Which Complications Disproportionately Affect Women of Colour? | Understanding Antenatal Care

Pregnancy is a time of both joy and challenges, and every expectant parent’s journey is unique. However, certain groups of people face additional risks that can affect both their health and the health of their baby. Women of colour—especially Black, Asian, and Indigenous women—are more likely to experience specific antenatal complications compared to their white counterparts. These disparities are shaped by a complex combination of social, economic, and healthcare-related factors. In this article, we will explore the complications that disproportionately affect women of colour during pregnancy, discuss why these disparities exist, and offer guidance on how antenatal care can help reduce these risks and promote a healthier pregnancy for everyone.

Understanding the Disparities in Pregnancy Care

Health disparities in pregnancy are not merely the result of biological differences but are influenced by social determinants of health, such as access to healthcare, socioeconomic status, racism, and stress. Despite the advancements in prenatal care, women of colour continue to face higher risks for complications during pregnancy. According to research, Black women are significantly more likely to experience severe pregnancy-related complications and even maternal death. For instance, in the United Kingdom and the United States, Black women are two to three times more likely to die from pregnancy-related causes than white women. These disparities are not only alarming but are preventable with proper care, awareness, and support. The aim of antenatal care is to ensure that all expectant parents have access to the services, support, and education necessary to reduce risks and improve outcomes.

Complications That Disproportionately Affect Women of Colour

Several key antenatal complications disproportionately affect women of colour, often due to a combination of genetics, environmental factors, and systemic inequities in healthcare. Understanding these risks can help expectant parents and healthcare providers take steps to manage and address these challenges early on in the pregnancy.

1. Gestational Diabetes

Gestational diabetes occurs when a pregnant person has high blood sugar levels that develop during pregnancy. While any pregnant person can develop gestational diabetes, certain ethnic groups—particularly African American, Hispanic, and Asian American women—are at higher risk. The condition can lead to a range of complications, including preterm birth, high birth weight, and an increased likelihood of developing type 2 diabetes later in life.

• Risk Factors: Genetics, age, and obesity are some of the main contributors. Women of colour are more likely to have a family history of diabetes or live in environments with limited access to healthy food and exercise, which increases their risk.
• Antenatal Care and Prevention: Regular antenatal checkups are essential for detecting and managing gestational diabetes. Early screening and lifestyle modifications, including a balanced diet and prenatal yoga, can significantly reduce the risks.

2. Pre-eclampsia

Pre-eclampsia is a pregnancy complication characterised by high blood pressure and damage to organs such as the kidneys and liver. This condition can be fatal if left untreated. Women of colour, particularly Black women, are at a higher risk for developing pre-eclampsia and its more severe form, eclampsia.

• Risk Factors: Chronic conditions like hypertension, obesity, and diabetes are known risk factors for pre-eclampsia. These conditions tend to be more prevalent in certain ethnic groups due to lifestyle factors and access to healthcare.
• Managing Pre-eclampsia: Close monitoring through regular antenatal scans and blood pressure checks is crucial for women at risk. If high blood pressure is detected early, lifestyle changes, medication, or even early delivery might be considered to ensure the health of the mother and baby.

3. Stillbirth

While stillbirth is a tragic and rare occurrence, studies have shown that Black women face a significantly higher risk than their white counterparts. The reasons behind this disparity are not fully understood, but research suggests that factors such as socioeconomic status, access to prenatal care, and the impact of racism may contribute to higher rates of stillbirth among women of colour.

• Risk Factors: These include inadequate prenatal care, pre-existing health conditions, and stress. Women of colour may experience higher levels of stress due to societal factors, which can increase the risk of complications.
• Reducing Risks: Regular antenatal appointments and antenatal education are key for monitoring the baby’s development and detecting potential issues early. Access to antenatal clinics and scans can provide reassurance and help ensure the best possible outcome.

4. Premature Birth

Premature birth, defined as a birth that occurs before 37 weeks of pregnancy, is another complication that disproportionately affects women of colour, especially Black women. Preterm birth can lead to long-term health issues for the baby, including respiratory and developmental challenges.

