Stories From Black Women in Iowa About Reproductive Health Care Experiences, Self-Advocacy, and Recommendations for Change

Melissa Lehan Mackin; Nicole Loew; Stephanie W Edmonds; Ann Weltin; Lynette Cooper; Lastascia Coleman

doi:10.1111/hex.70609

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Stories From Black Women in Iowa About Reproductive Health Care Experiences, Self-Advocacy, and Recommendations for Change

Journal article

Open access

Peer reviewed

Stories From Black Women in Iowa About Reproductive Health Care Experiences, Self-Advocacy, and Recommendations for Change

Melissa Lehan Mackin, Nicole Loew, Stephanie W Edmonds, Ann Weltin, Lynette Cooper and Lastascia Coleman

Health expectations : an international journal of public participation in health care and health policy, Vol.29(2), e70609

04/2026

DOI: 10.1111/hex.70609

PMCID: PMC12963792

PMID: 41787933

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Abstract

What are Black women's experiences when seeking reproductive health care in Iowa? Narrative-style qualitative research. Adult Black women in Iowa were recruited for phone interviews. Data was analysed using within and across case methodology. Clinical experiences included suboptimal healthcare, a lack of information, and being treated differently because they were Black. Consequences included not returning to the provider, mistrust of providers and health systems, but also greater self-advocacy. The findings from this study are illustrative of the realities that Black women in Iowa faced when seeking reproductive healthcare. Women in this study voiced a need for health professionals to actively listen to people under their care, demonstrate genuine human concern, and adopt person-centred and shared decision-making models for care delivery. Recommended system changes include a need to further diversify the workforce, improve training for the care of persons of colour, and develop better clinical tools that consider different skin and body types. Members of the public were involved in the study design and interpretation of findings. Their contributions included providing feedback on research proposal drafts and attending research team meetings to ensure that the research itself did not contribute to racism. Community members with the shared identity of research participants also provided an interpretive lens for the data, crucial for the understanding of white research team members who have not experienced racism.

Reproductive Health Services

Adult

Black or African American - psychology

Female

Humans

Interviews as Topic

Iowa

Middle Aged

Qualitative Research

Reproductive Health - ethnology

White

Young Adult

Details

Title: Subtitle: Stories From Black Women in Iowa About Reproductive Health Care Experiences, Self-Advocacy, and Recommendations for Change
Creators: Melissa Lehan Mackin - University of New Mexico
Nicole Loew - University of Iowa
Stephanie W Edmonds - Abbott Northwestern Hospital
Ann Weltin - University of Iowa
Lynette Cooper - University of Iowa
Lastascia Coleman - University of Iowa, College of Medicine, Iowa, USA
Resource Type: Journal article
Publication Details: Health expectations : an international journal of public participation in health care and health policy, Vol.29(2), e70609
DOI: 10.1111/hex.70609
PMID: 41787933
PMCID: PMC12963792
NLM abbreviation: Health Expect
ISSN: 1369-6513
eISSN: 1369-7625
Publisher: Wiley
Grant note: DAISY Foundation
Language: English
Date published: 04/2026
Academic Unit: Nursing; Obstetrics and Gynecology
Record Identifier: 9985141990402771

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