Acknowledging and Addressing Allostatic Load in Pregnancy Care

Kirsten A. Riggan, Anna Gilbert, Megan A. Allyse

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


The USA is one of the few countries in the world in which maternal and infant morbidity and mortality continue to increase, with the greatest disparities observed among non-Hispanic Black women and their infants. Traditional explanations for disparate outcomes, such as personal health behaviors, socioeconomic status, health literacy, and access to healthcare, do not sufficiently explain why non-Hispanic Black women continue to die at three to four times the rate of White women during pregnancy, childbirth, or postpartum. One theory gaining prominence to explain the magnitude of this disparity is allostatic load or the cumulative physiological effects of stress over the life course. People of color disproportionally experience social, structural, and environmental stressors that are frequently the product of historic and present-day racism. In this essay, we present the growing body of evidence implicating the role of elevated allostatic load in adverse pregnancy outcomes among women of color. We argue that there is a moral imperative to assign additional resources to reduce the effects of elevated allostatic load before, during, and after pregnancy to improve the health of women and their children.

Original languageEnglish (US)
Pages (from-to)69-79
Number of pages11
JournalJournal of Racial and Ethnic Health Disparities
Issue number1
StatePublished - Feb 2021


  • Allostatic load
  • Health disparities
  • Infant morbidity and mortality
  • Maternal morbidity and mortality
  • Weathering hypothesis

ASJC Scopus subject areas

  • Health(social science)
  • Anthropology
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health


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