An Exploratory Study of the Role of Birth Stories in Shaping Expectations for Childbirth among Nulliparous Black Women: Everybody is Different (but I'm Scared)

Abstract

Birth stories area source of information and vicarious experience for nulliparous women. Although health disparities research suggests that the childbirth experiences of Black women differ from those of white women, little research has been conducted about the nature of birth stories shared and their subsequent effect on expectations. Pregnant nulliparous Black women were recruited from a women's health practice in the southeastern United States. Participants completed in-depth semistructured interviews about the birth stories they had previously heard and their thoughts about their own upcoming birth experiences. Interviews were audio-recorded and transcribed. Researchers applied the traditions of thematic analysis to identify emergent themes. Fourteen women participated in the study (mean age, 28 years). Women reported hearing birth stories from a variety of sources, most commonly mothers and friends. Stories heard generally included details about process, outcome, and social context that often acknowledged past racist hospital policies and experienced discrimination. Women were an active audience to birth stories and sought out stories from some sources, avoided stories from other sources, and used rhetorical strategies to mark stories as either more relatable or less relatable. Women's reported fears, expectations, and choices they planned to make reflected features of the birth stories that they had heard. Nulliparous women accessed and evaluated birth stories from others and applied knowledge received from those stories to their own experiences. Birth stories played an important role in shaping women's hopes, fears, expectations, and childbirth-related choices. Health care providers should inquire about the birth stories shared with their patients to gain a sense of their childbirth desires and expectations. An appreciation for the importance of knowledge learned from birth stories has the potential to reduce maternal health disparities by improving patient-provider communication through a shared understanding of the patient's goals and fears.