Black women in the United States experience preeclampsia more often and are more likely to experience severe complications from it than White women. Traditional risk factors, such as high blood pressure, diabetes, body weight, and pregnancy history, do not fully explain this difference. This study explored whether experiences of racism may be connected to preeclampsia risk. Researchers in the United States used information from 5,181 participants in the Black Women’s Health Study who had their first birth between 1995 and 2009. Participants were asked about everyday experiences of racism, such as receiving poorer service or being treated as less intelligent, dishonest, or threatening. They were also asked about unfair treatment because of race in employment, housing, and interactions with police.

About 9% of the women reported having preeclampsia. Women with the highest levels of everyday racism had 50% higher odds of reporting preeclampsia than women with the lowest levels. Women who experienced racial discrimination in two institutional areas, such as both employment and housing, had 47% higher odds of preeclampsia than women who reported no institutional discrimination. These relationships remained even after researchers considered factors such as age, education, health insurance, pregnancy history, body mass index, smoking, and alcohol use.

The study does not prove that racism directly causes preeclampsia. Participants reported their own experiences and diagnoses, and the researchers could not measure every medical or social factor that might affect risk. However, the findings suggest that racism-related stress may contribute to physical changes involving blood vessels, inflammation, and stress hormones during pregnancy. The results support the need for healthcare systems to recognize racism as an important maternal health concern, listen to Black patients’ experiences, and strengthen respectful, patient-centered care.

Take Home Message: Greater experiences of everyday and institutional racism were associated with higher odds of preeclampsia among Black women. Preventing preeclampsia disparities may require addressing not only medical risk factors, but also the harmful social and healthcare environments that contribute to chronic stress and unequal care. More research is needed to further explore the connection betweeen racism and preeclampsia risks. If you are a patient, is important that you feel cared for, respected and heared. The Preeclampsia Foundation recognizes the difficult experiences of Black women in our community. To read more about how the Foundation is engaging diverse voices, improving healthcare practices, and advancing necessary research, click here.

Citation: Ogunwole SM, Bertrand KA, Palmer JR, Bennett WL, Zeng Y, Jennings JM, Amoah AA, Boyer T, Cozier YC, Thorpe RJ Jr. Experiences of Racism and Risk of Preeclampsia in the Black Women's Health Study. Hypertension. 2026 Jul;83(7):e26454. doi: 10.1161/HYPERTENSIONAHA.125.26454. Epub 2026 Apr 29. PMID: 42052660; PMCID: PMC13248917. https://pubmed.ncbi.nlm.nih.gov/42052660/