Tanya Dutt

Telling Women To 'Calm Down' Could Actually Raise Risk For Postpartum Hypertension

The <span>postpartum</span> period is described as the 'joyful time of bonding' with newborns, and for most mothers, this could be an uncomfortable time full of health-related complications. Women of color face specific challenges that most women are likely to ignore and overlook. Among those challenges is the condition of <span>postpartum <a href="https://www.healthandme.com/health/hypertension">hypertension</a></span>, which could pose long-term damage to the health of the mother and the child. Current studies indicate that microaggressions and systemic racism contribute greatly to blood pressure levels and further health conditions.

A medical condition occurring in a female after childbirth whereby her blood pressure is higher than normal. Such <span>hypertension</span> may become a continuation of preeclampsia or might develop independently, during the postpartum time. High blood pressure in this period is not merely a temporary inconveniences it increases the possibility of stroke and organ damage while also contributing to long-term diseases of the heart and blood vessels. 

Blood pressure is measured with two numbers.

<ul><li><strong>Systolic pressure:</strong> the pressure of the blood against walls of the artery during a pulse. </li><li><strong>Diastolic pressure:</strong> is the pressure found in arteries at any time between heartbeats.</li></ul> 

Although levels under 120/80 millimeters of mercury are considered perfectly normal, just small increases represent significant health problems for new mothers.

Microaggression refers to subtle verbal or nonverbal actions that affect individuals from marginalized or non-mainstream communities. The term was introduced around 1970 by Dr. Chester Pierce, a Harvard psychiatrist. Dr. Pierce coined the phrase to describe the frequent insults and dismissive behaviors he observed being directed at Black individuals by non-Black people. He recognized that these repeated experiences could significantly impact a person’s mental and physical health over time.

Microaggressions can be intentional or unintentional. There are 3 types- 

<ul><li>Microassaults are deliberate and intentional slights or insult</li><li>Microinvalidation is when someone attempts to discredit or minimize the experiences of a person</li><li>Microinsults are rude, insensitive comments that subtly disrespect a person’s racial heritage or identity</li></ul>

<h2>How Microaggressions Elevate Blood Pressure?</h2>

A study published in the journal Hypertension points out the association between microaggressions and high blood pressure in postpartum women of color. These are subtle, often unconscious slights, such as comments like, "You need to calm down," or being labeled "angry" for speaking assertively. While these remarks may seem trivial to some, their impact is profound.

The researchers studied nearly 400 women of color in Philadelphia and New York City, and 38% reported experiencing microaggressions during their pregnancy care. The study revealed that women subjected to these remarks had, on average, systolic blood pressure readings 2.12 points higher and diastolic readings 1.43 points higher. This increase in blood pressure highlights the potential health risks associated with subtle forms of racism and discrimination during maternal care.

It was more significant at higher levels of structural racism. Systolic was increased by 7.55 points, and diastolic was increased by 6.03 points. Such variations often determine the necessity for antihypertensive medication. 

Microaggressions are described as "death by a thousand cuts." They go far beyond postpartum hypertension, these little cuts in day-to-day exposure result in chronic stress that has its physical manifestation as:

<strong>Physical symptoms: </strong>Upset stomachs, tension and headaches. 

<strong>Mental health challenges:</strong> Stress, depression and sense of hopelessness. 

<strong>Biological consequences:</strong> Telomere shortening of protective ends of the chromosomes, vulnerability to chronic disease.

Also Read: <a href="https://www.healthandme.com/parenting/who-are-sandwich-carers-why-are-their-mental-health-declining-article-151119115" data-type="tilCustomLink" target="_blank">Who Are 'Sandwich Carers'? Why Are Their Mental Health Declining?</a>

Trust and healing through the healthcare system are sadly converted into a hotbed for all these experiences as patients describe not only disrespect, hearing, and not being taken seriously but also, in many instances, the added strain of their actual medical condition.

Structural racism—the ways in which systemic policies and practices disadvantage people—exacerbates this issue. For example, women of color living in communities characterized by systemic inequities are more likely to face health difficulties stemming from: access to adequate quality care, implicit bias within healthcare providers, and increased exposures to stressors such as poverty and unsafe conditions of living.

Microaggressions have significant impacts that well exceed the postpartum period and even healthcare venues. Studies show that Black men are stereotyped as being aggressive and that this stereotype can cause dangerous discrimination. Latina women are often objectified, reduced to physical characteristics, which continues the pattern of societal biases. 

Asian Americans suffer from backhanded compliments regarding their English fluency, though they have lived in the United States their entire lives, which illustrates a subtle yet pervasive form of racism that denies their identity and experiences. Though seemingly small and insignificant, these microaggressions carry a heavy emotional and psychological toll on the people who suffer them.

Over time, these experiences add up, leading to mistrust, social withdrawal, and other unhealthy coping mechanisms such as substance abuse or denial.

<h2>Tips to Combat Postpartum Hypertension</h2>

Postpartum hypertension, a critical health issue for many new mothers, is often exacerbated by microaggressions and systemic inequities. A systematic approach to tackling these challenges involves empowering individuals, creating inclusive healthcare systems, and addressing structural barriers.

