Women’s Perspectives: Trust in the Reproductive Health Care System and Key Sources of Information

The Role of Trust in Women’s Reproductive Health Care

Inequities in women’s reproductive health outcomes persist in the U.S., particularly among Black and younger (ages 18-25) women.1 2 3 4  Lower rates of access to and use of health care5 by Black and younger women result in disproportionately higher rates of unintended pregnancy1 2 and sexually transmitted infections,3 4 compared with rates documented among white women and in older age groups. Trust in the health care system plays a critical role in health care-seeking behavior,6 improving outcomes and promoting adherence to medical guidelines.7 However, polling results from the AAMC Center for Health Justice show that trust in hospitals and pharmacies has declined over the past four years and that women’s trust in health care teams declines during the pregnancy period. 

The spread of misinformation via mass media and social media8 9 has contributed to general declines in the public’s trust in medical institutions.10 This is particularly worrying in the context of reproductive health, where content on social media platforms often conflicts with medical guidance,11  further fueling mistrust12 among women who are and feel underserved by the health care system (e.g., Black women, LGBTQ+ individuals, and young adults).13 14 15 Additionally, little is known about how people assess the trustworthiness of the institutions that develop reproductive health policies.16 Insurance companies, for example, play a major role in shaping health care policies, especially in private and employer-sponsored plans,17 yet up to a third of women report not knowing about those policies.18

Trust in reproductive health information, systems, and policies is foundational to reproductive justice, which emphasizes not only the right to access care, but also the assurance that care is guided by accurate information delivered through trustworthy institutions and provided with dignity and respect.19 20

This polling brief presents findings from a nationally representative poll of 1,203 U.S. adult women (ages 18+), conducted on behalf of the AAMC Center for Health Justice in March 2025. The brief explores women’s levels of trust in the health care system, as well as in sources of reproductive health care medical standards, policies, and information.

Women’s Trust in Health Care Systems

A large majority of women (84%) reported trusting the health care system (defined in our poll as clinicians, hospitals and other health care facilities, and insurance plans). However, Gen Zers and millennials (born 1981-2012) (80%) and Black women (75%) expressed less trust than other women. (See Figure 1 and Supplemental Table 1 for more detailed information.)

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Women’s Trust in Reproductive Health Care Standards and Policies

Although most women (84%) expressed trust that medical standards ensure high-quality care, their level of trust differed, depending on the institution that developed the standards. Eighty-one percent of women reported trusting that the policies developed by the medical community were created with the patient’s well-being in mind, but only 65% of respondents said the same about policies developed by insurance companies. (See Figure 2. For more details on other subgroups, see Supplemental Table 2.)

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Some notable subgroup differences emerged. Gen Zers and millennials (80%) and single/never married women (81%) generally reported less trust in medical standards than did Gen Xers and baby boomers (86%) and married women (87%). Subgroup analyses also revealed that women living in rural areas (60%), non-Hispanic white women (59%), single/never married women (62%), and liberal women (59%) were significantly less likely to trust insurance company-developed reproductive health care policies than were women living in urban areas (70%), non-Hispanic Black women (74%), Hispanic women (78%), married women (69%), and politically moderate women (65%). (See Supplemental Table 2.)

Women’s Trust in Sources of Reproductive Health Care Information 

Women reported varying levels of trust in different sources of reproductive health information. While most women trust information from community-based organizations (81%), far fewer trust information from government websites (68%), public television and radio programs (55%), and social media platforms (TikTok, YouTube, Facebook, Instagram, and Bluesky) (41%). (See Figure 3 and Table 1 for more information.) 

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Patterns of subgroup differences emerged (Table 1). In general, non-Hispanic white women, conservative women, and women living in rural areas were less trusting of most sources of reproductive health information. Conversely, Hispanic women, non-Hispanic Black women, and women living in urban areas expressed greater trust in most sources. Ninety-two percent of Hispanic women, for example, reported trust in reproductive health information provided by community-based organizations. (See Supplemental Table 3 for more details.) 

