Did you know that black women experience higher rates of pregnancy-related complications and Perinatal Mood & Anxiety Disorders (PMADs) than other groups in the United States? What’s more, research shows that black women experience maternal mental health conditions at rates approximately two to four times higher than white women1 and are three to four times more likely to die from pregnancy-related complications.2 Yet many women of color continue to face barriers to receiving high-quality, culturally responsive healthcare and mental health support.
The good news is that awareness, early intervention, strong support systems and equitable healthcare practices can dramatically improve outcomes for black mothers and their babies.
Why Are Black Women at Greater Risk for PMADs and Pregnancy Complications?
Maternal health outcomes are influenced by much more than medical care alone. Social, environmental, emotional and healthcare-related factors all contribute to increased risk.
Social and Environmental Factors
Long before a first prenatal appointment, many Black women encounter social stressors that can negatively affect mental and physical health. These may include:
- Trauma
- Housing instability
- Income inequality
- Underemployment
- Experiences of discrimination and racism
Research consistently shows that exposure to racism and chronic stress can significantly increase the risk of postpartum depression and anxiety. The emotional impact of these experiences can accumulate over time, affecting overall health before, during and after pregnancy.
How Does Chronic Stress Affect Pregnancy and Postpartum Mental Health?
Chronic stress impacts both the mind and body. Black women are more likely to experience high-stress environments, which can contribute to both PMADs and pregnancy-related medical complications, including:
- Preeclampsia
- Uterine fibroids
- Preterm birth
When stress is persistent, the body’s systems remain in a heightened state of alertness. Over time, this can increase vulnerability to depression, anxiety and other mental health concerns during the perinatal period.
Healthcare Barriers that Affect Maternal Mental Health
Healthcare systems play a critical role in identifying and treating PMADs. Unfortunately, many Black women continue to encounter barriers that may delay diagnosis and treatment.
Mental Health Screening Does Not Always Capture Every Experience
Many screening tools were developed without sufficient representation from diverse populations. As a result, Black women may express symptoms differently than what providers traditionally expect. For example, they may be more likely to report physical symptoms, self-criticism or feelings of exhaustion rather than identifying primarily with sadness or hopelessness. When providers are not aware of these differences, mental health concerns can go unrecognized.
Systemic Bias in Healthcare
Historical and ongoing inequities within healthcare systems contribute to disparities in maternal outcomes.
Many women report feeling dismissed, unheard or unsupported when raising concerns about their health. These experiences can create distrust and discourage individuals from seeking care when they need it most.
Individual Provider and Cultural Bias
Not all healthcare providers receive specialized training in perinatal mental health or culturally responsive care. This can lead to missed opportunities for routine screening, diagnosis and early intervention during pregnancy and postpartum.
Cultural shaming and the historical burden of the “strong black woman” trope may prevent black women from discussing any feelings of hopelessness (a symptom of depression and anxiety) they might be experiencing.
How Families and Communities Can Support Black Mothers
Improving maternal mental health requires support at every level, from healthcare systems to family relationships. Whether you are a partner, friend, family member, healthcare provider or community member, here’s how you can help.
Notice. Arrive. Engage. Listen.
- Focus on community level intervention to help and join organizations that advocate for black maternal health, such as Black Mamas Matter Alliance.
- Attend trainings on implicit bias and culturally responsive healthcare practices. Consider March of Dimes’ Awareness to Action: Dismantling Bias in Maternal and Infant Healthcare.
- Join or follow housing advocacy groups that fight redlining and address housing inequities. Consider Family Promise, a group local to West Michigan.
- Screen for PMADs often and listen for warning signs.
- Encourage patients to take control of their care plans in the early stage of pregnancy. A great place to start it the book, Oh Sis, You’re Pregnant!: The Ultimate Guide to Black Pregnancy & Motherhood by Shanicia Boswell.
- Connect families with culturally aligned resources, including Black-led doula programs. One local to Grand Rapids is Day One Doula Collective.
- Empower black birthing parents to seek a different provider if they feel unheard or dismissed. Know culturally competent providers to refer out to.
- Make yourself available for telehealth visits to improve access.
- Learn healthy and culturally appropriate ways to support infant development and attachment.
- Promote integrated care and shared decision-making with your black birthing parents’ providers.
When it comes to improving Black maternal mental health, awareness is the first step, followed by meaningful progress in the form of action, accountability and sustained support. By working together to eliminate disparities and ensure culturally responsive care, we can help Black mothers feel empowered, valued and supported.
Many thanks to PMAD expert Sarah DeYoung, LMSW, PMH-C, for her contributions to this article.
Sources:
1. Reconsidering the Impact of Race on Maternal Mental Health – Obstetrics and Gynecology Clinics
2. NCHS Releases Final 2024 Maternal Mortality Data | NCHS Blog | CDC
You are not alone! Perinatal Mood & Anxiety Disorders are the #1 complication of pregnancy. Pine Rest has innovative, proven programs to help you feel like yourself again.
