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MATERNAL HEALTH DISPARITIES AMONG BLACK WOMEN
42.4 pregnancy-relateddeaths per100,000birthsfor Blackwomen intheUS (Oribhabor,etal.,2020).
84% ofpregnancy-relateddeaths couldhavebeenprevented (Trost,etal.,2022).
53% ofmaternaldeaths occurafterdelivery (Trost,etal., 2022).
3.3x
Blackwomenaremorelikely todierelatedtopregnancyas comparedtowhitewomen (Trost,etal.,2022).
27.2%
LowSESBlackwomen mistreatedvs18.7%ofwhite women (Trost,etal.,2022).
43% ofBlackmaternal deathsaredueto cardiovascularcauses (Trost,etal.,2022).
5X Pregnancyrelated MortalityRatio (PRMR)forBlack womenwitha collegeeducation vswhitewomen (CDC,2022).
(CDC,2022).
"Black women have to be more intentional about the medical team that they choose and have someone to advocate for them during pregnancy."
"You can hear her, but are you listening?" Implicit biases directly impact the health of women of color, especially Black women.
"The question will forever haunt me: how did she end up a statistic? If race were not the precursor to how people are dealt with in the health care system, I know this outcome would have been drastically different."
"You can hear her, but are you listening?" Implicit biases directly impact the health of Women of Color.
Twitter Post
https://www.joslin.org/patient-care/diabetes-education/diabete s-learning-center/managing-diabetes-during-pregnancy
PostpartumDepression
Beingafirsttimemotheris hard
FRIENDS&FAMILYCAN RECOGNIZETHERISK
First-time, very young or older motherhood
FACTORSFOR
Labor or Postpartum complications Isolation and Lack of social support Previous or Family History of depression Financial or employment problems F o r m o r e i n f o r m a t i o n r e g a r d i n g P P D , p l e a s e v i s i t t h i s w e b s i t e : h t t p s : / / w w w . w o m e n s h e a l t h . g o v / m e n t a l - h e a l t h / m e n t a l - h e a l t hc o n d i t i o n s / p o s t p a r t u m - d e p r e s s i o n
Having Persistent Headaches
Eating too little or too much Having Memory Problems
Feeling overwhelmed or guilty Sleeping too little or too much
FRIENDS&FAMILYCAN RECOGNIZETHE
SYMPTOMSFOR PostpartumDepression
F o r m o r e i n f o r m a t i o n r e g a r d i n g P P D , p l e a s e v i s i t t h i s w e b s i t e : h t t p s : / / w w w w o m e n s h e a l t h g o v / m e n t a l - h e a l t h / m e n t a l - h e a l t hc o n d i t i o n s / p o s t p a r t u m - d e p r e s s i o n
SOMETIMES,INFEARTHATI'M POTAGOOD ARENT
Maternal Mental Health Matters
What are the "baby blues"?
Baby blues is a feeling of sadness and anxiety, many women experience within the first ten days of giving birth (Pearlstein et al , 2009)
Baby blues often does not require treatment
If baby blues persist longer than two weeks, you most likely have postpartum depression (Office on Women’s Health, n d )
1 in 9
New mothers have postpartum depression (Office on Women's Health, n d )
What is Postpartum Depression?
Postpartum depression is a type of depression that happens after childbirth, where the feelings are more severe and last longer than “baby blues,” which affects your behavior and physical health (CDC, 2022)
PPD is the most common problem for new moms and can have significant consequences for the mother and family if left untreated
Risk factors of PPD
Warning signs of PPD
PPD is life-threatening and leads to suicide, which causes about of maternal deaths after giving birth (Ghaedrahmati et al., 2017).
Health Inequity
Age during pregnancy directly correlates with postpartum depression rates With the highest occurrence of PPD in persons ages 13-19 (Silva et al , 2012)
SIGNS AND SYMPTOMS
LONG TERM CONSEQUENCES
disorders in children with parents who had PPD
Poor emotional regulation in children with parents who had PPD
(Slomian et al 2019)
WHERE TO GET HELP?
