Stress during pregnancy: An ecological momentary assessment of stressors among Black and White women with implications for maternal health

Abstract

Background: Stress can lead to adverse physiological and psychological outcomes. Therefore, understanding stress during pregnancy provides insight into racial disparities in maternal health, particularly Black maternal health. Objectives: This study aimed to describe (1) daily exposure to self-reported stress levels during pregnancy, and (2) sources of stress among participants that identified as Black or White using data collected via ecological momentary assessment. Methods: We leveraged survey data from the Postpartum Mothers Mobile Study, a prospective longitudinal study using ecological momentary assessment data collection methods to describe patterns of stress during pregnancy. This article is descriptive and documents patterns of self-reported stress levels and sources of stress. Frequencies and percentages of stress responses were computed to describe these patterns. Results: The sample ( n = 296) was 27% Black ( n = 78) and 63% White ( n = 184). Results were based on at least one measurement of that stress level during pregnancy. A similar number of Black and White participants reported no stress during pregnancy. White (85%–95%) and Black (60%–70%) participants reported low to moderate levels of stress. Black participants (38%) and White participants (35%) reported experiencing high stress. Black and White participants reported similar sources of stress: stress from a partner, too many things to do, a baby or other children, and financial concerns. White participants reported work as a top stressor, and Black participants reported financial issues as a top source of stress. Conclusion: This study provides insight into daily exposure to stress that has implications for maternal health. We described patterns of self-reported stress and sources of stress among Black and White participants. The daily exposures to stress reported by this sample exist within a context of root causes of structural inequities in education, health care, income, wealth, and housing that must be addressed to achieve maternal health equity.