Prenatal Mindfulness Training and Race-Related Vigilance: A Mixed-Methods Study Among Pregnant Women at Risk for Hypertensive Disorders.

BACKGROUND: The experience of discrimination among pregnant women of color is linked to adverse pregnancy outcomes. Mindfulness training, in which participants are taught to observe stressors with acceptance and curiosity, may mitigate psychological consequences of discrimination. However, prior trials of mindfulness have lacked racial and ethnic diversity and may not be culturally congruent among women of color. OBJECTIVE: To assess the effects of prenatal mindfulness training on psychological consequences of discrimination as well as barriers and facilitators to mindfulness training, in a sample of pregnant women of color at risk for developing hypertension in pregnancy. METHODS: We included 53 participants enrolled in a clinical trial of mindfulness training who self-identified as women of color (race/ethnicity of Hispanic and/or non-white). Participants completed measures of race-related vigilance and prolonged activation and anticipatory race-related stress scales before and after randomization to mindfulness training or usual care. Qualitative interviews were conducted among 9 Black or Latina women who participated in the mindfulness intervention to identify barriers and facilitators to mindfulness training engagement. RESULTS: We observed a significant decrease in race-related vigilance after mindfulness training relative to usual care (F = 4.64, P = .04). Qualitative results confirmed and extended these findings with information from participants on their experiences of race-specific stressors as well as how mindfulness served as a tool for reducing reactions to stressors. CONCLUSIONS: Mindfulness may reduce race-related vigilance during pregnancy. In addition to individually delivered interventions, broader efforts are needed to address discriminatory policies and practices within healthcare systems to reduce racial disparities in pregnancy outcomes.