Table 2.

Themes, major findings, and supportive quotes from the qualitative analysis of Black women’s experiences seeking fibroid treatment

Themes	Main Findings	Supportive Quotes
Patient-Provider Interactions	Diagnosis experience: Fibroids diagnosis experiences impacted how participants navigated fibroid care and management.	“I kind of got frustrated because … it felt like the same speech every time I went. I did about six visits in a row trying to figure out [the problem] … it felt like a little run around to the point where I just said, “Forget it. I’m just gonna … deal with the pain.” (Nina, age 38, H) “The doctor explained that most women had fibroids … and that mine were so small that it was nothing to even be alarmed about.” (Ashanti, age 51, H)
	Patient expectations for clinicians: Women expressed the desire for more information from clinicians about fibroids, as well as a range of treatment options.	“[Hysterectomy] seemed like the only option, they didn’t have any other medical procedures that could either stop their growth …[or] maybe, lessen their growth, or just remove just the part [of the fibroid]. You know, like, those solutions weren’t offered.” (Pamela, age 45, H)
The Social and Historical Value of the Uterus	While some respondents expressed positive or neutral feelings about hysterectomy as a treatment option, others reacted negatively to the recommendation, conveying medical mistrust.	"The only [women] who told me … to find other doctors, were the [women] who were told [by clinicians] to have a hysterectomy … and [they] were like, ‘No, I don’t want that. I want to keep my uterus.’ It was interesting in the sense that all of them were Black women. And so, we all did not know whether there was a concept of our uterus isn’t valued because we’re Black women, is it because we’re not valuable as Black women?" (Lauren, age 42, M)
Fertility Consequences and Fear of Malignancy	Fertility consequences: Women under 40 years old were generally concerned about the fertility consequences of fibroids, with differing perspectives on whether surgical management would be helpful or harmful for pregnancy.	“I’ve been informed that there is a chance that [the fibroids] could … prohibit healthy pregnancies or even getting pregnant. So, it’s put a little bit of sense of urgency, I would say, in having them taken care of.” (Chloe, age 31, M) “Am I making the right decision having these removed? … Does [surgery] affect my ability to carry a baby full term? ” (Lynette, age 38, M)
	Uncertainty about cancer: Some women were motivated to pursue surgery due to concerns that fibroids could be cancerous.	“… [cancer] is what’s really, is driving me forward to just go ahead and get it over with.” (Zoe, age 47, H)
The Role of Community	Fibroid awareness: Most respondents were aware of fibroids as a health condition prior to their diagnosis and were often informed by other Black women.	“Most Black women, probably, in my life, in my age range definitely have experienced or have fibroids, or dealing with them, or have had surgery for them.” (Lynette, age 38, M)
	Seeking medical care: Social networks and community norms about reproductive health were instrumental in how Black participants conceptualized fibroids and evaluated their medical options.	“My siblings are just telling me… take care of it now, don’t let it linger on any later than you have, just get the surgery so you can feel good.” (Jada, age 32, M) “… in the Black or colored [sic] community when they hear about reproductive things, they tend to belittle you. Like ‘you’re half a woman, what’s wrong with you?’” (Cicely, age 38, M)