Date of Award

10-16-2023

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Sociology

First Advisor

Dana Garbarski

Abstract

A plethora of research exists on maternal health disparities, highlighting both its variation across ethnoracial identity and causes of it. Similarly, much research exists on the professional socialization of medical students. However, there is a lack of research that bridges the two seemingly disparate literature together. Maternal health outcomes are greatly influenced by doctor-patient interactions. During medical school, medical students learn what it means to be a physician and how to interact with patients. A key component of the professional socialization of medical students is the medical school curriculum, including both pre-clinical courses and clerkships. It is through the curriculum where students transition from layperson to a practicing physician who interacts with patients. I conducted interviews with 25 medical students at one allopathic, religiously affiliated private predominately White institution (PWI) and observed that the medical students in this study were not being professionally socialized into future doctors who actively seek to reduce maternal health disparities. In addition, I conducted a content analysis of the public-facing websites of 100 medical schools and observed that only 3 medical schools include information on their website on the instruction of maternal health disparities for medical students (none of these schools were the school that I conducted the interviews at). I also conducted interviews with 4 U.S. medical clerkship professors at the same medical school. Interestingly, I observed a disconnect between my 3 methods, as during my interviews with the 4 clerkship professors observed that the 2 OBGYN professors reported that maternal health disparities are incorporated into their clerkship curriculum. Additionally, this study investigated how chronic—experiences with racism and poverty— and acute stressors—interactions with health care professionals during pregnancy—affect maternal mental health using Phases 6-8 (2009-2020) of the Pregnancy Risk Assessment Monitoring System (PRAMS). I observed that recent mothers who were more satisfied with their interactions with healthcare professionals (acute stressors) or who did not experience stressful life events and racial discrimination (chronic stressors) had lower odds of experiencing postpartum depressive symptoms; and that these associations vary across ethnoracial identity—Black women have higher odds of postpartum depressive symptoms than Asian, White , other non-White, more than one race, and Latina women. In addition to assessing the association between acute and chronic stressors and postpartum depressive symptoms, I also assessed variations in who healthcare professionals are talking to about maternal health disparities during prenatal visits. I observed that Black women reported the highest odds of having discussions with healthcare professionals about postpartum depression during prenatal visits than women from all other ethnoracial identity groups.

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