Maternal and Child Health Journal

, 13:29

First online:

“It’s The Skin You’re In”: African-American Women Talk About Their Experiences of Racism. An Exploratory Study to Develop Measures of Racism for Birth Outcome Studies

  • Amani Nuru-JeterAffiliated withDivisions of Community Health and Human Development; and Epidemiology, School of Public Health, University of California
  • , Tyan Parker DominguezAffiliated withSchool of Social Work, SWC 224, University of Southern California
  • , Wizdom Powell HammondAffiliated withSchool of Public Health, University of North Carolina
  • , Janxin LeuAffiliated withDepartment of Psychology, University of Washington
  • , Marilyn SkaffAffiliated withDepartment of Family and Community Medicine, University of California, San Francisco
  • , Susan EgerterAffiliated withDepartment of Family and Community Medicine and Center on Social Disparities in Health, University of California, San Francisco
  • , Camara P. JonesAffiliated withSocial Determinants of Health, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
  • , Paula BravemanAffiliated withDepartment of Family and Community Medicine and Center on Social Disparities in Health, University of California, San Francisco Email author 

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Objectives Stress due to experiences of racism could contribute to African-American women’s adverse birth outcomes, but systematic efforts to measure relevant experiences among childbearing women have been limited. We explored the racism experiences of childbearing African-American women to inform subsequent development of improved measures for birth outcomes research. Methods Six focus groups were conducted with a total of 40 socioeconomically diverse African-American women of childbearing age in four northern California cities. Results Women reported experiencing racism (1) throughout the lifecourse, with childhood experiences seeming particularly salient and to have especially enduring effects (2) directly and vicariously, particularly in relation to their children; (3) in interpersonal, institutional, and internalized forms; (4) across different life domains; (5) with active and passive responses; and (6) with pervasive vigilance, anticipating threats to themselves and their children. Conclusions This exploratory study’s findings support the need for measures reflecting the complexity of childbearing African-American women’s racism experiences. In addition to discrete, interpersonal experiences across multiple domains and active/passive responses, which have been measured, birth outcomes research should also measure women’s childhood experiences and their potentially enduring impact, perceptions of institutionalized racism and internalized negative stereotypes, vicarious experiences related to their children, vigilance in anticipating future racism events, as well as the pervasiveness and chronicity of racism exposure, all of which could be sources of ongoing stress with potentially serious implications for birth outcomes. Measures of racism addressing these issues should be developed and formally tested.


Race Racism Birth outcomes African-American women