Understanding the Effects of Collective Allostatic Load on Maternal Health

Abstract

Black women in the United States experience disproportionately high rates of maternal and infant mortality, reflecting persistent racial inequities in healthcare. Problem Statement: The primary objective of this literature synthesis was to explore how pregnant Black women experience and interpret psychosocial stressors that contribute to elevated allostatic load, defined as the cumulative “wear and tear” on the body and brain due to chronic exposure. This includes sociocultural identity stressors, healthcare discrimination, systemic inequities, and anticipatory trauma in adverse maternal health outcomes. A literature synthesis was conducted using PRISMA guidelines across PubMed, Google Scholar, EBSCO, SpringerLink, and ProQuest databases. Six peer-reviewed studies published between 2020 - 2025 met inclusion criteria and were critically appraised using the Joanna Briggs Institute (JBI) and ConQual tool. Findings revealed three major themes: police and healthcare violence, interpersonal violence, and the psychological burden of survival. Participants described chronic exposure to racism, unsafe neighborhoods, intimate partner violence, financial instability, lack of social support, and dismissal by healthcare providers, contributing to chronic stress and increased allostatic load. Additional stressors included internalized racism, stereotype pressure, hair texture bias, and the “Strong Black Woman” expectation, which often normalized pain endurance and delay care/diagnosis. Black maternal health disparities are deeply rooted in structural and psychosocial inequities that extend beyond biomedical risk factors. Healthcare organization policy and practice should address black maternal care interventions that are accessible, cost effective, and community centered to combat elevated allostatic load and adverse health outcomes.