About SACRED Birth

The SACRED Birth Study officially ended January 31, 2021.

The Psychometric Validation of the Patient Reported Experience Measure of OBstetric racism©, also known as the PREM-OB Scale™ Suite, was completed in April 2021. 

The manuscript was accepted for publication on January 28, 2022 and will be made widely available on the internet to anyone with the URL without licensing and copyright restrictions via Open Access.  

Dr. Karen A. Scott, MD, MPH, FACOG, the owner and developer of the PREM-OB Scale™ Suite, is now living in Nashville, TN, (her birthplace) and leading her own Black woman-led quality improvement and implementation science, practice, and research firm called Birthing Cultural Rigor™, LLC. 

To learn more about her new journey, work, reach, and impact, click here.


Safety, Autonomy, Communication, Racism, Empathy, and Dignity

in Hospital Births During COVID19


Gina Mariela Rodriquez, Doula

Birthing Justice by Oparah & Bonaparte

What is the need for SACRED Birth?

Black women and persons with capacity for pregnancy are dying in childbirth because of racism and other oppressive structures and systems that permeate health care, public health, higher education, law enforcement, and other sectors of society. Research to date has traditionally been led by individuals that lack understanding of the impact of obsetric racism in the provision of hospital-based perinatal care, services, and support. Specifically, traditional perinatal quality improvement initiatives have failed to include an equity-based and anti-racist lens, focused on the lived experiences of Black women and people experiencing pregnancy, labor, birth, postpartum, and infant care and feeding.

What is the role of the community in SACRED Birth?

The SACRED Birth Study, led by Black women scholars in authentic partnerships with Black women-led/serving community-based organizations (CBOs), aims to validate a Patient Reported Experience Measure of OBstetric racism©, also known as the PREM-OB Scale™, one of the most culturally and scientifically rigorous perinatal PREMs developed and owned by Dr. Karen A. Scott, MD, MPH, FACOG.  The PREM-OB Scale™ illuminates the presence and magnitude of obsteric racism during chilbirth hospitalization as characterized for, by, and with impacted Black birthing communities.  This community informed work will evaluate the quality of perinatal services, support, and care provided in labor, birth, and the immediate postpartum in hospital settings across the United States, with a particular focus on California and Memphis, TN.  

In 2019, our research team led by Dr. Karen A. Scott, MD, MPH, FACOG identified the domain names, meanings and measures for evaluating obstetric racism in clinical and social behaviors as experienced and observed for, by, and with Black mothers and birthing people in hospital settings, with both scientific and cultural rigor.

Community identified domains of obstetric racism from our 2019 focus groups include: Safety, Autonomy, Communication, Racism, Empathy, and Dignity, where the first letter of each community identified domain spells the word: SACRED. 

Additionally, the community identified three solutions-centered domains to mitigate the onset, frequency, duration, or magnitude of obstetric racism in hospital birth settings:

  1. Establishing Accountability mechanisms and measures across levels of power and influence.
  2. Affirming existing and new forms of Social Networks, specifically Kinship ties, in the Black birthing community and community at large
  3. Implementing racially concordant and scientifically and culturally rigorous models of Holistic Care for the benefit of both Black birthing communities and the Black birth workforce.

What are the goals of the SACRED Birth Study?

In preparation for scaling up and replication in other health care settings across California and the United States, the SACRED Birth Study team will disseminate three products by 2021:

  1. validated PREM-OB Scale                                                              
  2. community centered – person focused, hospital-based QI toolkit developed by SACRED Birth Community Accountability Partners 
  3. summary analysis of the association between obstetric racism and birth outcomes, and obstetric racism and COVID19 hospital policies, practices, and procedures responses

What are the ways for community to be involved in SACRED Birth?

Representatives from fourteen Black women-led/serving community based organizations (CBO) across central, northern, and southern California serve as Community Accountabity Partners.  Each CBO acts as an accountablity partner to ensure cultural rigor in study methods from identifiying research questions to sharing data with the public.  The study principal investigator, Dr. Karen A. Scott, MD, MPH, FACOG and the the state lead CBO, California Black Women's Health Project, will facilitate montly meetings with the CAPs for the purpose of implementing a Virual Perinatal Quality Impovement Priorization by Affected Communities (V-QPAC) protocol.  

Please note the SACRED Birth survey validation study ended January 31, 2021.