In the United States, 29–44% of Black women experience postpartum depressive symptoms (PDS), yet few are properly identified and/or connected to mental care services. The purpose of this secondary analysis was to examine the relationship between maternal functioning and clinical variables (PDS, maternal–infant attachment), racial variable (Black racial identity types—low race salience, assimilated and miseducated, self-hating, anti-White, multiculturalist, and conflicted), and sociodemographic characteristics (relationship status, education, insurance, childbirth type). A total of 116 women living in the southern United States were included in the analysis. Multivariate analyses revealed that Black racial identity (p = 0.02), PDS (p < 0.0001), maternal–infant attachment (p < 0.0001), and educational level (p = 0.03) were independently associated with maternal functioning. This work provides new evidence regarding the role of various clinical and racial factors on Black postpartum women’s adjustment to motherhood. This analysis also adds to the growing body of evidence of reliability for the BIMF in Black postpartum women.

To identify structural factors associated with the receipt of mental health care treatment among Black women in California during pregnancy and after childbirth. Secondary analysis of data from the population-based Listening to Mothers in California survey. The sample included 194 non-Latina Black women in the postpartum period. We used descriptive statistics, including differences between means and logistic regression, to conduct a series of bivariate analyses. Most respondents (84.4%, n = 163) reported symptoms of perinatal mood and anxiety disorders prenatally, and half (50% n = 97) reported symptoms of perinatal mood and anxiety disorders in the postpartum period. Only 12.3% to 14.6% of those who reported symptoms received mental health care treatment. Furthermore, 21.2% (n = 38) of respondents were not screened for postpartum depression. Respondents with private insurance coverage were more likely to report receipt of mental health care after childbirth (OR = 4.6; 95% confidence interval [1.5, 13.5]) compared to respondents with public insurance coverage. Our results suggest a high prevalence of unmet mental health needs among non-Latina Black women who lived in California during the perinatal period. Practitioners in clinical settings may be more likely to make referrals to mental health care for women with private insurance coverage in the postpartum period.

Purpose: To assess Black women’s exposure to and appraisal of racism-related stress during the postpartum period and to distinguish its impact on three indicators of postpartum mood and anxiety disorders (PMADs) symptoms. Methods: Data from the Black Mothers’ Mental Wellness Study (N = 231) and linear regression models estimated the associations between racism-related stress and the PMAD indicators: 3-item Edinburgh Postnatal Depression Scale (EPDS-3), 8-item Patient Health Questionnaire (PHQ-8), and PHQ-15. Results: The majority of participants (80.5%, N = 186) experienced racism a few times a year or more, of which 37.1% (N = 69) were bothered somewhat and 19.3% (N = 36) a lot. Racism-related stress, income, level of education, and history of mental health diagnosis explained greater variance in PMAD symptoms as measured by the PHQ-8 score (R² = 0.58, p = < 0.001) compared to the EPDS-3 (R² = 0.46, p = < 0.001) or the PHQ-15 (R² = 0.14, p = 0.035). Conclusions: Racism is a stressor for Black women living in Los Angeles County, California. Racism-related stress and emotional expression of PMAD symptoms were salient to the postpartum mental health of the Black women in this study. Findings from this study suggest that the PHQ-8 should be used to assess how racism impacts Black women’s postpartum mental health.

This study examined the relationship between racial identity clusters and postpartum depressive symptoms (PPDS) in Black postpartum mothers living in Georgia. A cross-sectional study design using Cross’s nigrescence theory as a framework was used to explore the relationship between Black racial identity and PPDS. Black mothers were administered online questionnaires via Qualtrics. A total sample of 116 self-identified Black mothers were enrolled in the study. Participants ranged in age from 18 to 41 years (M = 29.5 ± 5.3) and their infants were 1 to 12 months old (M = 5.6 ± 3.5). The majority of mothers were married or cohabitating with their partner (71%), had a college degree (53%), and worked full-time (57%). Hierarchical cluster analysis identified six racial identity clusters within the sample: Assimilated and Miseducated, Self-Hating, Anti-White, Multiculturalist, Low Race Salience, and Conflicted. A Kruskal-Wallis H test determined there was no difference in PPDS scores between racial identity clusters. This study is the first to explore the relationship between Black racial identity clusters of postpartum mothers and their mental health. Findings emphasize the complexity of Black racial identity and suggest that the current assessment tools may not adequately detect PPDS in Black mothers. The implications for these findings in nursing practice and future research are discussed.

Background: The purpose of this study was to investigate the relationship between discrimination during childbirth hospitalization and postpartum care utilization among Black birthing people in California, United States.Methods: This was a secondary analysis of data from the Listening to Mothers in California survey, a population‐based survey of individuals with a singleton hospital‐based birth in California in 2016. The primary outcome was number of postpartum care visits. The primary exposures were racial, language, and insurance discrimination. A multiple linear regression model was used to estimate associations between discrimination and postpartum care use, adjusting for sociodemographic covariates.Results: Black birthing people in the sample had an average of two postpartum visits. Almost 15% of the sample reported one or more forms of discrimination during hospital‐based childbirth. In adjusted models, racial discrimination (β = 0.09, 95% CI = 0.04–0.14, p < 0.01) and language discrimination (β = 1.03, 95% CI = 0.98–1.07, p < 0.01) were associated with increased postpartum visits, while insurance discrimination was linked to decreased postpartum visits (β = −0.96, 95% CI = −1.04 to −0.89, p < 0.01).Conclusion: Among Black birthing people in California, the drivers of postpartum care utilization after childbirth are complex. There are multiple negative drivers (e.g., experiencing racial and language discrimination and unmet needs), barriers (e.g., insurance discrimination), and positive drivers (e.g., clinician type and education) that affect postpartum care utilization among Black birthing people.