Care is not delivered equally, and the gap is in the discretionary parts
What differs by race is not the protocol. It is the judgment calls.
In a study of 7,056 pregnancies in a large US health system, care driven by written guidelines showed few differences by race. Discretionary care did.
Black women were less likely to receive a prenatal depression screen (odds ratio 0.8) and more likely to have a urine drug test performed when they had denied drug use (odds ratio 1.6), compared with white women. Hispanic and Asian women were less likely than white women to be drug tested when denying use.
Access differs too. Pooling 15 studies covering roughly 200,000 Black women and 400,000 white women, prenatal care began in the first trimester for 60.7% of Black women and 72.9% of white women.
Why this belongs in a consent toolBecause it tells you that the parts of your care left to individual judgment are the parts where you may need to ask most directly for what you want.
Where this comes from:
263. Byrn MA, Buys EA, Mujahid M, Madsen K. Disparities in the provision of perinatal care based on patient race in the United States. Birth. 2023;50(3):627-635.
264. Silva PH, Aiquoc KM, da Silva Nunes AD, Medeiros WR, de Souza TA, Jerez-Roig J, et al. Prevalence of access to prenatal care in the first trimester of pregnancy among Black women compared to other races/ethnicities: a systematic review and meta-analysis. Public Health Rev. 2022;43:1604400.
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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.