Racial and Ethnic Differences in Prenatal Worry: Examining Work and Family, Health, and Financial Worries Among White, Black, and Hispanic Pregnant Women

Racial and ethnic disparities in maternal health remain a pressing public health crisis in the United States, yet less is known about how pregnancy-specific worry varies across racial and ethnic groups in the domains of work and family, health, and finances. Most prior research has examined aggregate prenatal stress rather than whether specific dimensions of worry differ across populations, and whether existing measures capture comparable experiences across groups. This study examines racial and ethnic differences in work and family, health, and financial prenatal worry among White, Black, and Hispanic pregnant women using data from the Family Matters Study, a socioeconomically diverse sample of 434 pregnant women recruited from a major healthcare system in North Carolina, of whom 337 comprised the analytic sample. Using a modified subset of the Prenatal Distress Questionnaire, I conducted confirmatory factor analysis and measurement invariance testing to establish the three-factor structure of prenatal worry, followed by MANOVA and MANCOVA models to examine group differences before and after sociodemographic adjustment. Hispanic women reported significantly higher financial and work and family worry than White women, with differences persisting after controlling for age, migration status, relationship status, parity, education, and income. No significant differences were observed for health-related worry. Black women did not differ significantly from White women in any domain, a pattern that likely reflects limitations in the cultural validity of existing prenatal stress measures rather than an absence of burden. These findings highlight that pregnancy-specific worry is not uniform across racial and ethnic groups and emphasize the need for domain-sensitive, culturally responsive approaches to prenatal stress assessment and care.