If you or someone you love is experiencing symptoms of postpartum depression reach out to your OBGYN, Primary Care Physician or another trusted medical provider
TYPES OF TREATMENT
The most common treatments for postpartum depression and anxiety are therapy and prescription medication (Leight et al., 2010).
Headaches Financial problems S l e epingtoolittleortoomu c h MemoryProblems Lackofsupport Laborcomplication s F a m ilyhistoryofdepressi o n POSTPARTUM
(PPD)
DEPRESSION
20% Excessive Crying Feeling hopeless or overwhelmed Thoughts of hurting yourself or your baby Feeling worthless or like a bad mother Reduced parent
of
Self-harm or suicide or hurting your baby
and baby bonding Higher rates
psychiatric
E a t ingtoolittleortoomuc h
POSTPARTUM DEPRESSION
YOU ARE NOT ALONE
Symptoms
Crying a lot
Feeling hopeless or overwhelmed
Feeling worthless or like a bad mother
Thoughts of hurting yourself or your baby
(Silva et al., 2012)
IF YOU'RE EXPERIENCING SYMPTOMS OF POSTPARTUM DEPRESSION TALK TO YOUR DOCTOR ABOUT TREATMENT Medication
TREATMENTS:
Therapy
For more information https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression
POSTPARTUM DEPRESSION OVERCOMING OBSTACLES FOR CARE KNOW THE SIGNS National Maternal Mental Hotline 24/7 confidential & culturally sensitive support in English and Spanish for new parents Call or text 1-833-9-HELP4MOMS (1-833-943-5746) Racial Disparities in New Black mothers experience PPD at twice the rate of new White mothers Yet, new Black mothers are 36% less likely to be screened for PPD comparatively Health Resources & Services Administration (2022) National Maternal Mental Health Hotline https://mchb hrsa gov/national-maternal-mental-health-hotline Iyer, P (2021, March 30) Racial Disparities Have Been Found in Screening for Postpartum Mood Disorders Scientific American https://www scientificamerican com/article/racial-disparities-have-been-found-in-screening-forpostpartum-mood-disorders/ Kozhimannil, K. B., Trinacty, C. M., Busch, A. B., Huskamp, H. A., & Adams, A. S. (2011). Racial and ethnic disparities in postpartum depression care among low-income women. Psychiatric services (Washington, D.C.), 62(6), 619–625. https://doi.org/10.1176/ps.62.6.pss6206 0619 PPD is treatable. Talk to your healthcare provider if you are experiencing prolonged feelings of sadness, hopelessness, or anxiety. Ask about culturally supportive care options. GET THE HELP YOU DESERVE
SIGNS OF POSTPARTUM DEPRESSION YOU ARE NOT ALONE 1 in 7 new mothers experience PPD Half of new cases go undiagnosed POSTPARTUM DEPRESSION Centers for Disease Control and Prevention (2022 May 7) Identifying Maternal Depression https://www cdc gov/reproductivehealth/vital-signs/identifying-maternal-depression/index html Health Resources & Services Administration (2022) National Maternal Mental Health Hotline https://mchb hrsa gov/national-maternal-mental-health-hotline Iyer, P (2021, March 30) Racial Disparities Have Been Found in Screening for Postpartum Mood Disorders Scientific American https://www scientificamerican com/article/racialdisparities-have-been-found-in-screening-for-postpartum-mood-disorders/ Kozhimannil K B Trinacty C M Busch A B Huskamp H A & Adams A S (2011) Racial and ethnic disparities in postpartum depression care among low-income women Psychiatric services (Washington D C ) 62(6) 619–625 https://doi.org/10 1176/ps 62 6 pss6206 0619 Melanin & Mental Health (2020) About Us https://www melaninandmentalhealth com/about-us/ Postpartum International (2022) Get Help https://www postpartum net/ RACIAL DISPARITIES IN Usually starts 1 - 3 weeks after birth Severe feelings of sadness, hopelessness & anxiety Loss of interest in daily life, withdrawing from friends & family Thoughts of harming yourself or your baby NEW BLACK MOTHERS HAVE A HIGHER RISK 2X more likely to experience PPD than White mothers 36% less likely to be screened for PPD OBSTACLES TO CARE FOR BLACK MOTHERS WHAT CAN NEW MOTHERS DO? RESOURCES ARE AVAILABLE National Maternal Mental Hotline 24/7 confidential support 1-833-9HELP4MOMS (1-833-943-5746) Melanin & Mental Health Connecting Black & Latinx/Hispanic people with culturally sensitive clinicians Text "HELP" or call 1-800-9444773 Postpartum Support International
