1. Problem Statement 
Persistent racial inequities in U.S. maternal healthcare raise questions about whose knowledge is recognized and acted upon. Studies of Black women's perinatal self-advocacy and experiences of severe maternal morbidity describe challenges involving dismissal, communication, and responsiveness (Hagan Thomas et al., 2024; Post et al., 2025). Research on person-centered and respectful maternity care likewise identifies dignity, communication, autonomy, and responsive treatment as central dimensions of quality (Afulani et al., 2022; Cantor et al., 2024).

 

The central concern is not simply whether mothers are heard, but whether their embodied and experiential
knowledge is recognized as credible, respected as consequential, and enacted to inform clinical decisions and
responsive care.

​

2. Purpose
To propose the MHAATTM Reciprocal Humanization Framework, integrating critical consciousness, epistemic justice, and culturally responsive caring to examine how maternal knowledge and clinician self-reflection may shape reciprocal engagement creating space whereby maternal knowledge and clinical expertise are mutually recognized, respected and enacted to shape care.

The framework examines maternal knowledge and clinician self-reflection as mutually consequential within the
mother–clinician relationship, without assuming equal institutional power or claiming demonstrated clinical
effects.

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

3. Conceptual Approach and Theoretical Foundations
Critical consciousness: Critical and emancipatory scholarship informs examination of historically constructed
assumptions about identity, knowledge, and authority, as well as reflection, dialogue, and action (Fanon, 2008;
Freire, 2018; Woodson, 2023; hooks, 1994; King, 1991; Brandon, 2006). These sources provide theoretical
grounding rather than direct evidence of maternal-health outcomes.

Epistemic justice: Fricker (2017) provides a lens for considering credibility, whose knowledge counts, and how
maternal accounts are recognized and used within unequal care relationships.

Culturally responsive caring: Gay (2018) informs the translation of cultural recognition and respect into responsive practice. Tervalon and Murray-García (1998) emphasize ongoing self-reflection, cultural humility, and attention to power imbalances.

Reciprocal enactment: The framework proposes that these theoretical conditions become consequential when
clinicians examine assumptions and power, maternal knowledge is recognized as legitimate, and both forms of
knowledge inform shared meaning, decisions, and responsive action. The five application pillars identified in the
APHA submission include historical and cultural consciousness, relational trust, contextualized communication,
community-supported care, and institutional accountability. Together, these pillars situate these interactions
within broader conditions.

The proposed MHAAT 360°TM Navigator may provide educational and relational support between clinical encounters, with maternal consent, complementing rather than replacing clinical care. Reciprocal humanization is an intended relational outcome, not a demonstrated effect.

​

4. Proposed Conceptual Contribution

Existing maternity-care scholarship already addresses person-centered care, respectful care, shared decision-
making, and culturally appropriate interventions (Afulani et al., 2022; Cantor et al., 2024; Alruwaili et al., 2023;

Coast et al., 2016). Provider-focused research also identifies reflection, accountability, and respectful-care
practices (Ofori-Parku et al., 2025). These are antecedents, not concepts originated by MHAAT.

Building upon established scholarship, the MHAATTM Reciprocal Humanization Framework proposes an integration of critical consciousness, epistemic justice, culturally responsive caring, maternal knowledge, and clinician self-reflection. Its conceptual emphasis is on the reciprocal enactment of these principles within the mother–clinician relationship, where maternal knowledge and clinical expertise are mutually recognized and used to shape care. Reciprocal humanization is proposed as an intended relational outcome, supported by educational, community, and institutional conditions. The framework's distinctiveness and effects remain to be established through comparative scholarship and empirical inquiry.

5. Central Poster Takeaway
Moving from Listening to Being Shaped by Mothers.

Centering maternal knowledge. Advancing equity. Transforming maternal healthcare.

​

References

Afulani, P. A., Altman, M. R., Castillo, E., Bernal, N., Jones, L., Camara, T., Carrasco, Z., Williams, S., Sudhinaraset, M., & Kuppermann, M. (2022). Adaptation of the Person-Centered Maternity Care Scale in the United States: Prioritizing the experiences of Black women and birthing people. Women’s Health Issues, 32(4), 352–361.
https://doi.org/10.1016/j.whi.2022.01.006

Alruwaili, T. A., Crawford, K., Jahanfar, S., Hampton, K., & Fooladi, E. (2023). Pregnant persons and birth partners’ experiences of shared decision-making during pregnancy and childbirth: An umbrella review. Patient Education and Counseling, 114, 107832. https://doi.org/10.1016/j.pec.2023.107832

Brandon, L. (2006). On dysconsciousness: An interview with Joyce E. King. Educational Studies, 40(2), 196–208.
https://doi.org/10.1207/s15326993es4002_12

Cantor, A. G., Jungbauer, R. M., Skelly, A. C., Hart, E. L., Jorda, K., Davis-O’Reilly, C., Caughey, A. B., & Tilden, E. L. (2024). Respectful maternity care: A systematic review. Annals of Internal Medicine, 177(1), 50–64. https://doi.org/10.7326/m23-2676

Coast, E., Jones, E., Lattof, S. R., & Portela, A. (2016). Effectiveness of interventions to provide culturally appropriate maternity care in increasing uptake of skilled maternity care: A systematic review. Health Policy and Planning, 31(10), 1479–1491. https://doi.org/10.1093/heapol/czw065

Fanon, F. (2008). Black skin, white masks (R. Philcox, Trans.). Grove Press. (Original work published 1952).

Freire, P. (2018). Pedagogy of the oppressed (M. B. Ramos, Trans.; 50th anniversary ed.). Bloomsbury Academic (Original work published 1968).

Fricker, M. (2017). Evolving concepts of epistemic injustice. In I. J. Kidd, J. Medina, & G. Pohlhaus Jr. (Eds.), The Routledge handbook of epistemic injustice (pp. 53–60). Routledge.

Gay, G. (2018). Culturally responsive teaching: Theory, research, and practice (3rd ed.). Teachers College Press. https://doi.org/10.65528/9780807776704 hooks, b. (1994). Teaching to transgress: Education as the practice          of freedom. Routledge.

King, J. E. (1991). Dysconscious racism: Ideology, identity, and the miseducation of teachers. The Journal of Negro Education, 60(2), 133–146. https://doi.org/10.2307/2295605

Ofori-Parku, C. Y., Harris, O. O., Baltzell, K., Little, E., & Asiodu, I. V. (2025). An exploration of perinatal healthcare providers’ perspectives on respectful maternity care in the United States: A scoping review. BMC Pregnancy and Childbirth, 25(1), 1165. https://doi.org/10.1186/s12884-025-08247-y

Post, W., Thomas, A., & Sutton, K. M. (2025). “Black women should not die giving life”: The lived experiences of Black women diagnosed with severe maternal morbidity in the United States. Birth, 52(1), 36–45. https://doi.org/10.1111/birt.12820

Tervalon, M., & Murray-García, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125. https://doi.org/10.1353/hpu.2010.0233

​

Woodson, C. G. (2023). The mis-education of the Negro (J. R. Givens, Intro.). Penguin Classics. (Original work    published 1933).