This commentary is in response to the Call for Papers put forth by the Critical Midwifery Studies Collective (June 2022). We argue that due to a long and ongoing history of gendered racism, Women of Color are devalued in U.S. society. Devaluing Women of Color leads maternal healthcare practitioners to miss and even dismiss distress in Women of Color. The result is systematic underdiagnosis, undertreatment, and the delivery of poorer care to Women of Color, which negatively affects reproductive outcomes generally and birth outcomes specifically. These compounding effects exacerbate distress in Women of Color leading to greater distress. Stress physiology is ancient and intricately interwoven with healthy pregnancy physiology, and this relationship is a highly conserved reproductive strategy. Thus, where there is disproportionate or excess stress (distress), unsurprisingly, there are disproportionate and excess rates of poorer reproductive outcomes. Stress physiology and reproductive physiology collide with social injustices (i.e., racism, discrimination, and anti-Blackness), resulting in pernicious racialized maternal health disparities. Accordingly, the interplay between stress and reproduction is a key social justice issue and an important site for theoretical inquiry and birth equity efforts. Fortunately, both stress physiology and pregnancy physiology are highly plastic—responsive to the benefits of increased social support and respectful maternity care. Justice means valuing Women of Color and valuing their right to have a healthy, respected, and safe life.

中文翻译：

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贬低有色人种女性的影响：压力、生育和正义


本评论是对批判助产研究集体（2022 年 6 月）提出的论文征集的回应。我们认为，由于性别种族主义长期存在，有色人种女性在美国社会中被贬低。贬低有色人种女性会导致孕产妇保健从业者忽视甚至忽视有色人种女性的痛苦。其结果是系统性地诊断不足、治疗不足，并且为有色人种女性提供的护理质量较差，这对生殖结果尤其是出生结果产生了负面影响。这些复合效应加剧了有色人种女性的痛苦，导致更大的痛苦。应激生理学历史悠久，与健康妊娠生理学错综复杂地交织在一起，这种关系是一种高度保守的生殖策略。因此，只要存在不成比例或过度的压力（痛苦），毫不奇怪，不良生殖结果的发生率就会不成比例和过度。应激生理学和生殖生理学与社会不公正（即种族主义、歧视和反黑人）发生冲突，导致有害的种族化孕产妇健康差异。因此，压力与生育之间的相互作用是一个关键的社会正义问题，也是理论探究和出生公平努力的重要场所。幸运的是，压力生理学和怀孕生理学都具有高度可塑性——能够对增加的社会支持和尊重的产妇护理的好处做出反应。正义意味着重视有色人种女性，重视她们享有健康、受尊重和安全生活的权利。