Black women in the U.S. are disproportionately affected by postpartum depression (PPD), but they often receive significantly less support than white mothers, leading to dangerous and sometimes fatal outcomes.
For Kay Matthews, the emotional devastation began in 2013 after the stillbirth of her daughter. But what made it worse, she recalls, was the lack of care and compassion at the hospital. She left with no guidance, no pamphlets, and no follow-up—just the clothes she came in with and a feeling of being completely alone.
“I was not receiving the care that I feel like you should receive,” Matthews says. Despite obvious signs of trauma and grief, no one identified her condition as postpartum depression. “They looked at my birth outcome and moved on.”
Her story reflects a broader crisis. Postpartum depression has sharply increased in recent years, rising from 9.4% of U.S. women in 2010 to nearly 19% in 2021. Among Black women, the increase is even more alarming—climbing to nearly 25%.
Contributing factors range from high pre-pregnancy BMI and underserved living conditions to long-term environmental stressors like air pollution. Yet, despite higher risk, Black mothers are 46% less likely to be screened for PPD, and less than 37% receive treatment—compared to 67% of white mothers, according to Columbia University data.
The effects of untreated PPD go far beyond the mother. It disrupts sleep for the entire household, impairs infant growth, and delays a child’s emotional and cognitive development. It can also affect maternal bonding, breastfeeding, and family stability.
The consequences can be deadly. Dr. Joy Baker, an obstetrician in rural Georgia, recalls one patient whose mental illness was overlooked due to the focus on her physical conditions. “She died by suicide, and it just wasn’t on my radar,” says Baker. Now a maternal mortality review committee member, she emphasizes that mental health drives nearly a quarter of maternal deaths.
Chronic stress, especially among low-income mothers relying on Medicaid, is a key trigger. Prolonged stress elevates cortisol levels and creates a toxic womb environment—raising the chances of preterm birth, low birth weight, and pregnancy-related hypertension or diabetes.
Medicaid, which covers around 40% of U.S. births, helps make treatment options like the $8,700 PPD drug Zurzuvae more accessible. But looming healthcare cuts could reverse progress. In Georgia, where nearly 50% of births are covered by Medicaid, the potential impact of federal budget reductions could be catastrophic.
To bridge the gap, Matthews founded the Shades of Blue Project, a nonprofit based in Houston that provides mental health support, baby supplies, and awareness programs, especially during Black Maternal Mental Health Week (July 19–25).
“This work chose me,” says Matthews. “It made me realize how prevalent racism is within the healthcare system.”
But she and other advocates fear that progress could be undone by policy changes threatening rural hospitals and nonprofit funding. Matthews says, “There’s going to be a lot of shut-down when it comes to social support services.”
As the maternal mental health crisis grows, experts like Baker stress that systemic change is essential. “We cannot forget mental health when it comes to saving moms’ lives.”
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