• Risk Factors: Premature birth can be triggered by factors like maternal age, stress, inadequate prenatal care, and previous preterm births. Chronic health conditions and lack of access to appropriate care also play a role.
• Antenatal Care and Support: Antenatal support is critical in preventing premature birth. This includes managing maternal health, reducing stress, and ensuring the expectant mother has access to necessary medical treatments and interventions.

5. Postpartum Haemorrhage

Postpartum haemorrhage (PPH) refers to excessive bleeding after childbirth, which can be life-threatening if not promptly addressed. Black women, in particular, are at a greater risk of experiencing PPH, likely due to higher rates of pre-existing health conditions like hypertension or fibroids.

• Risk Factors: Conditions such as obesity, diabetes, and previous surgeries (like C-sections) can increase the likelihood of PPH. These conditions are more common in certain ethnic groups, contributing to higher rates of the complication.
• Antenatal Care and Management: Effective antenatal care can help manage risk factors like high blood pressure and diabetes, thereby reducing the likelihood of excessive bleeding. Postpartum monitoring and immediate medical intervention are key to managing PPH if it occurs.

Why Do These Disparities Exist?

The reasons why women of colour are more likely to experience certain antenatal complications are multifaceted. These disparities cannot be attributed to any single factor but rather the intersection of various systemic, social, and economic influences:

1. Access to Quality Healthcare

Many women of colour face barriers to accessing quality healthcare, including prenatal care. These barriers may include economic hardship, lack of insurance, transportation issues, and healthcare provider bias. This leads to delays in seeking care or under-treatment of health issues during pregnancy.

2. Racism and Discrimination

Racism, both systemic and interpersonal, plays a significant role in the health outcomes of women of colour. Discrimination within healthcare settings may result in delays in diagnosis, inadequate care, or a lack of trust between patients and healthcare providers.

3. Socioeconomic Factors

Socioeconomic status, which often correlates with race and ethnicity, can influence pregnancy outcomes. Women of colour are more likely to live in communities with limited access to healthy food, safe housing, and healthcare resources, which can increase their vulnerability to pregnancy complications.

4. Chronic Stress

Women of colour, particularly Black women, often experience higher levels of chronic stress due to societal factors like racism, poverty, and discrimination. Chronic stress can have a profound effect on pregnancy outcomes, increasing the risk of conditions like preterm birth and pre-eclampsia.

How Can Antenatal Care Help Address These Disparities?

Although these complications disproportionately affect women of colour, proper antenatal care can significantly reduce the risks. Here are some ways to improve outcomes for all pregnant individuals:

1. Regular Antenatal Appointments and Monitoring

Regular visits to an antenatal clinic allow for early detection and management of complications. Screening for conditions like gestational diabetes, high blood pressure, and infections can help prevent serious problems before they escalate.

2. Comprehensive Prenatal Care

Pregnancy care should not only focus on the physical aspects of health but also consider mental well-being. Providing access to mental health support and addressing chronic stress can improve outcomes for women of colour.

3. Educational Resources and Support

Antenatal education is crucial for empowering expectant parents with the knowledge they need to manage their pregnancy. Antenatal classes can help women understand their pregnancy, how to maintain a healthy lifestyle, and how to manage risks.

4. Increased Access to Healthcare Services

Increasing access to antenatal scans, antenatal massage, and other supportive services, especially for women from underprivileged backgrounds, is critical for improving pregnancy outcomes.

5. Promoting Cultural Competence in Healthcare

Cultural competence among healthcare providers can help eliminate biases and improve the patient-provider relationship. This includes understanding the unique challenges faced by women of colour and providing care that is respectful, empathetic, and culturally sensitive.

Conclusion

The antenatal health of women of colour remains a significant concern, with various complications disproportionately affecting them. However, by addressing the systemic inequalities and ensuring all women have access to comprehensive, respectful, and timely antenatal care, we can reduce these disparities and improve pregnancy outcomes for everyone. It is essential for healthcare providers to remain vigilant and for expectant parents to seek out the support they need to stay informed and empowered throughout their pregnancy journey.