Postpartum Psychiatric Morbidity in Black and Hispanic/Latina Women in Association with Racial Discrimination

Abstract

Childbirth is often seen as a positive event that may overshadow negative mental health symptoms among new mothers. Maternal psychopathology is a key contributor of maternal death. It is well-documented that Black and Hispanic/Latina women have an increased risk for maternal physical morbidity in the context of life-threatening childbirth experiences. There is a critical gap in the literature of the impact of racial and ethnic status and racial discrimination on maternal mental illness after childbirth. A cross- sectional study design was used to examine the prevalence and severity of maternal psychopathology among minority (i.e., Black and Hispanic/Latina) and non-Hispanic White women (N = 4,425) who were 6-months postpartum. Additionally, in a subsample within 3-months postpartum (N = 28) we assessed the role of perceived discrimination (lifetime and in peripartum care) on negative maternal mental health outcomes. Odds Ratios (OR) revealed minority postpartum women were two times more likely to have depression (OR = 1.80, 95% CI: 1.30, 2.50) and anxiety (OR = 1.80, 95% CI: 1.23, 2.53), than non-Hispanic White women. Furthermore, minority women had higher odds of experiencing symptoms of clinical childbirth-related post-traumatic stress disorder (CB- PTSD; OR = 1.60, 95% CI: 1.12, 2.14). By controlling for known risk factors of maternal mental illness, including obstetric complications and demographic features, the pattern of results remained significant. Minority women experienced higher rates of perceived and peripartum discrimination, most significantly associated with subsequent levels of CB- PTSD. These results call for eliminating racial and ethnic inequities in maternal mental health, ensuring appropriate mental health resources are available for those most in need.