A Black Feminist Approach to Measuring Maternal Psychological Distress

Background and purpose:

Black women persistently experience the highest maternal and infant mortality rates in the United States. Infants born preterm and at low birth weight account for the majority of infant mortality experienced by black women. Stress has been explored as a psychological factor for these adverse birth outcomes in several studies. The results of these studies have been mixed. Several scales have been used to measure stress among black women in these studies, which may contribute to mixed results. Scales that do not consider the specific issues facing black women have the potential to under/overestimate exposure to stress. Developing instruments that specifically measure stress among black women is vital to understanding psychological factors associated to adverse maternal and infant birth outcomes. This paper uses Black feminist theory as a theoretical framework to develop a Black Woman Maternal Health Stress Measure.      

Methods:

Black feminist theory (BFT) was used to develop an instrument that specifically incorporates the lived experiences of black women. BFT assumes that black women experience and resist race, class, and gender oppression. To develop an instrument using BFT, a three-step process was conducted. First, a historical and current literature review of BFT was conducted. Secondly, what Black feminist scholar, Patricia Hill Collins calls the African American women’s standpoint was used to incorporate specialized knowledge created by African American women. This specialized knowledge is developed by black women outside of the academy and black feminist scholars are challenged to incorporate these perspectives into their research methodology. Lastly, the “Super Woman Role”, also referred to as “strength” has been suggested as a form of resistance by black women that has health and other psychological implications. Black feminist scholars, such as Beauboeuf-Lafontant and others have used this framework of “strength” in their work. The coping style of “strength” is used to measure the response to stress by black women. Each of these concepts and previous studies applying BFT black were used to develop a stress measure specific to black women.

Results:

The results indicated there is a dearth of empirical studies applying BFT to maternal and child health disparities. Therefore, BFT was used to develop an instrument for the Black Women’s Work and Maternal Health Study to test this theory. This instrument is currently being tested through semi-structured interviews with black women that had a live birth within the last 24 months. Data is collected on work-related psychological distress, maternal mental/physical health, infant birth outcomes, and postpartum experiences.

Conclusions and Implications:

BFT addresses a gap in social work theory and can be used to inform maternal and child health social work practice. Moreover, BFT can be used to explore, measure, and address psychological distress among black women to improve maternal mental health, pregnancy outcomes, and infant health. BFT is a useful theoretical framework to address health disparities and should be used by social work scholars addressing dis-equity in maternal and child health.