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

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.