Racial and Ethnic Representation in Studies of Psychological Trauma During Pregnancy in the United States

Women are more likely to experience certain types of psychological trauma, including intimate partner violence and pregnancy-specific psychological trauma. Psychological trauma exposure also varies across racial and ethnic groups. Moreover, racial disparities persist in health care and contribute to high maternal mortality and morbidity in the United States (US). Considering the role of trauma at the intersection of pregnancy and racial and ethnic identity, it is critical to understand the extent to which psychological trauma is assessed during pregnancy across differing racial and ethnic identities.

We conducted a secondary analysis of a systematic review on the measurement of psychological trauma history during pregnancy, focusing on studies conducted in the US to assess the frequency and type of psychological trauma measured during pregnancy by racial and ethnic groups.

We identified 216 relevant studies, 91.7% of which reported racial and ethnic information. Of the combined nearly 120,000 participants, 46% were white, 25.8% Black/African American, 13.5% Hispanic, 6.4% Asian, 0.8% Native American, 0.03% Middle Eastern, 5.2% other, 0.7% were multiracial, and 3.0% not reported. Across all racial and ethnic groups, interpersonal trauma was the most commonly assessed psychological trauma, followed by childhood abuse and general trauma history. Pregnancy-specific psychological trauma was the least commonly assessed across all groups.

Our findings show that racial and ethnic representation was comparable to US census numbers in many categories. Future works should continue to recruit and assess psychological trauma during pregnancy from minoritized participants to inform clinical practice, particularly among underrepresented groups, and should adopt a consistent method of assessing race and ethnicity across studies.