“LIKE A BUSINESS TRANSACTION”: BLACK WOMEN’S TRUST IN ABORTION HEALTHCARE IN OHIO

Abstract

Objectives

Growing research has examined the prevalence of medical mistrust among Black people and its impact on healthcare access, adherence, and outcomes. However, trust in the context of abortion has been seldom studied. These preliminary findings shed light on Black women’s conceptualizations of trust in their experiences with abortion and reproductive healthcare with the emergent theme of abortion as transactional.

Methods

We are conducting semi-structured, in-depth interviews with Black women in Ohio, asking them to describe their abortion and reproductive healthcare experiences. We used an iterative, inductive coding approach to analyze interview transcripts, allowing for insights from early interviews to inform ongoing data collection and refinement of codes.

Results

Many participants describe their abortion experience as being “like a business transaction,” with providers “just doing their job,” and the clinic “feeling like an assembly line” where “nothing moves without the payment,” highlighting the impersonal, bureaucratic, and commodified aspects of their care. Preliminary findings indicate transactional abortion experiences, with themes of clinical detachment, emotional distance, and perceived commodification of care. However, these experiences were not monolithic; some participants also reported moments of emotional connection and validation within clinical settings, reflecting the negotiation of trust and necessity under constrained circumstances of limited choice for care, resources, and time.

Conclusions

These initial findings complicate binary notions of medical trust and mistrust, suggesting that Black women navigate abortion care through nuanced and conditional forms of trust. Understanding these negotiations offers crucial insight into how reproductive healthcare systems can better address the specific needs and experiences of Black women.