Medical Mistrust Among Pregnant Women During the COVID-19 Pandemic

Abstract

INTRODUCTION: 

Medical mistrust has exacerbated health care inequities, especially amidst the COVID-19 pandemic. We sought to assess the effect of the COVID-19 pandemic on medical mistrust among pregnant women, including attitudes toward vaccines.

METHODS: 

An electronic survey was distributed among pregnant women aged 15–45 who were engaged in prenatal care at a medical institution in Baltimore, Maryland. Medical mistrust was evaluated by a validated survey using a five-item scale with a higher score indicating more mistrust. Another three questions assessed the effect of the COVID-19 pandemic on attitudes toward health care workers. Multiple linear regression models were used to compare scores by sociodemographic characteristics.

RESULTS: 

Of 303 pregnant participants, the mean age was 31.4±6.2 years. The mean medical mistrust scale score was 1.67 (SD 0.76), range 1.0–4.2 (median 1.4). Higher scores were reported among self-identified Black/African-American participants compared to White/Caucasian (difference 0.55, 95% CI 0.31–0.80) and among participants with a history of illicit drug use (difference 0.23, 95% CI 0.01–0.45). 24.4% of participants reported they trusted health care providers less after the pandemic, and 13.6% became more suspicious of information they received from health care providers. Black/African American pregnant participants were more likely to agree that the pandemic increased medical mistrust than White/Caucasian pregnant participants (P<.05). Over 46% of pregnant participants reported the pandemic made them more aware of vaccines, and less than 17% became more hesitant.

CONCLUSION: 

Nearly a quarter of participants trusted health care providers less after the COVID-19 pandemic. Black/African American pregnant women and those with a history of drug use have greater medical mistrust than White/Caucasian women.