Utilizing Black feminism as a tool for analysis and an approach to evaluation in maternal health

The maternal health crisis in the United States disproportionately impacts Black pregnant, birthing, and postpartum people. Because of the advocacy, scholarship, and leadership of Black women and gender-expansive people, there is widespread recognition of the social and structural determinants of health contributing to the inequities faced by these groups and significant efforts at the federal, state, and local levels to address them. Unfortunately, these efforts have fallen short of their promise to reduce or even eliminate racial and ethnic inequities in maternal health outcomes and improve the quality of care to Black women and birthing people. This dissertation used Black feminism, a theoretical and activist framework centering the lived experiences of Black women, to analyze this crisis and describe an approach to evaluation that can more effectively assess programs and policies targeting maternal health inequities. Black feminist evaluation builds on the contributions of culturally responsive and feminist evaluation and other evaluation theories rooted in social justice and human rights. The principles and steps for this approach and their operationalization in the evaluation of a birth center are described.