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Acknowledging and Addressing Allostatic Load in Pregnancy Care
Kirsten A Riggan1, Anna Gilbert1, Megan A Allyse2,3
1Biomedical Ethics Research Program, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Journal of Racial and Ethnic Health Disparities
|May 9, 2020
Summary
Maternal mortality in the USA is rising, especially for non-Hispanic Black women. Elevated allostatic load (cumulative stress) due to racism is a key factor driving these disparities.
Area of Science:
- Public Health
- Reproductive Health
- Sociomedical Sciences
Background:
- Maternal and infant morbidity and mortality are increasing in the USA.
- Significant racial disparities exist, with non-Hispanic Black women facing disproportionately higher mortality rates.
- Traditional explanations fail to fully account for the magnitude of these disparities.
Purpose of the Study:
- To explore the role of allostatic load in adverse pregnancy outcomes among women of color.
- To highlight the impact of cumulative stress from social, structural, and environmental factors, often linked to racism.
Main Methods:
- Review of existing evidence on allostatic load and pregnancy outcomes.
- Analysis of the disproportionate exposure of people of color to chronic stressors.
- Theoretical framework linking racism, stress, and health disparities.
Main Results:
- Growing evidence implicates elevated allostatic load in adverse pregnancy outcomes for women of color.
- Chronic stress, exacerbated by systemic racism, contributes to physiological changes impacting maternal health.
- Disparities are not solely explained by individual behaviors or healthcare access.
Conclusions:
- There is a critical need to address elevated allostatic load to reduce maternal health disparities.
- Increased resources are necessary to mitigate the effects of chronic stress before, during, and after pregnancy.
- Improving maternal and infant health outcomes requires tackling the root causes of stress and inequity.
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