Patient-Provider Communication

St. Joseph County, Indiana has one of the highest infant mortality rates in the state (8.7

deaths per 1,000 live births), which disproportionately affects women of color (i.e., 17.4

deaths per 1,000 for Black women). The elevated rates of infant mortality underscore the urgent need to examine root causes. Local data from the St. Joseph County Fetal Infant Mortality Review (SJC-FIMR) 2025 Annual Report highlighted one critical area of focus: the

quality of prenatal care. Specifically, the Report noted the need to examine how

providers listen to and respond to reports of possible signs and symptoms of

complications within time-constrained interactions. This is vital for building patient trust.

Patient–provider communication challenges have long-term implications for patients,

their infants, and providers alike– including delayed diagnosis, mortality, and distress.

To address these challenges, researchers at the University of Notre Dame (Co-Primary

Investigators: Chua and Hill) will partner with the Community Impact Team (Community

Co-Investigator: Dixon) at Beacon Health System in South Bend, IN and the Indiana Health Centers, to (1) examine perinatal care and birthing experiences from perinatal women as well as the experiences in providing perinatal care from healthcare providers (e.g., obstetricians, doulas, and nurses), (2) co-create actionable solutions for improving patient–provider interaction to support a future quality improvement study, and (3) disseminate findings to the general public and scientific community.

 

This innovative project is rooted in a community engaged approach. Using mixed methods

involving mirrored surveys and interviews from the perspectives of both perinatal patients and providers, this project will recruit perinatal patients and perinatal healthcare providers. Questions focus on perinatal experiences (e.g., delayed care, dismissal of specific concerns, specific terminology used to describe babies) from patient and provider perspectives, including patient endorsement of these experiences and provider evaluation of to what extent they agree with these statements and whether there are structural barriers they face related to these patient experiences. Interview data will be used to gather more contextual information, expanding on challenges and improvements from both perspectives that would enhance perinatal healthcare experiences. The ultimate goal is to address systematic disparities in maternal perinatal healthcare that drive elevated rates of infant mortality and design tailored interventions. Focusing on communication within existing perinatal care visits will lead to efficient, actionable steps to reducing the high mortality rates observed in this community.