Pregnancy and childbirth are often celebrated as joyous events in a woman’s life, but for some, especially Black women, this time may not be as cheerful as expected. Black women are much more likely to experience pregnancy-related complications and even death compared to white women, casting a shadow on an otherwise happy time and highlighting the need for targeted support and interventions.
Many factors contribute to this disparity, including other chronic conditions, lack of quality prenatal or perinatal health care, and structural bias in the medical system. Underlying all of these factors is “weathering” – a term that describes how constant stress and racism in society may lead to premature biological aging and poorer health outcomes for Black people.
Chronic stress, like weathering, is unhealthy for anyone, but it can be particularly harmful during pregnancy. Symptoms of prolonged stress, such as trouble falling asleep, loss of appetite, and headaches, can significantly impact expectant mothers and increase their risk of high blood pressure or preterm labor. While it’s normal to experience some new emotions or stress during pregnancy, severe stress can lead to mental health conditions and long-term effects for both baby and mother. For instance, mothers who experience postpartum depression or anxiety – which Black women experience at higher rates – may struggle to bond with their infants, affecting their child’s chance to thrive.
While most women experience some degree of the “baby blues,” certain factors increase the risk of more severe mental health issues, including a history of anxiety or mood disorders, a family history of postpartum depression, and fertility challenges. Women from under-resourced communities, those with little to no social support, and those who use substances like drugs or alcohol, also face higher risks. And among communities of color, stigma and judgment often prevent women (and men) from seeking mental health treatment, further exacerbating these challenges.
As a medical professional specializing in women’s health and a mother of two, I believe it is crucial to shed light on the wide range of challenges Black mothers face. We must recognize that pregnancy-related mental health conditions are not only prevalent but largely preventable. With a concerted effort to raise awareness and prioritize maternal mental health, we can take steps to ensure a safer journey into motherhood. Here are a few tips to help combat maternal mental health challenges:
Inform yourself. Take some time to familiarize yourself with certain conditions and emotional changes that can come with pregnancy and the postpartum period to feel a bit more in tune with your body, mind, and overall wellbeing. Learning about common experiences and knowing when things may be veering into more serious territory can be immensely helpful. This knowledge not only helps you set your own expectations but also empowers you to communicate effectively with healthcare providers.
Destigmatize mental health. It’s okay to talk about how we’re really feeling, even when it’s tough. Whether you’re pregnant, a new parent, or a supportive partner or friend, it’s important to normalize conversations about mental health. Let’s make it easier for everyone to seek the help they might need without fear.
Monitor your well-being. Keep an eye on how you’re feeling emotionally, not just physically. Changes in mood, energy levels, or thoughts can be subtle clues that you need some extra care. It’s like keeping a diary of your emotional world — noting down what feels different, what’s worrying you, or even what’s bringing you unexpected joy.
Call your health plan provider. Your health insurer can also help you access care. For example, some insurers like UnitedHealthcare have specially trained advocates to support members who might be struggling due to their social environment. They’re there to help members understand their benefits and guide them to timely care.
Take advantage of your Employee Assistance Program (EAP). These programs typically offer services that relatively few employees take advantage of. For instance, many EAPs offer confidential support from qualified clinicians. Depending on your situation, you may not need to seek additional behavioral health support with a care provider if your EAP offers personalized guidance.
Seek support. Don’t hesitate to ask your personal or professional networks for help. Anyone on your healthcare team can guide you to support services, such as talking to an expert in person or virtually or joining a network or discussion group. Your family and friends can be there for you by listening, offering their experience, or helping with household chores to give you time to rest. Taking action early is a proactive step toward maintaining your mental health. It’s a sign of strength.
As we journey toward safer motherhood experiences, it is essential to address the systemic barriers that hinder access to mental health resources within communities of color. By taking action to break the silence and prioritize maternal mental health, we can empower all women to embark on their motherhood journey with strength and resilience.
Lisa Saul, MD, is a seasoned physician and health care executive with nearly 20 years in clinical practice and more than ten years in health care administration. She is the National Medical Director/Chief Medical Officer, Women’s Health for UnitedHealth Care. In her role, she is responsible for improving affordability in women’s health and improving maternal and neonatal clinical outcomes. She lives in Minneapolis, Minnesota, with her husband and two teenage children.
