The experiences of Black women at the intersection of race, gender, and pregnancy

Pronounced racial disparities in maternal and infant health outcomes persist in the United States. Contrary to global trends, rates of poor maternal and infant outcomes have increased in the US and racial disparities in poor birth outcomes have recently widened.

Dr. Renee Mehra and co-authors interviewed 24 Black pregnant women to examine how gendered racism manifests in their everyday experiences, and how this may contribute to poorer maternal and infant outcomes. They found that the women they interviewed experienced gendered racism during pregnancy that manifested in a number of ways:

Everyday contexts: This showed up in the form of stereotypes stigmatizing Black motherhood that devalued Black pregnancies in everyday contexts. This included assumptions that they had low incomes, were single mothers, and had multiple children, regardless of the reality. This racism made it difficult to do routine tasks like going to the grocery store without scrutiny.

Obtaining health care: The women interviewed described how negative assumptions about Black pregnant women influenced access to and quality of health care, ultimately shaping their relationships with health care providers. One woman described the distress of being ignored at a pediatric clinic when she sought a pediatrician for her baby-to-be. Another woman described feeling pressured by a midwife to undergo a sterilization procedure after having her third child; this encounter by default perpetuates the historical control of Black women’s fertility through permanent contraceptive procedures.

Obtaining services and resources: Those interviewed also described how assumptions about Black pregnant women negatively affected their access to resources intended to support healthy pregnancies, with several perceiving social service providers to be judgmental and unwelcoming based on their attitudes.

For many of the women interviewed, this racialized pregnancy stigma was a source of stress and hindered their enjoyment of their pregnancies. Black pregnant women expressed that they and their pregnancies were devalued by society, leading to more stressors, with one woman noting, “I do think pregnancy is harder for Black, African-American women, I really do. We get the most judgment…I notice that there be a lot more Black women stressed during their pregnancy, that I have witnessed.” In an effort to counter racialized pregnancy stigma, the women interviewed reported using interconnectedness, spirituality, problem-oriented coping, and disengagement as coping mechanisms.

Researchers found that racialized pregnancy stigma may result in reduced access to quality health care; barriers to services, resources and social support; and poorer psychological health; as a result, this may ultimately contribute to poorer maternal and infant outcomes. Interventions targeting the adverse impacts of racialized pregnancy stigma should include “anti-bias trainings for health providers; screenings for racialized pregnancy stigma; providing evidence-based coping strategies; creating pregnancy support groups, and developing a broader societal discourse that values Black women and their pregnancies.”