Half of black birthing parents experience a perinatal mood and anxiety disorder (PMAD), a much higher rate than the 20 percent average for all birthing parents in the U.S. In addition, black birthing parents in the perinatal phase are three to four times more likely than their white or Hispanic counterparts to die from pregnancy-related complications. Addressing the social and environmental factors, emotional and physical factors, and systemic racism in healthcare can dramatically improve the maternal mental and physical health for black women and help optimize infant health and wellness.
Social & Environmental Factors
Societal challenges place black birthing parents in harm’s way prior to their first OB-GYN appointment. These factors increase the development of maternal mental health disorders and exacerbate the symptoms.
Some of those challenges include:
- Trauma
- Housing instability
- Income inequality
- Discrimination/racism
- Underemployment
Statistics show that black women who experience racism in the year prior to pregnancy have much higher rates of postpartum depression.
Emotional & Physical Factors: In the perinatal period
Both pregnancy-related complications and PMADs are more likely with high frequencies of encountering high stress environments. Black women experience higher rates of stress from their birthing experiences and above-average rates of pregnancy-related complications such as:
- Preeclampsia
- Uterine fibroids
- Preterm birth
Healthcare-Specific Factors
Unfortunately, race-related discrimination, bias in healthcare systems and bias of individual practitioners lead to sub-par treatment for black women.
Screening tools miss symptoms.
Under representation in minorities who create screening tools also apply to screening tools missing symptoms associated with other cultures. For instance, black women were more likely to report somatic and self-critical symptoms than stereotypical symptoms like hopelessness or depressed mood.
Bias in the healthcare system
Due to historical implicit biases in the medical field, this population experiences serious disparities in their mental and medical health care.
Bias of individual practitioners
Not all medical providers are trained in mental health, so often screenings are not done at appropriate intervals or at all.
Even the wealthiest black women are at risk and suffer graver outcomes. Think of Serena Williams (embolism after her c-section) and Beyonce (preeclampsia); both women have discussed feeling that their concerns were not taken seriously by their care team which resulted in emergency care and c-sections. When you pair this with decreased access to quality care, you have compounding factors on both sides.
Because of the historical burden of the “strong black woman” trope, black women often do not discuss feelings of hopelessness (a symptom of depression and anxiety) due to cultural shunning. If medical providers are not making efforts to be culturally competent, are not aware of their own biases, and are missing the symptoms of mental health, these black birthing parents are going to suffer.
Notice. Arrive. Engage. LISTEN.
So now that we know all of this, what can we do?
1. Focus on community level interventions to help.
Consider these options to build your own cultural competency with this population:
2. Attend trainings to learn and reduce your own biases.
Consider March of Dimes’ Awareness to Action: Dismantling Bias in Maternal and Infant Healthcare™.
3. Join or follow housing advocacy groups that continue fighting redlining.
Consider Family Promise, a group local to West Michigan.
4. Screen for Perinatal Mood and Anxiety Disorders often and listen for warning signs.
5. Encourage patients to take control of their care plans in the early stage of pregnancy.
A great place to start it suggesting the book, Oh Sis, You’re Pregnant!: The Ultimate Guide to Black Pregnancy & Motherhood by Shanicia Boswell.
6. Join movements that support this cause.
Consider Black Mamas Matter Alliance.
7. Locate black-led doula programs for your black birthing patients.
One local to Grand Rapids is Day One Doula Collective.
8. Empower black birthing parents to switch providers if they do not feel their needs are being met.
Know cultural component providers to refer out to.
9. Make yourself available for telehealth visits to improve access.
10. Learn healthy and culturally appropriate ways to support infant development and attachment.
11. Promote integrated care and shared decision-making with your black birthing parent’s providers.
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.
