Black maternal mental health risks: What you need to know 

Black women are nearly twice as likely to have depression during and after pregnancy. Find ways to protect your well-being. 

Pregnancy can come with a lot of mood swings. These ups and downs are normal before and after you give birth. But if you feel sad all the time, you could have depression.  

Prenatal depression is a mood disorder that happens during pregnancy. When it happens in the weeks after childbirth, it’s called postpartum depression.  

About 20% of all women have mental health symptoms like depression during and after pregnancy. But that number jumps to 40% for Black women. In fact, it might be even higher, since only about half of new Black moms ever tell their doctors that they feel sad or anxious. 

Untreated depression or anxiety can mean trouble for baby and mom. It can lead to:  

That’s why knowing the signs and speaking up is key. Here’s what Black moms should know. 

There are lots of reasons why Black women are more likely to feel sad or on edge during and after pregnancy. Here are some of them. 

They have higher stress levels. The everyday discrimination that Black mothers face causes higher rates of depression and anxiety. They may face it at work or in stores or restaurants. They even feel it while reading news reports about racism online or on social media. 

Health care providers can discriminate, too. How? One common way is by not taking Black women’s concerns seriously. A 2023 survey found that 40% of Black women reported racial discrimination by their providers.  

“Poor health care, unsafe housing, and not enough money are big problems for many Black women during pregnancy and after,” says Ndidiamaka Amutah-Onukagha, PhD, MPH. She’s the director of the Center for Black Maternal Health and Reproductive Justice at Tufts University. These factors can lead to higher levels of cortisol, the stress hormone, she says. And too much stress can lead to mental health issues like depression and anxiety.  

They suffer more pregnancy health issues. Pregnancy complications such as high blood pressure can increase the chance of depression. Black women are more likely than other groups to have high blood pressure. The condition can cause several other pregnancy health problems, including:   

They’re more likely to live in an unhealthy environment. Black families are more likely to live in neighborhoods with pollution and little access to green spaces. Unfortunately, pregnant women who breathe polluted air have a higher risk of postpartum depression. 

Drinking polluted water is an issue, too. It’s linked with depression and anxiety. Even access to parks plays a part in people’s moods. A recent study found a link between lack of green spaces and depression after pregnancy.  

Cultural differences can play a role. Black women are less likely to tell their doctors they feel sad or depressed. Why? In African American communities, there’s the idea of the “strong black woman,” says Angela Neal-Barnett, PhD. She’s a professor of psychology at Kent State University in Ohio. “It says you’re not supposed to ask for help.”  

Plus, symptoms of depression may look different in Black women. They may not report feeling depressed. Instead, they may report symptoms such as trouble sleeping or feeling irritable or self-critical.  

[Subhead] Here’s how to protect your mental health. 

Try these simple strategies to stay healthy and mentally well during your pregnancy. 

Learn as much as you can. Take a childbirth class. Talk to your doctor and nurses. Read about pregnancy and baby care. Know the symptoms of depression and anxiety and be on the lookout for them. The sooner you recognize the signs, the faster you can take actions to feel better. 

Join a mother’s group. Ask your doctor or other moms for group suggestions. Neal-Barnett’s program offers “sister circles.” They bring together new mothers and a counselor. They talk about their anxiety and stress. They learn positive coping strategies. “We also teach parenting skills,” says Neal-Barnett. “Research shows that can help reduce postpartum depression.” 

Tap into your network of family and friends, too. A recent study found that new moms who got help from their mothers and sisters had big improvements in their mental health.  

Speak up. Tell your provider if you notice signs of depression or anxiety. Some signs include: 

Your provider can help you get the support you need. It’s important to know that depression can be treated. Medication and talk therapy can both help. 

One other person you can talk to? A doula. That’s a person who’s trained to guide you through your pregnancy, childbirth, and the first year of new motherhood. They can play a role in your emotional well-being. (Some insurance plans cover doula services and others do not. Check with your plan to find out if you’re covered.) 

Take care of yourself. Take time to rest. Eat healthy food. And get some exercise. Even if it’s just a walk around the block with the baby. A recent study shows that self-care improves feelings of well-being for new mothers. And don’t forget to ask for help from family and friends. our care team directly. They can tell you if you need to call your doctor right away, or even head to the emergency room.  

Sources: 

[1] “Depression During Pregnancy.” March of Dimes, July 2023, https://www.marchofdimes.org/find-support/topics/pregnancy/depression-during-pregnancy 

[2] “Black Maternal Mental Health: the Data, the Barriers, and Organizations to Support.” 

 Maternal Mental Health Leadership Alliance Inc., Feb 1, 2024, https://www.mmhla.org/articles/black-maternal-mental-health-the-data-the-barriers-and-organizations-to-support 

[3] Dadi AF, Akalu TY, Wolde HF, Baraki AG. “Effect of perinatal depression on birth and infant health outcomes: a systematic review and meta-analysis of observational studies from Africa.” Archives of Public Health, January 2022. https://pubmed.ncbi.nlm.nih.gov/35057865/ 

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[5] “Vital Signs: Maternity Care Experiences — United States, April 2023.” Centers for Disease Control and Prevention. September 1, 2023. https://www.cdc.gov/mmwr/volumes/72/wr/mm7235e1.htm 

[6] Simmons, A., Louder, C. N., et al. “Racial Stress and Black Women’s Health in the United States: A Culturally Responsive Prevention and Health Promotion Intervention.” 

Journal of Prevention and Health Promotion, September 9, 2024. https://journals.sagepub.com/doi/10.1177/26320770241272185?icid=int.sj-abstract.similar-articles.8%27 

[7] Lewis J. “Walking on a Redline: Did Discriminatory U.S. Housing Policies Affect Greenspace Development?” Environmental Health Perspectives. March 31, 2021. https://ehp.niehs.nih.gov/doi/10.1289/EHP9033. 

[8] “Disparities in the Impact of Air Pollution.” American Lung Association. November 2, 2023. https://www.lung.org/clean-air/outdoors/who-is-at-risk/disparities. 

[9] Perez NB, D’Eramo Melkus G, et al. “Latent Class Analysis of Depressive Symptom Phenotypes Among Black/African American Mothers.” Nursing Research. March April 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC9992148/ 

[10] Gasperowicz M, Benzies KM. “Association between social relationship of mentors and depressive symptoms in first-time mothers during the transition from pregnancy to 6-months postpartum.” Maternal Health, Neonatology, and Perinatology, February 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC10835957/ 

[11] Rose, S Powell, Z Davis, C. “Self-Care and General Well-Being in Postpartum Mothers.” International Journal of Childbirth, April 2024. https://connect.springerpub.com/content/sgrijc/14/1/30