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Pregnancy-Specific Stress and Racial Discrimination Among U.S. Women

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Adverse birth outcomes among children born to women of color (WOC) have been associated with discrimination during pregnancy; however, little research has explored stressed caused by discrimination as well as pregnancy-specific stress. The purpose of this study was to examine differences in stress and racial discrimination (lifetime and during pregnancy) between U.S. women of different racial/ethnic groups.


Women between 18 and 45 years (n = 198; 101 non-Hispanic White, 58 Black, and 39 other WOC [i.e., Hispanic, Asian/Pacific Islander, American Indian, Mixed Race]) completed an online, cross-sectional survey between December 2019 and March 2020. Participants reported pregnancy-specific stress using the pregnancy distress questionnaire (PDQ) and pregnancy life events scale (PLE) and discrimination via the general ethnic discrimination scale (GED). ANOVAs explored differences between racial/ethnic groups’ stress and discrimination.


We found non-Hispanic White (p < 0.05) and other WOC (p < 0.01) reported higher distress during pregnancy than Black women, and other WOC (p < 0.05) reported more stressful prenatal life events (p < 0.05) than non-Hispanic Whites. However, Black (p < 0.001) and other WOC (p < 0.001) both experienced more ethnic discrimination throughout their lifetime and during their pregnancy than non-Hispanic Whites. Also, Black women experienced five times the stress from these encounters than White women (p < 0.001).

Conclusions for Practice

Previously developed pregnancy distress questionnaires may be better suited for non-Hispanic White populations and may miss important experiences unique to marginalized populations such as racial/ethnic discrimination. Adaptations to pregnancy-related stress scales are warranted given the toxicity of discrimination during pregnancy.

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Data may be made available upon request.

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Funding was provided by the University of Oklahoma.

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Authors and Affiliations



Conceptualization: [AJ]; Methodology: [AJ, PDD, LC; SM]; Formal analysis and investigation: [AJ, PDD]; Writing - original draft preparation: [AJ]; Writing - review and editing: [PDD; LC; SM]; Funding acquisition: [PDD]; Supervision: [PDD]

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Correspondence to Page D. Dobbs.

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The authors have no conflicts of interest to disclose.

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All procedures for this study were approved by the University of Oklahoma Institutional Review Board (IRB: 11362, IRB Approval Date: 12/04/2019).

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Johnson, A., Dobbs, P.D., Coleman, L. et al. Pregnancy-Specific Stress and Racial Discrimination Among U.S. Women. Matern Child Health J 27, 328–334 (2023).

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