Too Often, Postpartum Depression Goes Untreated in Black, Hispanic Women

Massive racial disparities exist in the treatment of pregnancy-related mood disorders in the United States, a new study shows.

White women suffering from depression or anxiety during or after pregnancy are nearly twice as likely receive treatment as women of color are, researchers report April 1 in the journal Health Affairs.

About two-thirds of white women (67%) said they received mental health treatment for their diagnosed depression or anxiety during pregnancy or in their first year of motherhood, researchers found.

Comparatively, fewer than two out of five (37%) Black and Hispanic received treatment for their pregnancy-related mood disorders, results show.

That number dipped to one in five (20%) for other ethnicities, including Asian, Native Hawaiian, Pacific Islander, Middle Eastern and North African.

“Our study in concert with existing work shows that Asian, Black and Latine birthing people, who may be at the greatest risk of postpartum depression, are the least likely to receive any form of postpartum mental health care — illustrating stark racial inequities in how postpartum depression is identified and managed in the U.S.,” said lead researcher Sarah Haight, a doctoral candidate in epidemiology with the Columbia University Mailman School of Public Health in New York City.

Nearly one in eight people who give birth wind up suffering postpartum depression, researchers said in background notes.

For the study, they surveyed more than 4,500 new mothers who gave birth in 2020 in seven places – Kansas, Michigan, New Jersey, Pennsylvania, Utah, Virginia and New York City.

About 12% of those surveyed reported having symptoms of depression within two to six months of delivery.

However, only one in four women with those symptoms received a proper diagnosis for pregnancy-related depression or anxiety, and about half said they received some form of mental health care within their first year of motherhood.

“By following people through the postpartum year, our findings elucidate how many individuals with mental health symptoms fall through the cracks and don’t ever receive the care they need,” said senior researcher Jamie Daw, an assistant professor of health policy and management at Columbia.

The findings of inequity jibe with another study featured in the same journal, which found that white women were more likely than Black, Hispanic or Asian women to receive antidepressant prescriptions during pregnancy.

However, the other study found that increased numbers of women overall were receiving proper diagnoses for their pregnancy-related mood disorders, compared to years past.

The rate of diagnosis nearly doubled between 2008 and 2020, that study reported, and the rate of talk therapy for pregnant women or new mothers actually more than doubled.

That research focused on data from private insurance companies, however. It did not include low-income women in the Medicaid program, which covers about 40% of all births in the United States each year, researchers said.

This new study included women covered by both private insurance and Medicaid, and so might offer a more complete picture of how pregnancy-related mood disorders are diagnosed and treated.

The results show that mental health screenings should occur at all doctor’s visits during pregnancy and after delivery, researchers said.

“Half of pregnancy-related deaths in the U.S. occur in the postpartum year and mental health conditions are the second leading cause of deaths in the late postpartum period,” Daw said in a journal news release. “Improving equitable access to … diagnosis and treatment is thus critical to addressing the maternal health crisis in the U.S.”

More information

Children’s Hospital of Philadelphia has more about pregnancy-related mood disorders.

SOURCE: Health Affairs, news release, April 1, 2024