Stress from microaggressions significantly impacts health outcomes. Providing women with tools to manage stress can help mitigate the effects of postpartum hypertension. Key strategies include:

<ul><li>Cognitive Restructuring: Encouraging women to reframe negative experiences positively can reduce the emotional toll of stressors. Simple practices like journaling or mindfulness exercises can assist in shifting perspectives.</li><li>Social Support Systems: Building robust support networks—through friends, family, or postpartum groups—creates safe spaces for sharing and understanding, reducing isolation.</li><li>Therapeutic Emotional Expression: Talking openly with therapists or trusted confidants helps new mothers process their experiences and relieve emotional burdens.</li></ul>

<h4>2. Inclusivity in Healthcare Settings</h4>

Healthcare environments must prioritize inclusivity and trust to ensure women feel respected and heard. Actionable steps include:

<ul><li>Training on Implicit Bias: Comprehensive programs for healthcare providers can improve their ability to identify and address unconscious biases, fostering more empathetic and equitable care.</li><li>Empowering Patient Advocacy: Women should feel confident expressing concerns about their care. Advocacy programs can support patients, ensuring their voices are acknowledged without judgment.</li><li>Culturally Sensitive Care: Delivering care to respect cultural and personal differences in healthcare ensures the uniqueness of every patient's needs are met.</li></ul>

<h4>3. Acknowledging and Addressing Structural Inequities</h4>

Most postpartum health disparities have been contributed by systemic racism and lack of resources. That is the primary reason for dealing with the source of the problems.

<ul><li>Investment in Underserved Areas: Better access to quality healthcare, education, and resources in these areas can eliminate health disparities.</li><li>Institutional Accountability: Policies that ensure regular audits and transparency in healthcare institutions can make systems accountable for equitable care practices.</li><li>Way Forward: A Call to Action</li><li>Postpartum hypertension is a reflection of deeper societal challenges that require urgent attention. Solutions lie in empowering women with stress-management tools, fostering inclusivity within healthcare, and dismantling structural inequities.</li></ul>

Each effort—whether individual, institutional or systemic—contributes to a larger goal of reducing health disparities and improving outcomes for generations to come.

<em><a href="https://journals.sagepub.com/doi/10.1177/1745691619827499" data-type="tilCustomLink" target="_blank" rel= "noopener nofollow noreferrer" target= "_blank">Microaggressions: Clarification, Evidence, and Impact. Perspectives on Psychological Science</a>. 2020</em>

<a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6007773/" data-type="tilCustomLink" target="_blank" rel="noopener nofollow noreferrer" rel= "noopener nofollow noreferrer" target= "_blank">Language Matters: Considering Microaggressions in Science.</a> CBE Life Sci Educ. 2018

<a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4386281/" data-type="tilCustomLink" target="_blank" rel="noopener nofollow noreferrer" rel= "noopener nofollow noreferrer" target= "_blank">Unconscious biases: racial microaggressions in American Indian health care</a>. J Am Board Fam Med. 2015

<em><a href="https://ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.124.23772" data-type="tilCustomLink" target="_blank" rel= "noopener nofollow noreferrer" target= "_blank">Racism and Postpartum Blood Pressure in a Multiethnic Prospective Cohort.</a> Hypertension. 2025</em>

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microaggressions in healthcare

