Compared to white women, Black women are still far more likely to suffer pregnancy-related complications or die than the overall population in the United States. Increasingly, experts say, the crisis is tied not only to physical care but also to mental health.
A Centers for Disease Control and Prevention Maternal Mortality Review Committee found that deaths tied to mental health conditions rose from 22.7% in 2021 to 27.7% in 2022. Suicide now accounts for roughly one in five pregnancy-related deaths. For Black women, almost 17% of pregnancy-related deaths were due to mental health conditions — roughly double the rate from the year before.
Studies show Black women report suicidal thoughts at roughly twice the rate in the months after childbirth while facing steeper barriers to diagnosis, treatment and consistent care.
Word In Black spoke with Dr. Joy Baker, an OB-GYN practicing in rural Georgia, about how mental health, systemic barriers and access to care shape outcomes for mothers, particularly Black women. The conversation has been edited for clarity.
Word In Black: What do you think should be the headline of this story?
Dr. Joy Baker: “For me, the headline is always the same: we need to raise awareness and sound the alarm about the fact that mental health disorders and substance use are the number one cause of [maternal] death across the country.”
“If you think about preeclampsia — or folks who are having uncontrolled anxiety with abnormal heart rates and rhythms — we’re doing all of these million-dollar workups, and then we conclude that this may actually be due to untreated anxiety.”
WIB: You mentioned rural health as something we didn’t cover. How does geography play a role?
Baker: “Rural [communities] lend themselves to more isolation, less support, and more difficulty seeking the care patients need.”
“Although in this particular study, folks in rural settings did not seem to suffer from the same health disparities in terms of readmission rates, I can tell you from having worked in several rural communities that we certainly did see higher rates of folks dealing with perinatal mood and anxiety disorders.”
WIB: What should we know about the significant increase in suicidality in Black women?
Baker: “Suicidality in Black women increased by about 10 times, which is startling. Substance use disorder goes hand in hand with all of this, because people are just self-medicating.”
WIB: Beyond the mental health component, what is the intersection between mental health and physical health?
Baker: “Especially in pregnancy, you can see increased risk of preterm birth, low birth weight, hypertensive disorders of pregnancy, and diabetes in pregnancy.”
“Living in that high-cortisol state when folks have really high anxiety is not healthy for the body. That’s one of the key factors in a condition known as ‘weathering,’ in which the body ages due to living in traumatic, stressful situations.”
Q: What should family members, friends and loved ones do if someone who has recently delivered a baby is struggling?
Baker: “If they’re seeing physical signs of distress — heavy bleeding, swelling, headaches that don’t go away with rest or Tylenol or Motrin, shortness of breath, or chest pain — those can all point to physical problems for newly delivered moms. But mental health is just as important.”
“If someone is not sleeping or sleeping too much, not eating or eating too much, no longer taking pleasure in things they used to enjoy, having crying spells that last longer than the first two weeks, or not wanting to bond with their infant — those are all signs that they need to have some diagnostic testing done.”
“If you’re able to get in front of these issues early, you can prevent some of the problems we’re seeing with substance use disorders and suicide.”
Q: When you say ‘two weeks,’ are you referring to two weeks of symptoms, or two weeks after delivery?
Baker: “Most people may have some emotional lability during the first two weeks after delivery — they may be up and down. We think postpartum blues should be gone within the first two weeks, but honestly, I see patients who are already struggling before they deliver.”
“I talk to my patients a lot about this. Everybody wants to come and visit the baby — tell them to pick up laundry detergent. Ask somebody to stop by and get dinner.”
“We talk a lot about engaging your support network, and I think the message we have to start giving our community is: what can you do to hold this mama, hold these parents, and help with the baby?”
This story originally appeared here.