Pregnancy Miscarriage and the Role of Direct and Vicarious Racism over the Life Course: Results from the African American Women's Health & Heart Study

Prior research on racial disparities in maternal health reveals a relationship between racism and pregnancy health outcomes, as measured by low birth weight and preterm birth. This study examines how instances of racism experienced over the life course shape miscarriage risk for black American women. Using data from the African American Women's Heart & Health Study (AAWHHS) and multivariate logistic regression, this study investigates the relationship between risk of pregnancy miscarriage and experiences of direct and vicarious racism at three life stages: childhood, adolescence, and adulthood. Findings reveal that direct racism during adulthood and vicarious racism during adolescence, that is, witnessing or hearing about incidents of racism or prejudice experienced by a close family member or friend, is associated with a marked increase in the likelihood of miscarriage. This study highlights the impact racism may have on miscarriage risk and underscores the critical need to consider the salient impact of direct and vicarious racism across the life course, with added attention to the negative consequences that "indirect" forms of racism may have on the pregnancy health of black American women