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APHA Scientific Session and Event Listing

Paula A. Braveman, MD, MPH¹, Soowon Kim, PhD¹, Tonya Stancil, MPH², Kristen Marchi, MPH¹, Susan Egerter, PhD¹, Marilyn Metzler, RN³, Moreen Libet, PhD⁴, and Shabbir Ahmad, DVM, MS, PhD⁴. (1) Family and Community Medicine, University of California, San Francisco, 500 Parnassus Ave., MU-3E, Box 0900, San Francisco, CA 94143-0900, 415-476-6839, braveman@fcm.ucsf.edu, (2) Department of Reproductive Health, CDC, 4770 Buford Hwy, NE, Atlanta, GA 30341-3717, (3) Division of Adult and Community Health, CDC, 4770 Buford Hwy, NE, Atlanta, GA 30341-3717, (4) Maternal, Child and Adolescent Health/Office of Family Planning Branch, California Department of Health Services, 1615 Capitol Ave., MS 8304, PO Box 997420, Sacramento, CA 95899-7420

Pregnancy is a time of particular vulnerability and opportunity with potential implications for health across the life course. Despite this and accumulating knowledge of links between stress and health, little is known about rates of major stressors among the general population of pregnant women. Using population-based postpartum mail/telephone survey data from California (Maternal and Infant Health Assessment--MIHA, 2002-2004) and 17 other states (CDC's Pregnancy Risk Assessment and Monitoring System--PRAMS, 2000-2001), we estimated rates of several self-reported major economic and/or psychosocial stressors (divorce/separation, domestic violence, incarceration, homelessness, job loss; and, in MIHA only, food insecurity, financial difficulties, lack of social support) among pregnant women overall and within groups defined by family income, race/ethnicity, age, insurance, and parity. In California and pooled PRAMS data, around half of pregnant women were low-income; one-third in California and nearly 30% in PRAMS were poor. In both sources, although rates and numbers of stressors generally were highest among low-income women and Black, Latina, and American Indian women, some stressors were relatively common in all groups examined. In California, for example, 45% of pregnant women overall reported at least one major stressor, with rates ranging from 66.4% among poor to 14.7% among women with incomes over 400% of poverty. Most pregnant women in the U.S. are low-income, with high rates and numbers of major stressors. Major stressors during pregnancy are not restricted to low-income women or any sociodemographic group. Mainstream social policies and health services should address economic and psychosocial stressors among childbearing women

Learning Objectives: At the conclusion of this session, the participant will be able to

• Describe the extent to which major economic and psychosocial stressors are a problem for pregnant women overall and in different sociodemographic groups
• Discuss the implications for social policy overall as well as for health services

Presenting author's disclosure statement:

Not Answered