Examining multilevel resilience as a moderator of associations between gendered racial microaggressions and postpartum mental health and functioning.

The United States is currently facing a maternal health crisis, and mental health issues are a leading preventable cause of maternal mortality. We assessed the influence of resilience on the relationship between gendered racial microaggressions (GRM) and postpartum depressive symptoms and functioning. We analyzed data among 265 postpartum Global Majority participants across four Philadelphia and New York hospitals. We administered the adapted Gendered Racial Microaggressions Scale (α = 0.97) to participants before discharge. Postpartum depressive symptoms, postpartum functioning, and resilience were assessed at 3 months postpartum using the Edinburgh Postnatal Depression Scale, the Patient-Reported Outcomes Measurement Information System Global Short Form, the Collective Efficacy Scale, and the Connor-Davidson Resilience Scale, respectively. Multilinear regressions tested the associations between GRM and postpartum depressive symptoms and functioning. Moderation analysis examined how community and personal resilience changed the relationship between GRM and postpartum depressive symptoms and functioning. Experiencing GRM during obstetric care was associated with postpartum depressive symptoms and lower postpartum functioning symptoms. Personal resilience moderated the association between GRM and postpartum functioning; this moderation was not observed for postpartum depressive symptoms. Community resilience did not moderate the association between GRM or postpartum depression and functioning symptoms. Gendered racial microaggressions, in obstetric contexts, harm postpartum mental and physical health. However, personal resilience may mitigate the impact of racism in obstetric care on postpartum health.