high blood pressure after pregnancy

postpartum stress management

maternal care inequities

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The postpartum period is described as the 'joyful time of bonding' with newborns, and for most mothers, this could be an uncomfortable time full of health-related complications. Women of color face specific challenges that most women are likely to ignore and overlook. Among those challenges is the condition of postpartum hypertension, which could pose long-term damage to the health of the mother and the child. Current studies indicate that microaggressions and systemic racism contribute greatly to blood pressure levels and further health conditions.A medical condition occurring in a female after childbirth whereby her blood pressure is higher than normal. Such hypertension may become a continuation of preeclampsia or might develop independently, during the postpartum time. High blood pressure in this period is not merely a temporary inconveniences it increases the possibility of stroke and organ damage while also contributing to long-term diseases of the heart and blood vessels. Blood pressure is measured with two numbers.Systolic pressure: the pressure of the blood against walls of the artery during a pulse. Diastolic pressure: is the pressure found in arteries at any time between heartbeats. Although levels under 120/80 millimeters of mercury are considered perfectly normal, just small increases represent significant health problems for new mothers.What Are Microaggressions?Microaggression refers to subtle verbal or nonverbal actions that affect individuals from marginalized or non-mainstream communities. The term was introduced around 1970 by Dr. Chester Pierce, a Harvard psychiatrist. Dr. Pierce coined the phrase to describe the frequent insults and dismissive behaviors he observed being directed at Black individuals by non-Black people. He recognized that these repeated experiences could significantly impact a person’s mental and physical health over time.Microaggressions can be intentional or unintentional. There are 3 types- Microassaults are deliberate and intentional slights or insultMicroinvalidation is when someone attempts to discredit or minimize the experiences of a personMicroinsults are rude, insensitive comments that subtly disrespect a person’s racial heritage or identityHow Microaggressions Elevate Blood Pressure?A study published in the journal Hypertension points out the association between microaggressions and high blood pressure in postpartum women of color. These are subtle, often unconscious slights, such as comments like, "You need to calm down," or being labeled "angry" for speaking assertively. While these remarks may seem trivial to some, their impact is profound.The researchers studied nearly 400 women of color in Philadelphia and New York City, and 38% reported experiencing microaggressions during their pregnancy care. The study revealed that women subjected to these remarks had, on average, systolic blood pressure readings 2.12 points higher and diastolic readings 1.43 points higher. This increase in blood pressure highlights the potential health risks associated with subtle forms of racism and discrimination during maternal care.It was more significant at higher levels of structural racism. Systolic was increased by 7.55 points, and diastolic was increased by 6.03 points. Such variations often determine the necessity for antihypertensive medication. Microaggressions are described as "death by a thousand cuts." They go far beyond postpartum hypertension, these little cuts in day-to-day exposure result in chronic stress that has its physical manifestation as:Some examples include: Physical symptoms: Upset stomachs, tension and headaches. Mental health challenges: Stress, depression and sense of hopelessness. Biological consequences: Telomere shortening of protective ends of the chromosomes, vulnerability to chronic disease.Also Read: Who Are 'Sandwich Carers'? Why Are Their Mental Health Declining? Trust and healing through the healthcare system are sadly converted into a hotbed for all these experiences as patients describe not only disrespect, hearing, and not being taken seriously but also, in many instances, the added strain of their actual medical condition.Structural RacismStructural racism—the ways in which systemic policies and practices disadvantage people—exacerbates this issue. For example, women of color living in communities characterized by systemic inequities are more likely to face health difficulties stemming from: access to adequate quality care, implicit bias within healthcare providers, and increased exposures to stressors such as poverty and unsafe conditions of living.Microaggressions have significant impacts that well exceed the postpartum period and even healthcare venues. Studies show that Black men are stereotyped as being aggressive and that this stereotype can cause dangerous discrimination. Latina women are often objectified, reduced to physical characteristics, which continues the pattern of societal biases. Asian Americans suffer from backhanded compliments regarding their English fluency, though they have lived in the United States their entire lives, which illustrates a subtle yet pervasive form of racism that denies their identity and experiences. Though seemingly small and insignificant, these microaggressions carry a heavy emotional and psychological toll on the people who suffer them.Over time, these experiences add up, leading to mistrust, social withdrawal, and other unhealthy coping mechanisms such as substance abuse or denial. Tips to Combat Postpartum HypertensionPostpartum hypertension, a critical health issue for many new mothers, is often exacerbated by microaggressions and systemic inequities. A systematic approach to tackling these challenges involves empowering individuals, creating inclusive healthcare systems, and addressing structural barriers.1. Stress-Reduction StrategiesStress from microaggressions significantly impacts health outcomes. Providing women with tools to manage stress can help mitigate the effects of postpartum hypertension. Key strategies include:Cognitive Restructuring: Encouraging women to reframe negative experiences positively can reduce the emotional toll of stressors. Simple practices like journaling or mindfulness exercises can assist in shifting perspectives.Social Support Systems: Building robust support networks—through friends, family, or postpartum groups—creates safe spaces for sharing and understanding, reducing isolation.Therapeutic Emotional Expression: Talking openly with therapists or trusted confidants helps new mothers process their experiences and relieve emotional burdens.2. Inclusivity in Healthcare SettingsHealthcare environments must prioritize inclusivity and trust to ensure women feel respected and heard. Actionable steps include:Training on Implicit Bias: Comprehensive programs for healthcare providers can improve their ability to identify and address unconscious biases, fostering more empathetic and equitable care.Empowering Patient Advocacy: Women should feel confident expressing concerns about their care. Advocacy programs can support patients, ensuring their voices are acknowledged without judgment.Culturally Sensitive Care: Delivering care to respect cultural and personal differences in healthcare ensures the uniqueness of every patient's needs are met.3. Acknowledging and Addressing Structural InequitiesMost postpartum health disparities have been contributed by systemic racism and lack of resources. That is the primary reason for dealing with the source of the problems.Investment in Underserved Areas: Better access to quality healthcare, education, and resources in these areas can eliminate health disparities.Institutional Accountability: Policies that ensure regular audits and transparency in healthcare institutions can make systems accountable for equitable care practices.Way Forward: A Call to ActionPostpartum hypertension is a reflection of deeper societal challenges that require urgent attention. Solutions lie in empowering women with stress-management tools, fostering inclusivity within healthcare, and dismantling structural inequities.Each effort—whether individual, institutional or systemic—contributes to a larger goal of reducing health disparities and improving outcomes for generations to come.Microaggressions: Clarification, Evidence, and Impact. Perspectives on Psychological Science. 2020Language Matters: Considering Microaggressions in Science. CBE Life Sci Educ. 2018Unconscious biases: racial microaggressions in American Indian health care. J Am Board Fam Med. 2015Racism and Postpartum Blood Pressure in a Multiethnic Prospective Cohort. Hypertension. 2025