What You Need to Know About Postpartum Anxiety in Black Mothers

Roughly 1 in 7 moms will experience postpartum depression in the year after giving birth. One study found that only 4 percent of Black moms received postpartum mental health care, compared to 9 percent of white moms—even though other research suggests that Black moms are twice as likely to suffer from postpartum depression in the first place.

Why is this?

“Being a Black mother in the U.S. is a life-threatening endeavor,” says Nathalie Walton, CEO of Expectful, a meditation and sleep app for fertility, pregnancy and motherhood. “Racism in maternal care is widespread and lethal. Regardless of socio-economic status or physical ability, to be pregnant as a Black woman in the United States remains an existential risk,” she explains.

Here’s what you need to know.

Why are Black moms less likely to be diagnosed and treated for postpartum mood disorders?

According to Dr. Ana Langer, director of the Women and Health Initiative at the Harvard T.H. Chan School of Public Health in Boston, “The reasons behind the racial disparities are many and complex.”

But there’s an even greater problem, she noted. “Basically, Black women are undervalued. They are not monitored as carefully as white women are. When they do present with symptoms, they are often dismissed.”

“And this disparity doesn’t end there,” says Walton. “Being successful, affluent, or even worldwide famous didn’t inoculate Serena Williams or Beyoncé from experiencing life-threatening complications in their pregnancies.”

As Linda Villarosa writes for The New York Times, “Education and income offer little protection. In fact, a Black woman with an advanced degree is more likely to lose her baby than a white woman with less than an eighth-grade education.”

Study after study have found this to be true, with the CDC reporting that Black mothers in the U.S. die at three to four times the rate of white mothers.

“Black women’s concerns aren’t taken seriously,” says Richelle Whittaker, LPC-S, PMH-C, an educational psychologist and maternal mental health therapist specializing in women of color. “Many healthcare providers are not well-versed in PMADs,” she says. “And the stigma of PMADs and mental health issues in general contribute to the racial disparities.”

What are symptoms of pregnancy and postpartum mood disorders to look out for?

“The symptoms of pregnancy and postpartum anxiety are very similar to those of generalized anxiety disorder,” says Urmi Patel, PsyD, Mental and Behavioral Health Program Lead at Mahmee, a maternal care management platform. “Women who have postpartum anxiety can experience elevated levels of worry, symptoms of panic, fear of childbirth or child-raising, excessive worry over their baby’s health, even fear of leaving the home while pregnant or after the baby is born. You may also experience symptoms of panic, which may include shortness or breath, rapid pulse, dizziness, chest or stomach pain. Fear may include feeling like you are having a heart attack, feeling detached from your baby or others, having thoughts of doom, fear of dying, or debilitative and excessive worried thoughts.”

Whittaker recommends looking out for the following signs:

• Worrying about your baby to a point that affects your daily functioning, for example staying up all night to make sure nothing happens to the baby
• Feeling irritable about the smallest things, to the point where other people struggle to have a conversation with you
• Feeling angry at yourself or others for no reason
• Feeling so overwhelmed that you can’t get anything done
• Ignoring self-care, for example if you’re no longer showering, getting dressed, eating regular meals, or doing things you used to enjoy
• Feeling emotional all the time and finding it impossible to regulate those emotions, for example crying over small things

When is it time to seek help?

“With any mental health concerns, if you feel like your ability to function in your daily life is impacted, that suggests that you might need to seek help for your emotional experience,” says Erin Miers, PsyD a psychologist and consultant for Mom Loves Best. “For instance, feelings of intense fatigue, significant unintended weight changes, profound feelings of sadness, or worthlessness are all signs of depression. However, as all new moms can tell you, intense fatigue and weight changes aren’t abnormal. But, if your fatigue prevents you from taking care of your new baby, if your sadness is overwhelming, these might be indicators that you need mental health support.”

Who can help?

“We suggest speaking with your primary care provider as soon as possible if you have experienced any of these symptoms often and are having difficulty managing these feelings and thoughts,” Patel says. “Support groups and counseling services are available to help support you during this time.”

A physician can refer you to a therapist, or talk to you about taking anti-anxiety medication. You may also find it helpful to join virtual support groups—postpartum anxiety is incredibly common, and a group of peers dealing with the same thing can be invaluable.

What if you’re experiencing symptoms, but doctors are dismissive?

The bad news is that this does happen. But the good news is that you have options. One of which is to offer feedback. “If you don’t feel heard by a mental health professional and feel that you can tolerate giving them feedback, tell them that you don’t feel heard,” Miers says. “Mental health professionals are trained to take feedback and integrate it to provide better care.”

If you don’t feel that you are up for giving feedback, please seek help in an alternative way. There are crisis support lines, and the crisis text line is 741741.

Another option is to bring in an advocate. “You can bring someone with you to your medical appointments so you have the support you need to speak up and share your experience and feelings after childbirth,” Patel says.

If you’d rather switch providers, Whittaker suggests reaching out to a Black health care provider or a therapist who specializes in perinatal mental health. Two resources she recommends are the Postpartum Support International Provider Directory and Therapy for Black Girls.

Is there anything you can do to lower your risks of postpartum anxiety?

It’s hard to predict who will suffer from an anxiety disorder and who will not. What you can do is make sure you and the people close to you are up-to-date on what symptoms to look out for, and that you have a plan to get prompt medical help if you notice them.

Meditation is scientifically proven to reduce stress and anxiety during pregnancy and postpartum.

“Mindfulness-based interventions, like meditation, have been associated with reduced perceived stress, anxiety, and depression in adults,” says Walton. “These findings are especially important during pregnancy, when women often encounter unique stressors, including naturally occurring physiological changes that allow the human body to adapt to a pregnancy. Anxiety and depression are relatively common disorders during pregnancy.”

Considering the importance of maternal health on birth outcomes, reducing maternal emotional distress can improve maternal wellbeing during pregnancy and health outcomes for her child, Walton explains.

If you’re interested in meditation but not sure how to go about it, Expectful has created a meditation library specifically for Black mothers, Black Mamas Meditate, that helps Black women advocate for themselves and incorporate radical self-care.

Plus, doing everything you can to take the stress out of the postpartum experience may help. If possible, try to plan ahead for postpartum meals, childcare, and other chores. “In my experience, most birthing individuals have a ton of prep for birth and labor but seldom have a postpartum plan ready,” says Ali Buchanan, a certified postpartum doula who specializes in mental health advocacy. “If possible, I would encourage the parents to create a postpartum plan covering the first 6 weeks to manage expectations.”

*Need help right away? Trained crisis counselors are available 24/7 at the National Suicide Prevention Lifeline at 1-800-273-8255; and at the National Maternal Mental Health Hotline via call or text to 1-833-943-5746 (1-833-9-HELP4MOMS).