Background: Colorism, a form of racism that allocates privilege and opportunity based on skin tone, significantly impacts Black/African American (AA) women. In healthcare settings, colorism and racial microaggressions have been linked to disparities in care. However, their role during interactions with obstetric healthcare providers remains poorly understood. This study examines the association between everyday experiences of colorism and perceived racial microaggressions from healthcare professionals (HCPs) among AA women seeking or receiving prenatal care (PNC).

Methods: We obtained data for a sample of 472 AA women from the ongoing Life Course Influences on Fetal Environments-2 Birth Cohort (LIFE-2) Study in Metropolitan Detroit, Michigan.  We assessed everyday colorism using the Colorism Scale and racial microaggressions while seeking/receiving PNC using the Daily Life Experiences of Racial Discrimination – PNC scale. We used binomial regression with an identity link to model risk differences (RD) for the relationship between everyday colorism and perceived racial microaggressions. We adjusted for demographic and socioeconomic characteristics, and healthcare access and utilization.

Results: Nineteen percent of women reported any racial microaggressions in PNC. Women experiencing more everyday colorism (above the median for those reporting any) had a 14–percentage-point higher probability of reporting more racial microaggressions in PNC in the fully adjusted model (RD = 0.14, 95% CI: 0.05–0.22).

Conclusions: Our findings suggest that everyday colorism was associated with a higher probability of racial microaggressions in PNC settings. Future research should move beyond skin-tone proxies to developing and validating instruments that directly measure colorism experiences in healthcare.