Signaling Allyship Via EARS: An Investigation of a Novel Allyship Framework Among Black Women in Maternal Health Settings

Low-quality patient-provider interactions contribute to and further exacerbate Black women's poor maternal health outcomes. Perceiving one's provider as an ally, or someone that acknowledges and addresses racial inequities can potentially transform the quality of patient-provider encounters; yet little research has investigated how to effectively convey racial allyship among Black women. In the present investigation we examined the utility of a novel racial allyship framework, EARS (i.e., Empowerment via collaborative decision-making, Approaching racism dialogue, Recognition of systemic racial inequities, and Social support for racism-related stress), a collection of interrelated patient care objectives to convey provider allyship among Black women in maternal health settings. We conducted a cross-sectional, retrospective survey with Black women that had received prenatal care in the United States since 2020 (N = 285). To gauge patient-provider interaction quality, participants reported perceptions of prenatal provider identity-safety (i.e., beliefs their identities were valued by their prenatal provider). Participants also reported pregnancy complications, and critically, perceptions their prenatal provider was an ally - as defined by our EARS framework. We found that perceptions one's prenatal provider was an ally significantly predicted greater prenatal provider identity-safety and fewer self-reported pregnancy complications, even when controlling for established predictors of provider evaluations (e.g., patient-provider race concordance, provider communication quality) and pregnancy-related complications (e.g., maternal age, number of prenatal visits). The present investigation documents the utility of the EARS framework, and, for the first time, links provider allyship to an improved pregnancy-related health outcome among Black women.