Date of Award

August 2020

Degree Type


Degree Name

Doctor of Philosophy



First Advisor

Erin Sahlstein Parcell

Committee Members

Sarah Riforgiate, Sang-Yeon Kim, Lucy Mkandawire-Valhmu


African American women, Contrapuntal Analysis, Maternal Healthcare, Motherhood, Pregnancy, Relational Dialectics Theory


Black women are experiencing pregnancy-related complications at a significantly higher rate than women of other races in the U.S., as Black women are three to four times likely to die from pregnancy-related complications compared to non-Hispanic White women (CDC, 2019a). I applied relational dialectics theory (Baxter, 2011), a critical communication theory, to examine dominant and marginalized discourses that are present in women’s talk about maternal care. I conducted interviews with 31 African American women living in Milwaukee county, Wisconsin. Women narrated their pregnancy stories, noting how they constructed meaning through the interactions they had with healthcare providers. Through a contrapuntal analysis of the transcripts, I identified the discourses of healthcare providers’ dominance (DHPD) and maternal healthcare as holistic (DMHH). The DHPD views pregnancy as primarily a medical condition that needs expert management from a healthcare professional. The DMHH constructs pregnancy as holistic life event needing the “expertise” of both healthcare professionals and women. In their construction of meaning, African American women resisted the hegemonic view of pregnancy as a medical condition, thus disclaiming the DHPD. Their narratives gave credence to the DMHH by incorporating their racial identity and background into maternal care. The findings exemplify how communication occupies a central position in healthcare delivery where individuals, especially those on the margins of the society, interpret their experience. The findings, in particular, identify hegemonic healthcare discourses that position African American women as subject to providers’ control. Importantly, the hegemonic discourses reflect racial discrimination as seen through the theme of “Unfair Treatment Because We are Black.” Additional findings include the discourses of intensive mothering, pregnancy (motherhood) as distressing, and the theme of African American women are baby mamas.

Keywords: pregnancy, African American women, maternal healthcare, relational dialectics theory, motherhood