Medical Mistrust and the Patient Experience: A National Survey on What Shapes Engagement in OB/GYN Care.

OBJECTIVES

To examine how media, geography, race, and social factors shaped patient experiences to inform strategies for improving trust and care.

DESIGN

We conducted a cross-sectional online survey of experiences and perceptions of OB/GYN care and medical mistrust using a stratified, randomised sampling approach.

SETTING

The survey was distributed through Prolific.

POPULATION: Inclusion criteria included assigned female at birth, age between 18 and 40 years, and residing in the United States.

MAIN OUTCOME MEASURES: Gender preference of OB/GYN clinician, demographic association with negative OB/GYN experiences, and degree of medical mistrust.

RESULTS

Of 579 respondents, 93% identified as women, 33.9% as LGBTQIA+, and 45.2% had a history of pregnancy. Anxiety was the most common (46.4%) emotion experienced when receiving OB/GYN care, and 25.8% reported negative experiences, primarily from minimization of concerns (68.5%). A majority (65.3%) preferred receiving care from a female OB/GYN. Identifying as Republican was associated with higher odds of having had a negative experience with an OB/GYN, whereas Asian race and lower education were linked to lower odds. Black, Asian, and multiracial participants were more likely to have a racial preference for clinicians. Medical mistrust was higher among Black respondents and those with lower education. Feeling heard by a clinician was the strongest predictor of care satisfaction.

CONCLUSION

Anxiety and negative experiences were prevalent among participants. Feeling heard was the strongest predictor of patient satisfaction, highlighting the importance of patient-centred OB/GYN care to reduce mistrust and improve patient experiences, particularly for marginalised groups.