Stigmatizing Mothers: Qualitative Analysis of Language in Prenatal Records

Area of Science:

• Medical Sociology
• Healthcare Disparities
• Clinical Documentation Analysis

Background:

• Pregnant individuals often encounter moral judgments within healthcare settings.
• Such biases can be embedded in clinical documentation, perpetuating inequities.
• Stigmatizing language in medical records contributes to disparities in maternal health outcomes.

Purpose of the Study:

• To identify linguistic features in obstetrical records that convey negative attitudes or moral judgment.
• To analyze how patient testimony and maternal fitness are represented in clinical notes.
• To understand the role of documentation in perpetuating bias in maternal healthcare.

Main Methods:

• Qualitative analysis of obstetrical records from 100 randomly selected patients.
• Examination of prenatal and delivery care documentation from an academic hospital system.
• Identification of themes related to epistemic injustice and moral judgment in patient records.

Main Results:

• Identified themes of epistemic injustice, including discrediting patient testimony (e.g., labeling as hysterical).
• Found unnecessary, objectifying, or unprofessional details within patient records.
• Observed judgments of maternal fitness, with women labeled negatively based on perceived characteristics.

Conclusions:

• Advocates for further validation of findings on stigmatizing language in medical records.
• Recommends revisiting medical education to address implicit bias in documentation.
• Supports the development of natural language processing (NLP) tools to detect and mitigate stigma in clinical notes.