Date of Award

Spring 6-9-2024

Document Type

Thesis (Undergraduate)

Department

Geography

First Advisor

Xun Shi

Second Advisor

Abigail Neely

Third Advisor

Zaneta Thayer

Abstract

Childbirth experiences are shaped by spatial context. This study considers the relationships between access to, selection of, and experiences with labor and delivery care among Black birthing people in Washington, DC. Informed by Reproductive Justice and reproductive geographies frameworks, I employ a mixed methods GIS design that integrates mapping of potential spatial access with qualitative analysis of community members’ lived experiences. On the quantitative side, nearest-neighbor and 2-step floating catchment area analyses reveal an east-west gradient of potential spatial access to labor and delivery wards, with low access concentrated in predominantly Black and low-income census tracts of Wards 5, 7, and 8. On the qualitative side, through interviews and surveys, birthing people residing in these neighborhoods confirmed experiencing structural barriers to perinatal care. Even when doing so introduced further obstacles, participants highlighted the necessity of accessing the birthplaces they considered safest, which they understood to be settings where emergencies were managed safely and racism was absent. In other words, quality matters, and participants felt responsible for overcoming geographic and socioeconomic barriers to ensure their own safety during birth. These results reaffirm the value of mixed methods research in reproductive geographies. While able to identify disparities in spatial access, purely quantitative geospatial analyses underestimate the magnitude, complexity, and intersections of these disparities, as manifested in participants’ lived experiences. Policy solutions in DC, including hospital construction in underserved areas, must commit to dismantling obstetric racism, improving and equalizing maternity care, and ensuring that Black birthing people both feel safe and are safe.

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