Racial Discrimination and the Black‐White Gap in Adverse Birth Outcomes: A Review

Giurgescu, Carmen; McFarlin, Barbara L.; Lomax, Jeneen; Craddock, Cindy; Albrecht, Amy

doi:10.1111/j.1542-2011.2011.00034.x

Cited by 99 publications

(88 citation statements)

References 37 publications

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“…This finding is in line with the literature that explores Black race as one of the most predictive factors for PTB. [54][55][56] In 14 studies, women were assessed on psychological measures more than once and repeated perinatal screening suggests an appreciation that mental health status during pregnancy is not static. It can be argued that measuring depression in early pregnancy may not be an accurate predictor because the development of subsequent depression might go undetected.…”

Section: Discussionmentioning

confidence: 99%

The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review

et al. 2015

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Section: Discussionmentioning

confidence: 99%

The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review

et al. 2015

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“…Several studies have documented the healthcare-related disparities and poor birth outcomes for women of color (Bryant et al, 2010;Gennaro et al, 2008;Agency for Healthcare Research and Quality, 2016;Kogan et al, 1994;Smedley et al, 2002;Braveman et al, 2015;Giurgescu et al, 2011). However, few studies have addressed the factors that contribute to these disparities.…”

Section: Background and Significancementioning

confidence: 99%

“…However, few studies have addressed the factors that contribute to these disparities. It is hypothesized that women of color experience longer lifetime exposure to chronic stress, which may lead to fluctuations in allostatic load (wear and tear) and contribute to the higher risk of PTB for these women (Braveman et al, 2015;Giurgescu et al, 2011). Other investigators have suggested that women of color experience discrimination, racism and disrespect in healthcare encounters and that this affects the health of women and their infants (Rankin et al, 2011;Tucker Edmonds et al, 2015;Ertel et al, 2012;Pullen et al, 2014;Nuru-Jeter et al, 2009;Dominguez et al, 2008;Slaughter-Acey et al, 2016).…”

Section: Background and Significancementioning

confidence: 99%

“…Although suggestive, the existing limited literature is insufficient to characterize how prenatal care is often experienced by women of color and to fully understand if and how such encounters add to or mitigate perceived stress and affect risk for PTB. Few studies have been conducted to understand the experience of healthcare encounters for people of color as distinct from their health seeking behaviors, in the context of experiencing racism and discrimination (Braveman et al, 2015;Giurgescu et al, 2011;Rankin et , 2016). It has been shown that Black women are less likely to get clinical advice and support to decrease smoking and alcohol use during pregnancy (Kogan et al, 1994).…”

Section: Background and Significancementioning

confidence: 99%

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Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth

McLemore¹,

Altman²,

Cooper

et al. 2018

Social Science & Medicine

254

251

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Background: Chronic stress is a known risk factor for preterm birth, yet little is known about how healthcare experiences add to or mitigate perceived stress. In this study, we described the pregnancy-related healthcare experiences of 54 women of color from Fresno, Oakland, and San Francisco, California, with social and/or medical risk factors for preterm birth. Methods: This study was a secondary analysis of focus group data generated as part of a larger project focused on patient and community involvement in preterm birth research. English and Spanish speaking women, age 18 or greater with social and/or medical risk factors for preterm birth participated in two focus groups, six weeks apart. Data from the first focus groups are included in this analysis. Results: Five themes emerged from thematic analysis of the transcripts. Participants described disrespect during healthcare encounters, including experiences of racism and discrimination; stressful interactions with all levels of staff; unmet information needs; and inconsistent social support. Despite these adverse experiences, women felt confidence in parenting and newborn care. Participant recommendations for healthcare systems improvement included: greater attention to birth plans, better communication among multiple healthcare providers, more careful listening to patients during clinical encounters, increased support for social programs such as California's Black Infant Health, and less reliance on past carceral history and/or child protective services involvement. Discussion: The women in this study perceived their prenatal healthcare as a largely disrespectful and stressful experience. Our findings add to the growing literature that women of color experience discrimination, racism and disrespect in healthcare encounters and that they believe this affects their health and that of their infants.

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“…Specifically, the association of ethnicity to PTB was mediated through lower levels of personal resources, language barriers, economic difficulties, separation from friends and family, racial and neighbourhood discrimination for migrants (Coussons-Read et al, 2012;Rini et al, 1999;Ruiz et al, 2012), which all present an important area for future investigations. This finding is in line with the literature that explores Black race as one of the most predictive factors for PTB (Giurgescu, McFarlin, Lomax, Craddock, & Albrecht, 2011;Graham, Frank, Zyzanski, Kitson, & Reeb, 1992;Kiely et al, 2011). In 14 studies, women were assessed on psychological measures more than once and repeated perinatal screening suggests an appreciation that mental health status during pregnancy is not static.…”

Section: Discussionsupporting

confidence: 82%

“I am the worst pregnant woman ever”: A mixed-method study of the nature of psychological distress during pregnancy

Staneva¹

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Pregnancy constitutes a major life event that confronts women with unique physical, social, economic and psychological adjustments. Epidemiological evidence suggests that the prevalence and severity of most common mental health disorders (such as depressive and anxiety disorders) during pregnancy are not different from those in the population of non-pregnant women. However, the mental health state of pregnant women has received considerable clinical and scientific attention because of its suggested influence on the pregnancy outcome, the baby, and the future child. There is emerging evidence that experiencing antenatal distress may lead to suboptimal birth, adverse birth outcome, This thesis begins with an outline of the research problem and sets the scene by providing the theoretical and methodological assumptions that underlie the design and the conduct of this thesis. In introducing this work, I argue that it is important to draw from a mixed-methodology scholarship grounded in feminism and critical realism to ensure a multi-faceted understanding of such complex phenomena as pregnancy and distress. I then position my research within a background of the existing literature, and pinpoint the gaps which this thesis aims to address. Starting with an epidemiological systematic review, I explore the link between antenatal distress and preterm birth, followed by a meta-synthesis of the qualitative literature that has examined the experience of antenatal distress. First, Isuggest that direct causal relationships between antenatal distress and adverse birth outcomes cannot be established in a conclusive way, and secondly I argue that such assumptions can be problematic for women as the experiences of antenatal distress involve a complex journey. I then suggest that pregnancy distress entails a process similar to that of iii grief and loss as a result of women's inability to situate their experience within the good and perfect mother discourse.The empirical section of this thesis draws on data I collected both via an online survey and through interviews and is presented in three consecutive studies. The online survey, which was completed by over 290 eligible pregnant women from Australia and New Zealand, consisted of various psychosocial questionnaires administered at three time points (twice during pregnancy and once after birth). This longitudinal data formed the basis for the first empirical study which explored the psychosocial predictors of antenatal distress. In this study I conclude that it is a woman's overall sense of coherence that predetermines her distress during pregnancy. In order to advance the understanding of the meanings that women ascribed to their experience, and how these affected their 'at odds' perceptions of motherhood, I then present the findings from a qualitative study with 18Australian women who reported pregnancy distress. Together, these studies point to the need to develop a more general framework for understanding antenatal distress allowing for factors such as global sense of fi...

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Racial Discrimination and the Black‐White Gap in Adverse Birth Outcomes: A Review

Cited by 99 publications

References 37 publications

The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review

The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: A systematic review

Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth

“I am the worst pregnant woman ever”: A mixed-method study of the nature of psychological distress during pregnancy

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