New findings indicate that experiencing microaggressions related to gender and race during pregnancy and delivery may contribute to elevated blood pressure after giving birth. This study, released Thursday in the American Heart Association journal Hypertension, highlights that subtle, possibly inadvertent comments directed at pregnant individuals—such as telling them to “calm down”—were linked to increased blood pressure in mothers following childbirth.
Dr. Teresa Janevic, the study’s lead researcher and an associate professor of epidemiology at Columbia University Mailman School of Public Health, emphasized that while it is widely recognized that women of color, including Black, Hispanic, and South Asian individuals, face microaggressions in healthcare, the connection between these slights and higher blood pressure levels has not been thoroughly examined.
Postpartum hypertension, although infrequent, poses serious health risks, potentially leading to heart disease later in life, particularly for women with prior pregnancy-related blood pressure complications such as preeclampsia.
In this research, scientists utilized an adapted version of the Gendered Racial Microaggressions Scale, which comprised 26 items across four categories, to assess the experiences of pregnant women during obstetric care. A total of 373 participants—Asian, Black, and Hispanic women aged 16 to 46—delivered their babies at hospitals across Philadelphia and New York City. The study also incorporated assessments of place-based structural racism by aligning electronic medical records with census tract data, analyzing factors like eviction rates, home values, income, education, and employment within different communities.
Participants were provided with home blood pressure monitors to record their readings, which were sent via text twice daily for the first ten days after their hospital discharge and then biweekly for the subsequent 11 to 90 days.
Over one-third of the participants reported experiencing at least one form of microaggression based on race and gender during their care. Among those who experienced such incidents, there was a slight increase in average blood pressure readings at the three-month mark compared to those who did not. Remarkably, individuals facing microaggressions in areas characterized by significant structural racism exhibited the highest blood pressure readings, whereas those in neighborhoods with lower levels of structural racism and no reported microaggressions had the lowest readings. The difference in systolic pressure (the top number) was recorded at 7.55 mmHg, alongside a 6.03 mmHg difference in diastolic pressure (the bottom number).
Janevic noted that the correlation between microaggressions and elevated blood pressure was most pronounced between 12 days and three months after giving birth, marking a critical phase for managing high blood pressure. She stressed the need for healthcare professionals and policymakers to prioritize maternal health equity, expanding blood pressure monitoring and interventions into the postpartum period, where health outcomes might be influenced by social factors and racial microaggressions.
Dr. Lisa Levine, the study’s senior author and an associate professor in reproductive health at the University of Pennsylvania Perelman School of Medicine, reinforced this idea, stating that these findings underscore the enduring effects of racism on health. She pointed out that the cumulative nature of physiological changes over time could contribute to the health disparities observed in various outcomes.
Dr. Natalie Cameron, an internal medicine expert at Northwestern University Feinberg School of Medicine, who was not involved in the study, remarked on the deep effects of structural and interpersonal racism. She noted that such experiences could significantly influence whether individuals require blood pressure-lowering treatments. Cameron emphasized that managing hypertension should encompass more than merely prescribing medication, advocating for future initiatives aimed at minimizing gendered racial microaggressions in healthcare and their impacts on postpartum blood pressure.
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