The presence of stigmatizing language in the electronic health record (EHR) has been used to measure implicit biases that underlie health inequities. The purpose of this study was to identify the presence of stigmatizing language in the clinical notes of pregnant people during the birth admission. We conducted a qualitative analysis on N = 1117 birth admission EHR notes from two urban hospitals in 2017. We identified stigmatizing language categories, such as Disapproval (39.3%), Questioning patient credibility (37.7%), Difficult patient (21.3%), (...) Stereotyping (1.6%), and Unilateral decisions (1.6%) in 61 notes (5.4%). We also defined a new stigmatizing language category indicating Power/privilege. This was present in 37 notes (3.3%) and signaled approval of social status, upholding a hierarchy of bias. The stigmatizing language was most frequently identified in birth admission triage notes (16%) and least frequently in social work initial assessments (13.7%). We found that clinicians from various disciplines recorded stigmatizing language in the medical records of birthing people. This language was used to question birthing people's credibility and convey disapproval of decision‐making abilities for themselves or their newborns. We reported a Power/privilege language bias in the inconsistent documentation of traits considered favorable for patient outcomes (e.g., employment status). Future work on stigmatizing language may inform tailored interventions to improve perinatal outcomes for all birthing people and their families. (shrink)

Most patterns of an organism develop reproducibly and predictably. Thus, most biological patterns are largely predetermined by the nature of the zygote and by the nature of the surrounding world. Some ontogenetic patterns can also be considered to be preformed. Eighteenth and nineteenth century definitions of 'preformation' suggested that all aspects of a precursor pattern--its elements and its configuration--are preserved during development. Today, the idea of preformed configurations has been lost. To revive this lost idea, we offer the following biologically (...) contemporary definition for preformed ontogenetic patterns: preformed patterns are those patterns with topologies that have been conserved during their ontogenies. This definition is presented in precise mathematical language, and its application is demonstrated in a system of developing, abstract patterns. (shrink)