"Where is this coming from?" Uncovering Trustworthiness Ideals in AI-powered Peripartum Information Seeking

2026-06-08

AI Summary

This study addresses the frequent neglect of governance structures underpinning trustworthiness in perinatal AI health tools, which often fail to confront historical inequities and ongoing trust deficits. Through four concurrent focus groups involving 24 pregnant individuals, clinicians, and health workers, the research employs qualitative analysis and design probes to investigate user expectations regarding trust in AI-driven question-answering systems and their practices for verifying information. It introduces the concept of “verifiable trustworthiness,” emphasizing transparency, accountability mechanisms, and ecosystem-wide coordination over unilateral claims of reliability. From this, four core governance themes emerge, informing the development of design components that foster awareness against misplaced trust. The work offers a sociotechnical governance framework and principle-based guidance for designing pluralistic, transparent AI systems in high-stakes perinatal health contexts.

Abstract

AI-powered tools increasingly promise to fill information gaps in health, especially in domains like maternal and reproductive health that demand timely, accurate, and actionable information. This is extremely important, as the United States leads peer nations in preventable deaths, with stark racial disparities. However, current AI and NLP-powered systems aim to improve access to vetted maternal health information by routing user queries to a factual response while under-specifying the socio-technical governance structures that shape trust, use, and harm in practice. We report findings from four synchronous focus groups ($n=24$) with three stakeholder groups central to peripartum information support: birthing people, clinicians, and health workers (e.g., doulas, social workers, community health workers) exploring topics around information seeking, experience with current clinical infrastructure, misinformation, and an AI-enabled factual answering tool design probe. Our inductive analysis surfaces a central finding: in high-stakes health contexts shaped by historical inequities, trustworthiness must be inspectable and not asserted. While stakeholders diverge on what makes information credible, they converge on the need for transparency, recourse, and ecosystem complementarity. Based on the discussions, we identify four themes and governance requirements: (1) support for social and identity-based sensemaking, (2) pluralistic verification practices, (3) inspectable governance with recourse mechanisms, and (4) ecosystem-aware integration that avoids shifting burden. Building on these findings, we propose design artifacts that are mistrust-aware and promote principled governance mechanisms for transparent, pluralistic AI systems. Finally, we discuss the implications of our findings for expanding human-AI evaluations and improving the transparency of deployed AI systems.

Problem

• trustworthiness
• AI governance
• peripartum health
• information seeking
• health equity

Innovation

• inspectable trustworthiness
• mistrust-aware design
• pluralistic verification
• socio-technical governance
• peripartum AI