OBJECTIVE: To describe situational domains in which publicly insured pregnant Black women experience racial discrimination during pregnancy. STUDY DESIGN: This analysis includes data collected between January 2016 and June 2017 from a study that examined how stress, resiliency, and coping during pregnancy influence publicly insured Black women's (N = 55) risk for preterm birth in Oakland, California. Racism-associated stress (racial discrimination) was measured three times during pregnancy (18-20, 24-26, 30-32 weeks) using the modified experiences of discrimination (EOD) scale. Participants responded "yes" or "no" to ever experiencing discrimination based upon their race/ethnicity in nine situational domains (e.g., "getting medical care"). Women included in this analysis had at least one data point across the three times. Descriptive statistics were used to describe the sample demographics and the burden of racial discrimination across the nine situational domains. RESULTS: Most women were aged 20-29 years old (n = 30, 55%), single/never married (n = 33, 60%), Christian (n = 34, 62%), and reported having poor physical or mental health at least one day during the past 30 days (n = 28, 51%). Three quarters (n = 42, 76%) of the women reported experiencing racial discrimination in one or more situational domains [across their lifetime]; 15% (n = 9) indicated EODs in all nine situational domains (M = 6.11). The most frequent reports of racial discrimination occurred in school (n = 25, 46%), stores or restaurants (n = 24, 44%), and public settings (n = 24, 44%) (Figure). CONCLUSION: Experiences of racial discrimination were widespread in a sample of pregnant Black women. Given the previously documented association between experiences of racial discrimination and poor birth outcomes (e.g. preterm birth, low birth weight, fetal loss), further research is warranted to explore the specific situations and processes by which racism influences birth outcomes. Additionally, explorations of the healthcare workforce and their contribution to these experiences should be considered. (Figure Presented).
Chambers, B. D., Arega, H., Spellen, S., Arabia, S. E., Stanley, D., Gomez, A. M., … McLemore, M. R. (2018). 961: Pregnant Black women’s experiences of racial discrimination. American Journal of Obstetrics and Gynecology, 218(1), S569. https://doi.org/10.1016/j.ajog.2017.11.448