Transportation Is Not Just a Ride: How Transportation Shapes Prenatal Care Experiences Among Black Women

Prenatal care improves maternal and infant outcomes; however, transportation as a social determinant of health influences both access to care and the conditions under which care is experienced. Transportation is often conceptualized as a barrier to appointment attendance, limiting understanding of its broader role in prenatal care. This study examined how transportation shapes prenatal care experiences among Black women.

We used a concurrent triangulation mixed-methods design with 8 Black women who completed 2 semistructured interviews (preprenatal and postprenatal visit) and a ride-along observation. Qualitative data explored transportation, care experiences, interactions with health care providers, and emotional well-being. Quantitative data examined mode of transportation, travel time, and road conditions. Data were analyzed concurrently and integrated through triangulation.

Five themes emerged: (1) Not every ride is a good option; (2) driving while pregnant; (3) it takes a village to feel safe in my care; (4) roads matter: infrastructure as a determinant of prenatal care; (5) I would expect them to give me some grace. Transportation was multidimensional, encompassing safety, cost, reliability, physical discomfort, and emotional burden. Structural factors-including institutional policies, scheduling inflexibility, parking challenges, and road conditions-influenced both access to care and experiences within care. Despite these challenges, participants consistently prioritized prenatal care.

Transportation is a structural determinant that shapes both access to and experiences of prenatal care. Findings challenge deficit-based narratives by highlighting how Black women actively navigate complex systems to obtain care. Efforts to improve maternal health equity should integrate transportation considerations into health care delivery, health system design, and community-informed strategies that address structural barriers to person-centered care.