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. 2023 Jul-Sep;24(4):520-537.
doi: 10.1080/15299732.2023.2212406. Epub 2023 May 26.

WHEN REPRODUCTION IS NO LONGER AUTONOMOUS: FEELING RESPECTED BY MATERNITY CARE PROVIDERS MODERATES THE ASSOCIATION BETWEEN AUTONOMY IN DECISION MAKING AND BIRTH-RELATED PTSD SYMPTOMS IN A COMMUNITY SAMPLE OF POSTPARTUM BLACK WOMEN

Emma C Lathan  1 , Abby Britt  2 , Meghna Ravi  1 , Marcia J Ash  3 , Elizabeth McAfee  1 , Shimarith Wallace  1 , Colin B Johnson 2nd  1   3 , Briana Woods-Jaeger  3 , Abigail Powers  1 , Vasiliki Michopoulos  1   4
Affiliations

WHEN REPRODUCTION IS NO LONGER AUTONOMOUS: FEELING RESPECTED BY MATERNITY CARE PROVIDERS MODERATES THE ASSOCIATION BETWEEN AUTONOMY IN DECISION MAKING AND BIRTH-RELATED PTSD SYMPTOMS IN A COMMUNITY SAMPLE OF POSTPARTUM BLACK WOMEN

Emma C Lathan et al. J Trauma Dissociation. 2023 Jul-Sep.

Abstract

Black individuals are at particularly high risk for birth-related posttraumatic stress disorder (PTSD) symptoms, in part due to a lack of opportunity to lead maternity care decisions. Maternal care providers need evidence-based ways to reduce pregnant persons' risk for birth-related PTSD symptoms despite reduced autonomy in decision making resulting from heightened restrictions on reproductive rights. We investigated whether a potential relation between autonomy in decision making and birth-related PTSD symptoms would be moderated by being mistreated or feeling respected by maternity care providers in a community sample of Black women (N = 52; Mage = 28.2 years, SDage = 5.7 years) seeking maternity care at a public hospital in the southeastern United States. At six weeks postpartum, participants completed measures assessing autonomy in decision making, current birth-related PTSD symptoms, number of mistreatment events, and feelings of respect from providers during pregnancy, childbirth, and the postpartum period. Autonomy in decision making was negatively correlated with birth-related PTSD symptoms, r=-.43, p < .01. An interaction between autonomy in decision making and mistreatment by providers was trending toward significance, B=-.23, SE=.14, p = .10. Autonomy in decision making and feeling respected by maternity care provider interacted to predict birth-related PTSD symptoms, B = .05, SE=.01, p < .01. Feeling respected by providers may buffer against the negative effects of lack of autonomy in decision making on birth-related PTSD symptoms, highlighting the importance of providers' ability to convey respect to pregnant patients when they cannot lead care decisions.

Keywords: Maternity care; autonomy in decision making; birth-related PTSD; mistreatment; respect.

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Conflict of interest statement

Declaration of Interest Statement: The authors have no competing interest to declare.

Figures

Figure 1.
Figure 1.
Autonomy in Decision Making by Mistreatment by Providers Interaction
Figure 2.
Figure 2.
Autonomy in Decision Making by Feeling Respected by Providers Interaction
Figure 3.
Figure 3.
Scatterplot of Autonomy in Decision Making by Mistreatment by Care Providers
Figure 4.
Figure 4.
Scatterplot Autonomy in Decision Making by Feeling Respected by Providers
See this image and copyright information in PMC

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