Rehbein Emily, Levinson Amanda, Preis Heidi, Mahaffey Brittain, Lobel Marci
Department of Psychology, Stony Brook University, Stony Brook, New York, USA.
Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.
Int Perspect Psychol. 2024 Jul;13(3):119-127. doi: 10.1027/2157-3891/a000104. Epub 2024 Jul 1.
High stress experienced during pregnancy increases risk for adverse birth outcomes such as low birthweight and preterm birth that occur disproportionately among women of color in the United States. Prior research has identified a distinct form of discrimination, gendered racism in pregnancy (GRiP), that likely elevates stress and is suspected to contribute to racial disparities in birth outcomes among American women. We investigated associations of GRiP experiences and distress with two types of stress, pregnancy related and pandemic related, among 2,995 women in the U.S. pregnant at the height of the COVID-19 pandemic, a time when health care restrictions, social contact limitations, and concerns about COVID-19 infection created added stress for pregnant women. Using data collected online during the second U.S. pandemic surge (December 2020), we found that pregnant self-identified Hispanic/Latina ( = 233), Non-Hispanic/Latina Black/African American ( = 182), and Multiracial/Other ( =201) women experienced greater GRiP and greater stress of both types than Non-Hispanic/Latina White women. Structural equation modeling indicated a strong association of racial/ethnic identity with prenatal stress that was mediated by GRiP, independent of other contributors to prenatal stress. Focusing on the harmful impact of gendered racism coupled with culturally-informed individual interventions and change at multiple societal levels and institutions may help reduce the poorer reproductive outcomes that are disproportionately common among communities of color in the U.S. Addressing and alleviating discrimination can improve reproductive justice for all who choose to give birth throughout the world, regardless of their race, ethnicity, nationality, or other identities.
孕期经历的高压力会增加不良分娩结局的风险，如低出生体重和早产，在美国有色人种女性中这些情况不成比例地高发。先前的研究已经确定了一种独特的歧视形式，即孕期性别歧视（GRiP），它可能会加剧压力，并被怀疑是导致美国女性出生结局存在种族差异的原因。我们调查了2995名在新冠疫情高峰期怀孕的美国女性中，GRiP经历和困扰与两种压力（与怀孕相关的压力和与疫情相关的压力）之间的关联，当时医疗保健限制、社交接触限制以及对新冠病毒感染的担忧给孕妇带来了额外的压力。利用在美国第二次疫情高峰期间（2020年12月）在线收集的数据，我们发现自我认定为西班牙裔/拉丁裔（=233）、非西班牙裔/拉丁裔黑人/非裔美国人（=182）以及多种族/其他（=201）的孕妇比非西班牙裔/拉丁裔白人孕妇经历了更多的GRiP以及这两种类型的更大压力。结构方程模型表明，种族/族裔身份与产前压力之间存在强烈关联，这种关联由GRiP介导，独立于产前压力的其他影响因素。关注性别歧视的有害影响，结合基于文化的个体干预以及在多个社会层面和机构进行变革，可能有助于减少美国有色人种社区中不成比例地普遍存在的较差生殖结局。解决和减轻歧视可以改善全世界所有选择生育的人的生殖正义，无论他们的种族、族裔、国籍或其他身份如何。
