Impact of racial microaggressions on outcomes in pregnancy (MOP) study
Open Access
- Author:
- Swedberg, Claire
- Area of Honors:
- Biobehavioral Health
- Degree:
- Bachelor of Science
- Document Type:
- Thesis
- Thesis Supervisors:
- Laura Cousino Klein, Thesis Supervisor
Kari Christine Kugler, Thesis Honors Advisor - Keywords:
- microaggressions
maternal health
allostatic load
pregnancy
BIPOC
race and ethnicity
biobehavioral health - Abstract:
- As the state of maternal health in the United States continues to worsen, racial disparities in pregnancy outcomes result in black women dying at a rate 3 to 4 times higher than white women (Mehta et al., 2020; World Bank, 2021). The purpose of this thesis was to investigate the relationship between racial microaggressions in healthcare committed by general practitioners (GP) and prenatal healthcare providers as a contributing factor to racial disparities in pregnancy outcomes. Two thousand and seventy-eight 21-35 year old women who had a child in the last 3 years completed an anonymous national online survey. Maternal and infant health outcomes such as hypertension, gestational diabetes, gestational age, birth weight and birth length were analyzed in relation to racial microaggressions in healthcare along with measures of social support. It was predicted that women who identify as Black, Indigenous, or person of color (BIPOC) would report higher levels of GP and prenatal racial microaggressions than White women and that the number of antenatal diagnoses would be positively correlated with GP microaggressions. It was also predicted that participants with high levels of GP microaggressions would be a stronger predictor of gestational age, birthweight, and birth length than would prenatal microaggressions and that measures of social support would positively correlate with gestational age, birthweight, and birth length. BIPOC women were significantly more likely to report GP microaggressions and prenatal microaggressions than White women [F’s(5,2039) > 20.90, p’s<0.001]. The number of antenatal diagnoses in BIPOC women was positively correlated with microaggressions committed by general practitioners (r = +0.14, n = 899, p < 0.001). The significant negative correlation found between GP racial microaggressions gestational age (r = -0.13, n = 1780, p<0.001) was stronger than the correlation between racial microaggressions by prenatal practitioners and gestational age (r = -0.14, n = 1781, p<0.001). However, no significant relationship was found between levels of GP racial microaggressions and birthweight or birth length. Collectivism was significantly positively correlated with birth length (r = +0.05, n = 1495, p<0.05) and gestational age (r = +0.15, n = 1495, p<0.05) but not birth weight. Familism was significantly negatively correlated with birth weight (r = -0.05, n = 1495, p<0.05) and positively correlated with gestational age (r = +0.15, n = 1495, p<0.05) but not birth length. These results are new and show that racial microaggressions committed by GPs across the lifespan have significant and meaningful negative health impacts on BIPOC mothers, above and beyond the short-term microaggressions committed by prenatal health care providers. However, the positive health outcomes associated with social support, an important social determinant of health, reveals a potential mechanism of protective factors that could be explored for future interventions. This undergraduate thesis adds to the literature investigating contributing factors to the racial disparities in maternal health that exist in the United States and underlines the importance of examining biobehavioral determinants of pregnancy outcomes.