“It All Starts by Listening:” Medical Racism in Black Birthing Narratives and Community-Identified Suggestions for Building Trust in Healthcare

Jasmine Y. Zapata, Laura E. T. Swan (), Morgan S. White, Baillie Frizell-Thomas and Obiageli Oniah
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Jasmine Y. Zapata: Department of Pediatrics, University of Wisconsin-Madison, Madison, WI 53792, USA
Laura E. T. Swan: Reproductive Equity Action Lab, Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI 53726, USA
Morgan S. White: Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI 53705, USA
Baillie Frizell-Thomas: Department of Family Medicine, University of Colorado, Aurora, CO 80045, USA
Obiageli Oniah: School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA

IJERPH, 2025, vol. 22, issue 8, 1-12

Abstract: 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 ( N = 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.

Keywords: medical distrust; provider bias; racial discrimination (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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