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Published on: January 12, 2018
Experiences of Blame Among Pregnant Black Women During Prenatal Care
Alison R Walsh1, Emily Dove-Medows2
1Department of Health Behavior and Clinical Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA. walshar@umich.edu.
Objective:
To measure the prevalence and identify correlates of self-reported experiences of provider-perpetrated blame and self-blame during maternal care among Black women in the US.
Study Design:
This exploratory cross-sectional pilot study surveyed 131 Black adult women who received maternal healthcare in the US within the past 5 years. Participants reported sociodemographics and experiences with maternal care, including provider-perpetrated blame and self-blame during their most recent pregnancy. Bivariate analyses (chi-squared and Kruskal-Wallis tests) were used to assess associations between individual-level characteristics, maternal care characteristics, and self-reported experiences of provider-perpetrated blame and self-blame during pregnancy.
Results:
49 (37.99%) of participants reported that at least one maternal care provider had indirectly or directly blamed them for their pregnancy complications, negative outcomes, or risk thereof and 37 (28.24%) reported self-blame. Neither type of blame was significantly associated with demographic characteristics (age, ethnicity, skin tone, education, income, employment). The two types of blame experiences were significantly associated with each other-57.14% (N = 28) of those who reported provider-perpetrated blame reported self-blame as well (p < 0.001). Both blame experiences were positively associated with receiving maternal care from a primary care physician, general practitioner, or family doctor (p < 0.01 for both blame types) and telehealth visits (p < 0.001 for both blame types). Both types of blame were also associated with perceptions that provider-communication was based in stereotypes or assumptions, lacking opportunities for questions, and provided insufficient information for informed decision-making (p < 0.001 for all comparisons).
Conclusions:
Experiences of provider-perpetrated blame and self-blame may be highly prevalent in Black women's maternal care. These results suggest that Black women's experiences of provider-perpetrated blame and self-blame in maternal care are correlated with clinical characteristics as opposed to individual-level sociodemographics and may co-occur with negative and disenfranchising maternal care experiences linked to racial bias.
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