“It Affected Me so Much That I Even Had to Tie My Tubes”: The Role of Patient−Provider Communication on Black Women’s Perceptions of Pregnancy Risk

Structural failures and systemic racism increase the likelihood of Black women having adverse outcomes during pregnancy, but little is known about the role of communication with healthcare providers in amplifying or attenuating perceptions of pregnancy risk. Using a Black Feminist metatheoretical approach and the Social Amplification of Risk Framework, this study assesses the role of communication with healthcare providers on Black women's perceptions of risk and provides recommendations for empowering pregnancy-related communication between Black women and their healthcare providers. This study's metatheoretical underpinning in Black Feminist Theory informed the use of reflexivethematic analysis in the qualitative analysis of the in-depth interviews in order to center the narratives, perspectives and lived experiences of Black women. This study found that in a context in which Black women unjustly face heightened likelihood of poor outcomes, healthcare providers attenuated Black women's pregnancy risk perceptions when they communicated with clarity, fostered patient agency, and demonstrated empathy toward patients. In contrast, unclear communication and obstetric violence led to the amplification of concerns and worries about pregnancy as well as erosion of trust in healthcare. This study therefore underscores the importance of healthcare providers' clear communication, demonstration of empathy and fostering of patient agency as critical factors to empowering communication that attenuates Black women's pregnancy-related risk perceptions.