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Midwives' Communication Practices About Risk and Racism With Black Women During Pregnancy: "We've Got to Find a Way"
Emily Dove-Medows1, Cathrine Corwin1, Alison R Walsh1
1School of Nursing, University of Michigan, Ann Arbor, Michigan.
Journal of Midwifery & Women'S Health
|August 11, 2026
Summary
Midwives use adaptive communication strategies when discussing racism-related risks with pregnant Black women, but face internal conflict and a desire for more training. Enhanced education is needed to improve communication about structural racism in perinatal care.
Area of Science:
- Perinatal Care
- Health Equity
- Maternal Health Communication
Background:
- Patient-provider communication is crucial for addressing disparities in pregnancy outcomes.
- Midwives' communication practices regarding racism-related risks with pregnant Black women are under-explored.
Purpose of the Study:
- To explore midwives' perceptions of their communication practices about racism-related risks with pregnant Black women.
Main Methods:
- A national mixed-methods study involving 14 midwives.
- Semistructured interviews analyzed using thematic analysis.
Main Results:
- Three themes emerged: Evolving Communication (adaptive, patient-centered strategies), Tension (conflict between addressing racism and fear of offense), and Room for Growth (lack of formal training, desire for more knowledge).
Conclusions:
- Midwives employ adaptive strategies but experience tension in communicating about racism-related risks.
- There is a need for enhanced midwifery education on discussing structural racism and contextual factors impacting Black women's health.
- Improved training can reduce reticence and foster open dialogue, supporting equitable perinatal care.
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