors such as access to care, perceived level of care, provider bias, and provider decision-making as non-clinical indicators of maternal mortality. The purpose of this study was to examine a) non-clinical influences and factors contributing to poor quality of care in a sample of women and (b) assess the relationship between self-reported quality of care and maternal health outcomes, as measured by current perceived health status. Method: This study explored self-reported non-clinical factors influencing perceived quality of obstetric care and their relationship to post-partum health status. Women aged 18-49 who gave birth in Georgia within the past five years were recruited using purposive sampling. Results: The study found no link between structural factors and self-reported poor quality of care, nor between provider-patient relationships and perceived care quality. Shared decision-making was associated with higher quality ratings and rurality was associated with low perceived health status. Discussion: Shared decision-making was linked to higher self-reported quality of care while other structural factors were not, contradicting previous research. No connection was found between quality of care and postpartum health, though rural women reported poorer health. A key limitation was the lack of racial diversity, limiting insights into Black women’s experiences. The study highlights the need for more diverse samples, provider assessments, and community engagement. Findings emphasize the importance of equity-focused policies and interventions to reduce maternal health disparities and improve outcomes.
Recommended Citation
Berry, Alexus, "Patient Experience as a Non-Clinical Contributor to Maternal Morbidity and Mortality Among a Sample of Women in Georgia" (2025). Electronic Theses and Dissertations. 2920.
https://digitalcommons.georgiasouthern.edu/etd/2920
Research Data and Supplementary Material
No
