Zapata Jasmine Y, Swan Laura E T, White Morgan S, Frizell-Thomas Baillie, Oniah Obiageli
Department of Pediatrics, University of Wisconsin-Madison, Madison, WI 53792, USA.
Reproductive Equity Action Lab, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI 53726, USA.
Int J Environ Res Public Health. 2025 Jul 31;22(8):1203. doi: 10.3390/ijerph22081203.
This study documents Black Wisconsinites' birthing experiences and their proposed solutions to improve Black birthing people's trust in healthcare. Between 2019 and 2022, we conducted semi-structured, longitudinal interviews (both individual and focus group interviews) with those enrolled in a local perinatal support group program for Black birthing people ( = 25), asking about their pregnancy, birthing, and postpartum experiences and their ideas for building trust in healthcare. Using the Daughtering Method and Braun and Clarke's method of reflexive thematic analysis, we coded the interview data and then iteratively collated the codes into themes and subthemes. Participants described experiencing medical racism, including healthcare trauma and provider bias, during pregnancy and delivery. They drew connections between those experiences and the distrust they felt toward healthcare providers and the healthcare system. They provided actionable strategies that individual providers and the healthcare system can take to build the trust of Black birthing people: employ more Black providers, listen to Black birthing people, exhibit cultural humility, engage in shared decision-making, build personal connections with patients, and spend more time with patients. This study connects Black birthing people's experiences of medical racism to feelings of medical distrust and provides community-identified actionable suggestions to build trust and shape how we combat racial disparities in healthcare provision and health outcomes.
本研究记录了威斯康星州黑人的分娩经历以及他们提出的改善黑人分娩者对医疗保健信任的解决方案。2019年至2022年期间，我们对参与当地黑人分娩者围产期支持小组项目的人员（n = 25）进行了半结构化的纵向访谈（包括个人访谈和焦点小组访谈），询问他们的怀孕、分娩和产后经历以及他们对建立医疗保健信任的想法。我们使用“女儿化方法”以及布劳恩和克拉克的反思性主题分析方法，对访谈数据进行编码，然后反复将代码整理成主题和子主题。参与者描述了在怀孕和分娩期间经历的医疗种族主义，包括医疗创伤和提供者偏见。他们将这些经历与他们对医疗保健提供者和医疗系统的不信任联系起来。他们提供了个体提供者和医疗系统可以采取的可行策略，以建立黑人分娩者的信任：雇佣更多黑人提供者、倾听黑人分娩者的意见、展现文化谦逊、参与共同决策、与患者建立个人联系以及花更多时间陪伴患者。本研究将黑人分娩者的医疗种族主义经历与医疗不信任感联系起来，并提供了社区确定的可行建议，以建立信任并塑造我们消除医疗保健提供和健康结果方面种族差异的方式。
