US black women’s pregnancy communication networks: A qualitative network analysis

The ongoing Black maternal health crisis necessitates a closer examination of how Black women in the United States utilize communication to mitigate the dangers racism poses for pregnancy, delivery and the postpartum period. Previous studies have highlighted the importance of supportive networks to Black women's wellbeing during pregnancy. However, few studies utilize a qualitative network approach to explore communication about pregnancy and related risks within a social network. Twenty-eight Black women from 12 US states who self-identified as previously, currently or recently pregnant, were recruited to participate in this study. Following data collection, participants' networks and related commentary from the interview were qualitatively analyzed for composition and context of networks (who is in the network and why?) and the content of communication (what is discussed and how?). This study found that Black women's perceptions of pregnancy risk and enactment of agency in response to risk was influenced by communication with individuals within their communication networks. The findings of this study also demonstrate that emotional support and guidance for navigating the dangers of the healthcare system constituted an important component of communication with strong ties, including partners, family members and close friends. Additionally, Black women enacted agency in response to pregnancy risk by leaning on trusted experts (healthcare providers) within their networks. However, this study also found limitations to the role of pregnancy communication networks. First, negative ties (relations) with alters (individuals with whom Black women have communication ties) and unwanted advice or guidance was found to be a source of stress. Furthermore, although mothers were an essential source of support for many women, differences related to generation, culture and the circumstances of pregnancy limited the relevance of the advice Black women receive from their mothers. Finally, immigrant women faced an additional challenge, as their support networks were sometimes geographically distant from them.