Trauma, Stress, and Reproductive Health: A Bio-Psycho-Social Perspective on Violence Exposure in Immigrant Women.

Abstract

Marginalized women, particularly immigrants, face disproportionately high levels of violence that can adversely impact their physical and mental health. However, the interconnections among the various drivers of this violence and reproductive health complications remain underexplored. This cross-sectional study utilized a bio-psycho-socio-ecological model to investigate the correlates of cumulative violence exposures and reproductive health complications among 127 immigrant women in the United States who reported lifetime cumulative violence exposures. Results indicated that structural-level stressors, specifically everyday discrimination, were associated with higher cumulative violence exposure. At the individual level, elevated cortisol levels and higher perceived stress were linked to greater lifetime exposure to violence. Additionally, both cumulative violence and everyday discrimination were independently associated with increased reproductive health complications. In contrast, greater endorsement of gender-equitable norms was associated with lower odds of reproductive health complications. These findings underscore the multi-level determinants of violence exposure and their downstream impact on reproductive health, highlighting the need for integrated clinical and public health approaches. Interventions may include trauma-informed reproductive health care that addresses physiological and psychological stress, policies aimed at reducing discrimination, and community-level efforts to transform harmful gender norms and promote gender equity.