Research & Findings
Four key themes emerged through thematic analysis across ALL child birthing experiences of each participant within the past fifteen years:
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Medical Dismissal and Neglect
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Patient Advocacy and Birth Plans
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Provider Bias and Systemic Barriers
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Patient Centered Communication and Cultural Competency
Theme Validation:
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Member checking (Zoom)
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Literature triangulation (Cross-checking)
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Review by an EVMS CITI-certified assistant
Medical Dismissal and Neglect
Many participants reported their pain, concerns, or complications were ignored, resulting in trauma, loss, or mistrust:
"I should have been sent to the back like a direct admit, and taken care of not just sitting there for hours. The OBGYN at the time didn't communicate good with other hospital staff to get me taken care of, and I ended up miscarrying and carrying a deceased baby inside of me from the Christmas holiday through the new year —like the 12th of January was when the baby was removed. "
(Interviewee 2)
Patient Advocacy and Birth Plans
Having a doula, midwife, or informed family member present led to more positive outcomes and better communication:
"I think the difference for me was that I had midwives versus an OB/GYN. I ended up having the best, most comfortable, most precious angel deliver me."
(Interviewee 11)
Provider Bias and Systemic Barriers
From assumptions about insurance to unnecessary C-sections, implicit bias was reported across providers, regardless of race:
"I work at a college. I am a college professor. I came in there with my husband. I had my badge on, and she asked me, 'Do you have your Medicare papers and Medicaid paperwork?' And I was so confused. I said, 'I use Blue Cross Blue Shield. "
(Interviewee 8)
Patient-Centered Communication and Cultural Competency
Open dialogue, empathy, and shared decision-making directly contributed to better birth experiences:
"The doctor allowed me to ask all types of questions. She made sure I had the support that I needed. She came in 2 to 3 times to make sure I was okay, just walking me through the process of what I needed to know, especially as a Black woman. So I can say that I had an amazing birthing experience, and you know, there was no trauma or anything like that."
(Interviewee 12)