Postpartum Depression Becoming a new parent is exciting, but also brings new pressures that can lead to feelings of exhaustion, stress, anxiety, and depression. You are Not Alone 1 IN 7 WOMEN SUFFER FROM You are Not to Blame Untreated postpartum depression can have lasting effects on your health and and the development of your child. Yet, new Black mothers are two times less likely to receive treatment. National Maternal Mental Health Hotline 24/7 culturally sensitive support in English and Spanish for new parents Call or text now: 1-833-9-HELP4MOMS (1-833-943-5746) Health Resources & Services Administration (2022) National Maternal Mental Health Hotline https://mchb hrsa gov/national-maternal-mental-health-hotline Kozhimannil, K. B., Trinacty, C. M., Busch, A. B., Huskamp, H. A., & Adams, A. S. (2011). Racial and ethnic disparities in postpartum depression care among lowincome women Psychiatric services (Washington, D C ), 62(6), 619–625 https://doi org/10 1176/ps 62 6 pss6206 0619 & BLACK MOTHERS ARE MORE AT RISK Help is Available
On June 24 2022 the US Supreme Court’s Dobbs v Jackson Women’s Health Organization decision overturned Roe v Wade reversing the constitutional right to abortion care
Current status of U.S. Abortion Policies and Access
15 states have implemented total or six-week abortion bans
These states are home to 22 million women of reproductive age (aged 15–49), severely restricting access to abortion care for 29% of women of reproductive age in the U S (Kirstein et al , 2022)
Many of these bans include criminal penalties for healthcare professionals who provide abortions, patients who receive abortion care, and individuals who “aid and abet” a woman in obtaining an abortion (Sun 2020)
Implications of Overturning of Roe v Wade
The consequences of the Dobbs decision will disproportionately affect low-income women women of color, and women in rural communities access to reproductive health care
How do Abortions Vary by Race/Ethnicity?
Hispanic
Economic Barriers to Accessing
2007-2016 Reproductive rights & abortion access in the U.S
(Artiga References:
(Artiga et al 2022)
127 408 115
Black Hispanic
Mortality (per 100 000 births) by Race/Ethnicity 1 VOTE
bans are estimated to increase overall mortality by 21% and increase mortality for Black women by 33% (Sun 2020)
Guaranteeing the legal right to access reproductive health care, such as abortion and birth control is crucial for protecting reproductive rights
2
al 2022) Pregnancy-Related 3 EDUCATE YOURSELF & OTHERS
On the importance of abortion rights why abortion is essential healthcare, & the abortion laws in your state Attend a rally or event supporting
abortion
Abortion
Racial Disparities in Maternal Mortality
Percent of Women Ages 18-49 with Income Below 200% Poverty by Race/Ethnicity 2019
et
44%
42%
four ways to advocate for reproductive rights & abortion access Artiga S Hill L Ranji U & Gomez I (2022 October 6) What are the Implications of the Overturning of Roe v Wade for Racial Disparities? KFF http // kff g/ i l- q ity- d-h lth-p li y/i -b i f/ h t- -th -i pli ti - f-th - t i g- f- - - d -f - i l-di p iti / Hickox C (2022 July 5) Seven Things You Can Do Right Now For Abortion Rights Center for Reproductive Rights Retrieved October 21 2022 from https://reproductiverights org/seven-things-you-can-do-right-now-advance-abortion-rights/ Kirstein M Dreweke J Jones & Philbin (2022 October 6) 100 Days Post-Roe: At Least 66 Clinics Across 15 US States Have Stopped Offering Abortion Care Guttmacher Institute https://www guttmacher org/2022/10/100-days-post-roe-least-66-clinics-across-15-us-states-have-stopped-offering-abortion-care S N (2022) O t i g R W d p d i g i j ti BMJ 1588 http //d i g/10 1136/b j 1588
