Date of Award
2026
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
Committee Chair
Ann Bianchi
Committee Member
Jennifer Bail
Committee Member
Shameka Cody
Committee Member
Carrie Henry
Committee Member
Ellise Adams
Research Advisor
Ann Bianchi
Subject(s)
African American women--Medical care--Alabama, Patient-centered health care, Maternal health services--Alabama, Prenatal care--Social aspects--Alabama, Postnatal care--Social aspects--Alabama
Abstract
Black women in the United States experience disproportionately high rates of maternal morbidity and mortality and often report feeling unheard, dismissed, or excluded from decision-making during pregnancy and childbirth. Understanding how Black women experience prenatal care and how those experiences relate to empowerment during pregnancy is essential for improving care and addressing persistent inequities. This study examined the relationship between person-centered prenatal care and pregnancy-related empowerment and explored Black women’s prenatal care experiences in Alabama using a sequential Quan → QUAL mixed methods design. In the quantitative phase, relationships among person-centered prenatal care, pregnancy-related empowerment, and care-related factors were examined among Black pregnant and postpartum women (N = 65). Participants completed self-reported surveys, including the Person-Centered Prenatal Care (PCPC) Scale and the Pregnancy-Related Empowerment Scale (PRES). Data were analyzed using descriptive statistics and Kendall’s tau-b correlations. Results showed a strong positive association between person-centered prenatal care and pregnancy-related empowerment. Both constructs were also positively associated with continuity of care and longer time established with a prenatal care provider, while demographic variables showed limited association. The qualitative phase explored how women described their prenatal care experiences and how those experiences shaped perceptions of empowerment. Semi-structured interviews were conducted with 11 participants selected from the quantitative sample. Inductive thematic analysis yielded six themes: feeling heard versus dismissed; desiring autonomy and shared decision-making; needing emotional presence and human connection; systemic and structural barriers amplifying vulnerability; the transformative impact of finding the right provider; and navigating prenatal care amid disparities. Integration of findings showed that higher person-centered prenatal care and empowerment aligned with experiences of respect, inclusion in decision-making, emotional support, and continuity with providers, while lower scores aligned with dismissal, rushed encounters, and limited involvement. Although women reported similar challenges, they differed in how they responded, including speaking up, holding back, seeking support elsewhere, or changing providers. Overall, findings highlight the importance of relationships, communication, and continuity in shaping Black women’s prenatal care experiences and sense of empowerment and highlight the need to prioritize person-centered approaches to advance maternal health equity.
Recommended Citation
Milam, Lauren, "Exploring pregnancy-related empowerment and person-centered prenatal care in Black pregnant and postpartum women in Alabama" (2026). Dissertations. 498.
https://louis.uah.edu/uah-dissertations/498
Comments
Submitted ... in the Joint Nursing Science Program.