A new study from the University of Cambridge suggests that stress from racism and deprivation may contribute to the higher likelihood of black women dying during childbirth. The research reviewed 44 existing studies examining three physiological pathways linked to worse pregnancy outcomes: oxidative stress, inflammation, and uteroplacental vascular resistance. Black women were found to have higher levels of all three metrics.
Physiological Differences Not Genetic
According to the researchers, these physiological differences are not due to genetics but rather indicate that socioenvironmental stressors—such as systemic racism and deprivation—have a measurable biological effect that can impair the body's ability to function healthily during pregnancy.
Grace Amedor, first author of the study published in Trends in Endocrinology and Metabolism, stated: “Pregnancy and childbirth put great stress on a woman’s body. Black women may experience additional strain due to factors including systemic racism, socioeconomic disadvantage and environmental stressors. During pregnancy, this strain may affect key biological processes in ways that increase the risk of conditions such as pre-eclampsia. I was surprised that although this disparity had been known for a long time, there was little research into the potential underlying physiological reasons.”
Biological Mechanisms
Increased uteroplacental vascular resistance involves the tightening of blood vessels, reducing blood flow to the placenta. Higher oxidative stress occurs when reactive oxygen species overwhelm antioxidant defenses. High inflammation levels are also linked to worse pregnancy outcomes. These complications are strongly associated with pre-eclampsia, preterm birth, and fetal growth restrictions, negatively affecting pregnant women and their children.
In the UK, black women are 2.7 times more likely to die during childbirth than white women and are also more likely to experience serious birth complications and perinatal mental health illnesses. Black babies are twice as likely to be stillborn.
Senior author Prof Dino Giussani commented: “The significant disparity in pregnancy complications between black and white women is well-known and has often been explained in terms of differences in medical care, alongside broader social and environmental inequalities. We’ve found these exposures can disproportionally affect black women’s bodies, making them less able to function healthily during pregnancy.”
Dr. Jenny Barber, vice-president of the Royal College of Obstetricians and Gynaecologists, added: “It is unacceptable that black women and babies continue to face significantly higher health risks during pregnancy and childbirth than white women in the UK. This study explores how important physiological processes may be impacted by systemic racism and socioeconomic disadvantages, which could be a factor in the persistently poorer outcomes impacting black women. We hope the findings encourages further research in this area. Ending racial and ethnic health inequalities is possible but requires coordinated cross-government action to tackle the root causes of inequality. We also need sustained investment in maternity services so that every pregnant woman can receive safe, personalized, and compassionate care.”