25%
Abortion
Abortion rates (per 100,000 women) by Race/Ethnicity, 2019 (Artiga et al , 2022)
access 4 PROTEST Support and vote for officials and candidates who support abortion rights
DONATE TO ABORTION FUNDS
Abortion funds provide financial and logistical assistance to patients seeking abortion
care (Hickox
2022)
White
The maternal mortality rate for Black women is 2 9 times higher than for White women (Sun, 2020)
White Black
66 238 117
In 2019 38% of abortions were among Black women (23 8 per 1 000 women) 33% were among White women (6 6 per 1,000 women), and 21% were among Hispanic women (11 7 per 1,000 women) (Artiga et al , 2022)
White
Black Hispanic
Women of color and low-income women have more limited financial resources making it more difficult for them to travel out of state for an abortion due to cost and transportation options (Artiga et al 2022)
Postpartum Depression: A Guide for Black Women
Postpartum depression is a depressive mood disorder that can present within birthing people any time during the first year after giving birth (ACOG, 2021).
1 in 8 women report symptoms of depression after giving birth (Bauman et al , 2020)
Black women are about 2X more likely to experience symptoms of postpartum depression (Bauman et al., 2020).
Characteristics of women who were more likely to experience symptoms of postpartum depression (Bauman et al., 2020):
less than 19 years old Black or African American Medicaid experienced a preterm birth
What are the risks of postpartum depression? (Bauman et al , 2020; Sidebottom et al , 2021)
Trouble bonding with your baby
Increased stress
Decreased breastfeeding
Developmental issues among babies
Increased risk of infant death
Increased risk of maternal substance use and death
How can I lower my risk of postpartum depression (OASH, 2021; CDC, 2022; Kilgoe, 2021)?
Recognize the signs and symptoms of postpartum depression
Isolating from friends and family
Crying more than usual
Feelings of guilt or anger
Sleeping more or less than normal
Doubting your ability to care for your baby
Fears of harming yourself or your baby
Feeling emotionally detached from your baby
Seek help if you think you have signs of postpartum depression
Locate a provider of color online
Therapy for Black Girls
Black Therapist Rock
Only a doctor can diagnose you, so call right one away or ask a loved one to call for you
Tell your loved ones how you are feeling
Talk with other mothers or join a support group
The Shades of Blue Project
22% 18% 17% 17%
References American College of Obstetricians and Gynecologists (ACOG). (2021, December). Postpartum depression. https://www.acog.org/womens-health/faqs/postpartum-depression Bauman, B.L., Ko, J. Y., Cox, S., D’Angelo Mph, D. V., Warner, L., Folger, S., Tevendale, H. D., Coy, K. C., Harrison, L., & Barfield, W. D. (2020). Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression - United States, 2018. MMWR. Morbidity and Mortality Weekly Report, 69(19), 575–581. https://doi.org/10.15585/mmwr.mm6919a2 CDC. (2022, May 23). Depression among women. Centers for Disease Control and Prevention. https://www.cdc.gov/reproductivehealth/depression/index.htm#risk Kilgoe, A. (2021, July 26). Addressing the increased risk of postpartum depression for Black women. National Alliance on Mental Illness. https://www.nami.org/Blogs/NAMIBlog/July-2021/Addressing-the-Increased-Risk-of-Postpartum-Depression-for-Black-Women OASH. (2021, February 17). Postpartum depression. https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression Sidebottom, A., Vacquier, M., LaRusso, E., Erickson, D., & Hardeman, R. (2021). Perinatal depression screening practices in a large health system: identifying current state and assessing opportunities to provide more equitable care. Archives of Women’s Mental Health, 24(1), 133–144. https://doi.org/10.1007/s00737-020-01035-x
