Interview with study lead researcher, Molly Altman.
Study Authors: Molly R. Altman, Talita Oseguera, Monica R. McLemore, Ira Kantrowitz-Gordon, Linda S. Franck, Audrey Lyndon
Please describe your research findings.
Our study found that providers (midwives, doctors, nurses) were shown to “package” the information that they share with women of color as a way to exert power over a patient’s autonomy and influence decision-making. Various factors influenced how much (or how little) a provider altered the information shared with patients, including whether they had a relationship with their patient or whether the patient had levels of privilege or marginalization (i.e. education, socioeconomic status, race). Other contextual factors that influenced the way providers changed information, included their own bias and judgment towards patients, larger systemic issues within health care systems, and the power dynamic between patient and provider.
Are there any “first(s),” “biggest(s), or “only(s)” with this study – i.e., first study to quantify or examine something, the largest study of its kind, etc?
This was the first study to describe how provider power influences how women of color receive information and how they are given (or not given) opportunity to understand their experience and be involved in decision-making during pregnancy and birth.
What is already known about this topic, and how do your findings add to or change this existing knowledge?
Much has come out recently on how women of color are mistreated, not listened to, and discriminated against within the health care setting. This study both validates these assertions and takes it deeper, to further identify the role that health care providers play, particularly in regards to how they share information within patient-provider interactions.
How does your research impact current clinical practice? How does your research impact patients?
Women of color, particularly Black women, are faced with much higher rates of preterm birth, neonatal mortality, maternal mortality, among other poor birth outcomes. Our research digs deeper at why women of color are having negative experiences during pregnancy and birth care, which can be used to improve care at the individual patient-provider level. If we can find ways to improve care experiences for women of color, we can ultimately have a positive effect on the significant health disparities that they face.
What should researchers/providers/patients/public health workers/etc. do as a result of these findings?
This research is a big step towards developing useful interventions aimed at providers – trainings that only focus on implicit bias and discrimination only address one part of the problem. This study provides evidence to change how providers share information, utilize informed consent, and provide respectful care for women of color during pregnancy and birth.
