Maternal & Infant Health
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Disparities in maternal mental health: a rising public health issue

April 15, 2024
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National Minority Health Month brings awareness to the many health conditions Black, Indigenous, and People of Color (BIPOC) experience, including maternal mental health (MMH). In a study reported by the United States Government Accountability Office, in 2020 more Black or African American women reported depressive symptoms after pregnancy at roughly 8.1 percent compared to 7.9 percent of white women. Both races experienced depressive symptoms after pregnancy at a rate of 7.7 percent in 2021. While the rate between Black and white women were the same, Black women are more likely to experience MMH challenges than white women.

Over 50 percent of postpartum depression cases experienced by BIPOC go underreported.

According to the Maternal Mental Health Leadership Alliance (MMLA), roughly 40 percent of Black mothers and birthing parents suffer from maternal mental health conditions. Moreover, over 50 percent of postpartum depression cases experienced by BIPOC go underreported. Other races and ethnic groups are also affected by MMH issues. Some researchers explained that compared to non-Latina(x) white women, more Latina(x) women reported anxiety during pregnancy. U.S. born and foreign-born Latinas(x) expressed depression during or after pregnancy, at between 23 percent to 52 percent. Asian American women experienced increased rates of postpartum depression.

Barriers to getting help for maternal mental health conditions

BIPOC individuals deal with many barriers that prevent them from addressing MMH conditions. Stigma is a major barrier as birthing parents of BIPOC individuals often feel they cannot talk about these conditions in order to remain strong. Black women are encouraged to keep their problems private and not be seen as weak, crazy, or lacking faith. They must maintain the “strong Black woman” mentality; remain strong enough to take care of others while dismissing themselves.In a study conducted by Van Ta Park, Deepika Goyal, and their colleagues on Asian mothers and their perspectives about postpartum depression, some Chinese American women reported that depression was a sign of weakness in their culture. Some Latina women feel pressured to become a perfect mother, like the Virgin Mary or a martyr mother, a concept called marianismo. When these mothers feel like they cannot live up to this expectation of perfection, it leads to feelings of inadequacy, and not noticing the symptoms of anxiety or depression they may be experiencing. Similarly to Black women, this study also showed that Latina women often feel pressured to remain strong for others while ignoring themselves as individuals.Social determinants of health (SDOH), sometimes called social drivers of health – factors that affect health outcomes — is another barrier to seeking care for maternal mental health conditions. Some BIPOC individuals have trouble accessing healthcare, for example they may lack transportation to get the care; transportation is a social driver of health. Black women are disproportionally affected by SDOH as they are more likely to experience high levels of gender-related violence.

Black women are disproportionally affected by SDOH as they are more likely to experience high levels of gender-related violence.

Miguel Ceballos, Gail Wallace, and Glenda Goodwin conducted a study about Latina and Black women who live in rural areas. They reported that Latina women who did not have U.S. citizenship had more difficulty adjusting the U.S. culture. They are concerned about their documented status, which leads to stress and a higher risk for postpartum depression. Latina and Asian women can also face language barriers when trying to receive the care they need.Racism and weathering contribute to racial disparities in maternal mental health. Weathering occurs when persistent racism and discrimination drives a person into constant state of stress. Weathering can lead to negative health outcomes, and mental health conditions are not the exception. For instance, Kelly M. Bower, Ruth J. Geller and their colleagues explained that Black women who experienced racism the year before giving birth are at higher odds of suffering from depression during pregnancy. In addition, BIPOC and individuals of lower socioeconomic status expressed lower quality of care during births in hospitals. This can lead to Black women having higher rates of maternal mental health disorders and maternal mortality than their white counterparts.

Solutions to address racial disparities in negative maternal mental health conditions

Although MMH conditions are affecting BIPOC individuals, there are solutions to address them. One of the solutions is to break the stigma of the conditions. It is important for birthing parents—like Latina women as stated by the Seleni Institute—to know that feeling sad or stress does not lead to a permanent diagnosis, and it does not mean they are a bad parent. It is important to normalize the ways to treat MMH conditions.

Increasing minority representation in behavioral health can improve trust between patients and providers.

Another solution is to increase members of the behavioral health workforce that are BIPOC. According to the National Institute for Health Care Management (NIHCM) Foundation, only 10.4 percent of psychiatrists are either Native American, Black, or Hispanic, while 81 percent of white psychologists are in the workforce. Increasing minority representation in behavioral health can improve trust between patients and providers and reduce the chances of negative health outcomes for birthing parents of color, including maternal mental health conditions. The Center for Community Solutions will continue to share information about MMH and highlight solutions to address these disparities.*Although we use the terms ‘women’ and ‘mothers’ in some cases due to how earlier data was reported, we acknowledge and recognize that not everyone who could carry a pregnancy refers to themselves this way. We respect the identity of all pregnant or birthing parents.

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