Title: An Online Investigation Into Factors Related to Black Maternal Mortality Using Retrospective Recall of a Prior Birth Hospitalization With a Risk of Death— Predicting Medical Mistrust
Description: The problem that this study addressed was the high rate of maternal mortality for Black women in the United States, which has been rising, including before the COVID-19 pandemic. The goal was to identify significant predictors of medical mistrust. The study recruited a convenience sample via an online social media campaign. The resultant sample was 100% Black and female (N=192) with a mean age of 33.23 (SD= 4.980, min=24, max=61), while 94.8% were born in the United States (n=182). Using background stepwise regression, the following were found to be significant predictors of a higher level of medical mistrust: older age (B = .033, p = .001); higher levels of education (B = 0.205, p = .000); lower annual household income (B = -.055, p = .026); higher level of perceived racism, discrimination, and inequity in treatment from medical staff (B = 0.137, p = .046); lower levels of cultural sensitivity/ competence/ humility ratings for medical staff (B = -.155, p = .002); higher past year mental distress (i.e., Depression, Anxiety, Insomnia and Trauma) (B = .369, p = .000); and lower levels of social support post-partum (B = -0.162, p = .004)—with 46.5% of the variance predicted by the model (R2 = 0.698, Adjusted R2 = 0.465).

The study findings highlight a crisis of Black maternal mortality in the United States, as well as a crisis in healthcare service delivery to Black women, as uncovered via this study. The data betrays a dimension of the crisis in healthcare service delivery to Black women who report experiencing discrimination for being Black at 75.5%, for their appearance (skin tone, hair, etc.) at 62.0%, and for being overweight or obese at 28.6%. Implications of the findings are discussed, while recommendations for future research are offered. In terms of those implications, perhaps most importantly, this data effectively identifies the year after a high-risk birth hospitalization as an essential time for ensuring Black women enter counseling with licensed and certified mental health professionals.