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.
Keywords Race - Racism - Birth outcomes - African-American women