Home > Abstract Details > Community Discrimination Leads to Vigilance and Provider Mistrust

« Back to Search

Community Discrimination Leads to Vigilance and Provider Mistrust

Purpose: This study assessed the association between everyday experiences of discrimination and patient-provider relationships, including women’s recommendations for improving their relationships in order to better perinatal care.


Background: Experiencing discrimination can lead to hyper-vigilance in multiple settings and across various types of relationships. Pregnant women of color and low SES are particularly vulnerable. Patient-provider relationships are negatively influenced by discrimination.


Methods: This mixed-methods study combined survey data from a sample of 244 postpartum women, and focus group results from a subset of 57. Quantitative measures included the Everyday Discrimination, Vigilance, and Provider Relationship scales.  The twelve focus groups were audio recorded, transcribed, and consensus-coded for themes, which were stratified by level of vigilance, race and SES.


Results: Nearly half (45.9%, n=112) of women reported experiencing discrimination monthly or more often. Women of color and low income reported double the rates of discrimination. Discrimination was significantly related to vigilance (B.428 w/CI .281,.575, p< .001).  Vigilance, in turn, significantly detracted from provider relationship (B .214 w/CI .088,.341, p=.001).  Major themes associated with high-vigilance were feeling not heard, not trusted and not respected by providers. Women approached these relationships with higher levels of mistrust.


Discussions: When pregnant women experience discrimination in the community, they experience the world with a heightened sense of vigilance, which in turn affects perinatal visits. Given the state of health inequity in perinatal care and the non-white infant mortality rate, this study indicates the need for providers to be respectful of their patients’ prior experiences and be attentive to the patient-provider relationship.

Topics: CREOG & APGO Annual Meeting, 2021, Student, Resident, Faculty, Clerkship Director, Clerkship Coordinator, Osteopathic Faculty, Residency Director, Residency Coordinator, Patient Care, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, CME, Public Health, Advocacy, Maternal-Fetal Medicine,

General Information

Student,Resident,Faculty,Clerkship Director,Clerkship Coordinator,Osteopathic Faculty,Residency Director,Residency Coordinator,
Patient Care,Interpersonal & Communication Skills,Practice-Based Learning & Improvement,
Public Health,Advocacy,
Clinical Focus
Maternal-Fetal Medicine,

Author Information

Megan Sandberg, B.S., Western Michigan Homer Stryker School Medicine; Drew Moss, BS; Claudia Waters, BS; Lynette Gumbleton, BA; Silvia Linares, MD; Megan Deibel, DNP, CNM

Additional Materials

Related Abstracts

Association of Professors of Gynecology and Obstetrics

2130 Priest Bridge Drive, Suite 7, Crofton, MD 21114


APGO logo

Follow Us

Association of Professors of
Gynecology and Obstetrics (APGO)