Black Maternal Mental Health Deserves Better

We talk often about Black maternal mortality.
But we speak far less about the quiet, persistent crisis underneath it: Black maternal mental health.

Black women are frequently described as strong—during pregnancy, childbirth, and postpartum. Strength becomes a compliment, a badge of honor, and sometimes an expectation. But when strength is assumed, support is too often withheld.

Maternal mental health conditions—such as depression, anxiety, and substance use—are among the leading contributors to pregnancy-related complications and deaths. According to the Centers for Disease Control and Prevention, mental health conditions are a significant cause of pregnancy-related mortality in the United States, and Black women remain three to four times more likely to die from pregnancy-related causes than white women.

This is not because Black women are less resilient.
It is because the systems designed to care for mothers are not designed to care for them.

What the Research Tells Us

Studies published in Obstetrics & Gynecology and Health Affairs reveal consistent patterns:

Black women are more likely to experience chronic stress during pregnancy
They report higher levels of depressive symptoms
They are less likely to be accurately diagnosed or treated
Experiences of racial bias, discrimination, and medical mistrust increase risk for perinatal mood disorders

These mental health challenges do not exist in isolation. Untreated maternal mental health conditions are associated with preterm birth, low birth weight, increased maternal morbidity, and long-term effects on child development.

Yet, too often, distress is overlooked—interpreted as normal stress, minimized, or missed entirely.

The Cost of “Resilience”

Here is the uncomfortable truth:
When a healthcare system expects resilience, it often justifies inaction.

Black women are praised for enduring hardship, navigating pain, and “pushing through.” But endurance should never replace care. Resilience should never be used as a reason to delay screening, ignore symptoms, or underfund support services.

Maternal mental health for Black women cannot be treated as:

An optional referral
A postpartum checkbox
A crisis response only after harm occurs

It must be embedded into care from the very beginning.

What Real Support Looks Like

If we are serious about improving maternal and infant outcomes, maternal mental health care must be:

Integrated into prenatal and postpartum care
Culturally responsive and trauma-informed
Proactively screened and followed
Delivered by clinicians and public health professionals who understand lived experience—not stereotypes
Supported by systems that prioritize equity, accountability, and trust

This is not only a mental health issue.
It is a public health issue, a maternal health issue, and a systems issue.

Moving Beyond Awareness

Awareness alone does not save lives.
Implementation does.

Improving Black maternal mental health requires moving beyond statements and into actionable, culturally aligned strategies—from care coordination and community partnerships to leadership accountability and program design that actually reaches mothers where they are.

Healthy mothers are the foundation of healthy families.
And mental health is not secondary to maternal health—it is central to it.

If we want different outcomes, we must build systems that do more than admire strength.
We must build systems that hold, support, and protect Black mothers—before, during, and after pregnancy.

References

Centers for Disease Control and Prevention (CDC). Pregnancy-Related Deaths in the United States
Alhusen, J. L., et al. (2016). Racial discrimination and adverse birth outcomes. Obstetrics & Gynecology
Howell, E. A., et al. (2018). Reducing disparities in severe maternal morbidity and mortality. Health Affairs
American College of Obstetricians and Gynecologists (ACOG). Maternal Mental Health