Table 1. Reported trust in different sources of reproductive health information, by demographic characteristics

Addressing Gaps in Women’s Reproductive Health Care Information, Systems, and Trust

Our findings demonstrate that most women trust the health care system, but Gen Zers and millennials and non-Hispanic Black women are more likely to report lower levels of trust. Experiences of poor treatment, lack of adequate support, and pressure around medical decisions during childbirth and reproductive care have been well documented within the health care system among younger (ages 19-24) and non-Hispanic Black women.21 22 For the health care system to foster trust and address health inequities, the widespread implementation of existing strategies that recognize and respond to the lived experiences of these groups is required. Such practical strategies include improving respectful care with measurable performance indicators, like the person-centered contraceptive counseling measure developed to assess the quality of contraceptive counseling;23 providing staff training and increased services to be responsive to cultural health beliefs and practices;24 and ensuring community-led monitoring, like community advisory boards or The Community Score Card, in reproductive health care settings.25 26

We also found that reproductive health care policies developed by insurance companies were less trusted than policies developed by the medical community. Previous research has reported that only 56% of consumers trusted their health insurance provider to act in their best interest, a feeling fueled by coverage denials and rising medical debt, both of which are more common in underserved populations, further reducing trust and discouraging health care utilization.27 28 29 30 Implementation of insurance reforms that increase awareness and provide greater transparency regarding coverage for essential preventive and reproductive services can improve the trustworthiness of insurance policies.31 Health care and public health professionals can also increase awareness of consumer assistance programs by directing individuals to information centers such as the Centers for Medicare & Medicaid Services’ Center for Consumer Information and Insurance Oversight, which oversees the Consumer Assistance Program, to provide information and technical support, helping consumers understand their health insurance coverage and appeal coverage denials.32

Although only 4 in 10 women trust social media as a source of reproductive health information overall, more than half of non-Hispanic Black women, Gen Zers and millennials, and over two-thirds of Hispanic women expressed trust in information from social media platforms. This finding aligns with other polling showing that younger (ages 18-35), Black, and Hispanic adults increasingly rely on social media for health information, despite recognizing the prevalence of misinformation from these sources.33 34 The increasing role of social media as an informal source of health education highlights the pressing need for public health strategies that enhance digital literacy, amplify credible information, and equip health care providers to effectively address misinformation in their interactions with patients.35 There are notable gaps in understanding how misinformation and disinformation affect trust in reproductive health across different communities, particularly among underserved groups such as Black women, LGBTQ+ individuals, and young adults.15

In addition, we found that white women were the least trusting across all information sources. This is consistent with other findings showing that white participants’ trust in government health agencies and in family or friends as credible sources of information has dropped significantly.36 In contrast, we found that Hispanic women had high levels of trust for all information sources. This may be due to higher uninsured rates37 and structural barriers to care,38  leading them to rely more on accessible, culturally familiar channels for health information, such as Spanish-language television and social media.39

Overall, our findings demonstrate the importance of both the source of health information and the institutions that develop health care policies. In the wake of state-level restrictions on abortion,40 persistent racial inequities in reproductive health outcomes,41 and increasing financial barriers to preventive care,42 developing community-informed health care policies is more urgent than ever. To sustain and strengthen trust in the health care system, health care leaders must prioritize culturally relevant community engagement.43 Community, health care, and public health leaders can also ensure that accurate, high-quality information reaches audiences through trusted platforms, by leveraging community-based messengers and using tailored communication strategies.44 45

The Center supports organizations and institutions in fostering trust through the Principles of Trustworthiness Toolkit, which can help support long-term trust building by centering community voices, acknowledging historical and contemporary injustices, and fostering continuous engagement to promote transparency, collaboration, and accountability. Health care providers and institutions can further enhance trust in reproductive health information, health care systems, and medical policies by connecting communities to disinformation-awareness campaigns such as Voices of Truth: Empowering Communities to Counter Disinformation. Equipping communities with the tools to both identify misinformation and codevelop local health solutions46 is essential for establishing and sustaining women’s trust in the health care system.