The Influence of Personal and Group Racism on Entry Into Prenatal Care Among-African American Women

• Published in: Women's health issues Vol. 23; no. 6; pp. e381 - e387
• Main Authors: Slaughter-Acey, Jaime C., PhD, MPH, Caldwell, Cleopatra H., PhD, Misra, Dawn P., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2013
• Subjects: Adolescent; Adult; Antenatal care; Baltimore; Black or African American - psychology; Black or African American - statistics & numerical data; Denial; Female; Health Services Accessibility; Humans; Logistic Models; Low income women; Obstetrics and Gynecology; Patient Acceptance of Health Care - ethnology; Patient Acceptance of Health Care - psychology; Postpartum women; Pregnancy; Pregnancy Outcome; Pregnancy Trimesters; Prenatal Care - psychology; Prenatal Care - statistics & numerical data; Prevalence; Prospective Studies; Racism; Retrospective Studies; Socioeconomic Factors; Women; Young Adult
• ISSN: 1049-3867; 1878-4321
• DOI: 10.1016/j.whi.2013.08.001

Abstract Background Racism has been hypothesized as a barrier to accessing health care. No quantitative study has directly assessed its influence on women's initiation of prenatal care (PNC). We examined the relationship between PNC entry and experiences of personal and group racism among low-income, African-American (AA) women. We also examined whether the use of denial of racism as a coping mechanism was associated with a delay in accessing PNC. Methods Using a prospective/retrospective cohort design we collected data from 872 AA women (prenatally, n = 484; postpartum, n = 388). Multinomial logistic regression was used to assess the relationship between the overall denial of racism index and PNC initiation. Findings PNC entry was not associated with personal experiences of racism ( p = .33); it was significantly associated with group experiences ( p < .01). Conclusion Denial of racism experienced by other AAs was a barrier to early PNC among low-income, AA women. Delayed access to PNC may be rooted in the avoidance of racialized experiences among less empowered women when faced with discrimination. Our findings have important implication for the engagement of AA women into the PNC delivery system and the health care system postpartum.