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Minority Maternal Mental Health: The Crisis at Hand

Despite advances in health care, there are still great racial and ethnic disparities in maternal and infant health in the United States. The overturning of Roe v Wade will also increase the gap in abortion and pregnancy care for people of color by creating more barriers to care in many states. Black and Indigenous women have higher rates of pregnancy death than White women (3 and 2 times higher respectively). BIPOC women also have increased risk of birth complications, and higher infant mortality rates.

About 700 women die from pregnancy related issues each year. The statistics are pretty evenly split with about one third dying in pregnancy, one third in delivery, and one third postpartum (Hill et al., 2022). However, some data show that up to 53% of deaths occur in the postpartum period (Trost et al., 2022). Overall, mental health conditions are the leading cause of perinatal death, especially for the Hispanic population.

Hill et al. (2022) tell us that BIPOC women are more likely to have infant risk factors and increased infant mortality than White women. BIPOC women have less access and therefore utilize less prenatal care, and are more likely to go without care altogether. Teen birth rates are also higher in BIPOC communities than White communities.

Some of the barriers to care are lower rates of health insurance, access to care including in rural areas where care may not be available, and the availability of culturally and linguistically competent care. Systemic factors that increase poorer outcomes for black and brown mothers include racism, chronic stress due to systemic discrimination, and mistreatment during care. These factors lead to increased rates of perinatal depression and anxiety. Mistreatment during care, such as yelling, scolding, not believing clients, and refusing pain medication or other interventions all contribute to the disparities in mortality rates for BIPOC women (Hill et al., 2022).

About one in five birthing people experience a perinatal mood and anxiety disorder (PMAD) or maternal mental health (MMH) disorder. These disorders are treatable but birthing people must have confidence in the system to seek help. Unfortunately, centuries of systemic racism, discrimination, and social injustice has created multi-generational trauma and mistrust of the very system that could help. Structural racism and discrimination have also created financial and logistical barriers for clients seeking mental health services (Green, 2021).

We must make collective efforts to eradicate systemic racism. We must increase and expand access to health coverage and care for BIPOC people, including a broader array of diverse services and providers that support maternal and infant health. We must take steps to provide culturally responsive care that meets the needs of BIPOC clients. As a society we must invest in resources to reduce barriers, reduce stigma, and increase access to mental health services. The National Partnership for Women and Families (2021) recommends mandatory increased Medicaid coverage for at least a year postpartum. They recommend increasing funding and initiatives to build a more diverse and culturally responsive workforce that will focus on screening and treating BIPOC birthing people. They suggest supporting the work of BIPOC-led birthing justice organizations that focus on the needs of marginalized birthing people.

What can we do as individuals, organizations, and as a society as a whole? We can contact our lawmakers and ask them to support the Moms Matter Act (H.R. 909/S. 484), the Kira Johnson Act (H.R. 1212), and the Tech to Save Moms Act (H.R. 937/S. 893), all part of the Black Maternal Health Momnibus. We as professionals can work with and support BIPOC-led birthing justice organizations. We as individuals can make space to listen to BIPOC birthing people, hear their stories, and acknowledge their experiences (Green, 2021).

Download the Maternal Mental Health Leadership Alliance, Maternal Mental Health For Black Women & Birthing People Fact Sheet

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Green, S. (2021). The maternal mental health crisis undermines moms’ and babies’ health. The National Partnership for Women and Families.

Hill, L., Artiga, S., & Ranji, U. (2022). Racial disparities in maternal and infant health: Current status and efforts to address them. KKF.

Trost SL, Beauregard J, Njie F, et al. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017-2019. (2022). Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services.

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