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

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; M_age = 28.2 years, SD_age = 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
• birth-related PTSD
• autonomy in decision making
• mistreatment
• respect

Acknowledgments

We wish to thank our participants for their time and involvement in this

study. We also thank members of the Grady Trauma Project for their assistance with data

collection

Disclosure Statement

No potential conflict of interest was reported by the authors.

Data Availability Statement

The data and materials that support the results or analyses presented in this study will be made available via e-mail to the corresponding author, EL ([email protected]), upon reasonable request.

Additional information

Funding

This work was supported by the National Institute of Mental Health(MH115174) and the National Center for Complementary & Integrative Health (K23AT009713).