Emotion and Inequality in Maternity Care

This chapter highlights that economically disadvantaged African American women have frequent experience with poor credibility and lack of communication in medical settings. Among women whose fear of poor health outcomes has a real basis, the sense of not being believed, of having their symptoms discredited, ignored or explained away in unintelligible jargon generates anxiety about their pregnancy and care. The lack of response to their anxiety appears to be a symptom of inadequate care. The African American women responded to this anxiety among their peers not by encouraging trust in their doctors, but by encouraging distrust. Group emotion management defined doctors' lack of response as injustice, calling for anger and self assertion. Demands for care, especially medical tests and other intrusive care, are deemed the appropriate patient behavior by these women. Assertiveness, even outright aggression in the face of poor care, is considered a positive action, met with approval by peers. Thus, the approved emotion and expression norms of medical settings were, for these women, in direct contradiction to the expectations into which the doctors and providers were socialized. The emotion and expression norms of these women are understandable in context of their experiences and their interpretations of behavior in the light of those experiences. However, their emotion and expression norms encourage actions that are almost diametrically opposed to the traditional ones of medical environments