It takes a village to raise a child.
This age-old idiom rings true for cultures across the globe and its premise rings true even in pregnancy. Social support is an important contributor to the health and well-being of both pregnant women and their children and has been shown to mitigate risks to maternal and child health (such as low socioeconomic status), particularly among Latinos who often attribute strong familial and community ties to better birth outcomes (James, 1993). Conversely however, discrimination of mothers during pregnancy has been linked with infant mortality (Zuvekas, Wells, and Lefkowitz, 1999), sexually transmitted infections including HIV (Rosenthal et al., 2014), and maternal depression (Walker et al., 2012).
Discrimination during pregnancy can be inflicted on the mother as a result of her race/ethnicity, age, perceived socioeconomic status, or because of her pregnancy status. Diverse women are more likely than their white counterparts to experience discrimination during pregnancy, and young mothers are more likely to be discriminated against than their older counterparts.
Regardless of the justifications, discrimination at any phase is unacceptable.
During pregnancy, the discriminatory practices not only affect the health of the pregnant woman, but also set physiological set points for the growing infant that affect health throughout his life course. To further complicate the issue, overt signs of pregnancy discrimination in the workplace have been outlawed thanks to The Pregnancy Discrimination Act of 1978, but have instead been replaced by more subtle discriminatory acts. Subtle forms of discrimination, or microaggressions, arguably have the potential to cause significant harm within the healthcare system, where decreased rates of specialist referrals, increased wait times, decreased health education, and poor patient-provider communication all contribute to negative health outcomes that affect daily living and economic viability well beyond pregnancy.
In the era of the Affordable Care Act, where millions more now have access to health insurance, it is even more imperative to address other potential barriers to obtaining quality health care.
To address evolving but persistent issues of discrimination and bias in healthcare, researchers at the University of North Carolina – Chapel Hill will be collaborating with photojournalist Janet Jarman to generate discussions among pediatric residents about their own implicit biases against the burgeoning Latino communities in North Carolina through the Yo Veo Salud project. In particular, UNC researchers will be highlighting the lived experiences of young Latina mothers in the surrounding area using photovoice, where marginalized groups participate directly in research that affects them and use photography to shed light on the subtle discrimination that these young women continually face, particularly when trying to access healthcare services.
By addressing persistent instances of discrimination before, during, and after pregnancy, we can better meet the needs of Latino families throughout the life course and for generations to come.
This post is part of the Mother’s Day #WhatMothersNeed week of action during which NHCOA is joining several national organizations and advocates to raise awareness about quality maternity care, pregnancy discrimination, paid family and medical leave, paid sick days, fair pay, affordable health care, and more. Join the conversation May 5-9, 2014 at 3pm ET on Twitter and tell us #WhatMothersNeed.