Researchers have reviewed 44 studies and found that stress from systemic racism and deprivation could explain why black women are more likely to die during childbirth. The study, published in Trends in Endocrinology and Metabolism, examined three physiological pathways - oxidative stress, inflammation, and uteroplacental vascular resistance - and found black women had higher levels of all three. These differences aren't genetic, the researchers say, but rather result from socioenvironmental stressors like racism and socioeconomic disadvantage that measurably affect the body's ability to function healthily during pregnancy.
Grace Amedor of the University of Cambridge, the first author, noted that pregnancy puts great stress on a woman's body, and black women may experience additional strain from systemic racism, socioeconomic disadvantage, and environmental stressors. This strain can affect key biological processes, increasing risks of conditions like pre-eclampsia. She expressed surprise that despite long-known disparities, there was little research into underlying physiological reasons. Increased uteroplacental vascular resistance tightens blood vessels, reducing placental blood flow; higher oxidative stress involves damaging reactive oxygen species overwhelming antioxidant defenses; and high inflammation is linked to worse pregnancy outcomes - all strongly associated with pre-eclampsia, preterm birth, and fetal growth restrictions.
In the UK, black women are 2.7 times more likely to die during childbirth compared to white counterparts, and more likely to experience serious birth complications and perinatal mental health illnesses. Black babies are twice as likely to be stillborn. Senior author Prof. Dino Giussani emphasized that the disparity is well-known but often attributed to differences in medical care or social inequalities; this study shows these exposures disproportionately affect black women's bodies. Dr. Jenny Barber of the Royal College of Obstetricians and Gynaecologists called the situation unacceptable and urged coordinated cross-government action to tackle root causes of inequality and sustained investment in maternity services.