Perceptions of blame among black women during prenatal care: A mixed methods study.
Emily Dove-Medows, Alison R Walsh, Francesca A Williamson
PMID 40010057WHAT IT FOUND
Black women interviewed about prenatal care often blamed themselves for complications, linking them to diet, stress, or not speaking up.
All said hearing 'it's not your fault' would be affirming and could build trust.
Key findings
01Nine of 17 interviewees said they blamed themselves for a pregnancy condition or experience, often connecting it to food, feelings, or not advocating enough.
02All interviewees said hearing 'it's not your fault' would be affirming, and some linked it to trust and feeling supported.
03Participants wanted providers to name structural and system-level factors, and to frame preventive steps as reducing risk rather than assigning fault.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 17 interviewees were included, and they were recruited by convenience, so the findings may not apply to all Black women. The interview sample was highly educated, mostly employed, and mostly reported incomes that allowed them to live comfortably, so it may not represent women with different resources. The survey and interviews relied on recall of past pregnancies, which may have missed or distorted blame experiences. The blame items were developed by the study team and had not been validated, and the survey captured blame only at an aggregate pregnancy level, not by specific provider. The study was cross-sectional, so it cannot show that blame caused outcomes or that provider messages improved outcomes. Self-identified gender was not collected, and the study focused on women, not all Black birthing people.
Declared interests
The authors declared no known competing financial interests or personal relationships that could have appeared to influence the work.
The easy way to misread this
Do not conclude that saying 'it's not your fault' improves maternal health or that provider blame caused complications. The study reports participants' perceptions and themes, not a tested communication intervention or causal outcomes.