Examining the Impact of the Syndemic on Black Birthing Individuals in the USA: a Systematic Review.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic created a unique set of challenges within the USA. The combination of the pandemic and long-standing systemic racism has generated greater maternal health disparities in minoritized populations, especially Black birthing individuals, creating a syndemic. This systematic review evaluated studies conducted between March 2020 and December 2024 to examine how Black birthing individuals' lives were impacted by the COVID-19 pandemic and systemic racism. Studies were included if (1) Black birthing individuals' experiences were examined; (2) these experiences were a focus of the study; (3) they were peer-reviewed, empirical articles; and (4) data was collected after March 2020. Utilizing PRISMA guidelines, we conducted a systematic review of the published literature up to December 2024 using PubMed, PsycINFO, Web of Science, and EBSCOhost and examined peer-reviewed articles that met inclusion criteria. Four authors independently screened studies and abstracted data. A total of 843 articles were screened, and from the 50 studies that were included in this paper, two overarching areas were identified: (1) societal-level themes and (2) individual- and interpersonal-level themes. Within these two areas, seven total subthemes were identified: (1a) Restrictions; (1b) Medical Mistrust and Healthcare Discrimination; (1c) Delivery, Birth, and Postpartum Experiences; (1d) Police Brutality and Community Violence; (2a) Health and Well-Being; (2b) Financial, Housing, Food, and Work-Related Challenges; and (2c) Caregiving and Family Relationships. Our findings emphasize the need for research to understand Black birthing individuals' experiences and to use these findings to create comprehensive targeted approaches.