“Recently, while completing additional training in perinatal mental health through Postpartum Support International, I encountered a set of statistics that stopped me in my tracks,” writes Janae Johnson, PMHNP-BC.
Not because I was unaware that disparities exist in Black maternal mental health. But there is a difference between knowing disparities exist and seeing the numbers laid out in front of you. 84.4%. That was the first number that caught my attention. 84.4% of non-Latina Black women report symptoms consistent with a perinatal mood and anxiety disorder (PMAD) during pregnancy.
Then I kept reading.
50% reported symptoms during the postpartum period, yet only approximately 12.3% to 14.6% of those reporting symptoms received mental health treatment. 21.2% were not screened for postpartum depression.
A troubling story
I went back and read the numbers again. Because when you place them beside one another, they tell a troubling story. What I came to realize was that women were experiencing symptoms. Many were not receiving treatment. Some were not even screened.
As a psychiatric mental health nurse practitioner whose work has increasingly centered on women’s mental health, these numbers felt especially personal to me. I spend most days listening to women describe anxiety, depression, exhaustion, overwhelm, and the pressure to continue functioning even when they are struggling internally. Some of these women are not pregnant or postpartum. So, imagine experiencing those same struggles while also navigating the physical, hormonal, and emotional changes of pregnancy, recovering from childbirth, caring for a newborn, and adjusting to an entirely new version of yourself.
The expectation to be strong
But there was something else shared during that training that stayed with me: when it comes to maternal mental health outcomes, Black women so often find themselves clustered at the most concerning ends of the spectrum. Highest in maternal mortality. Lowest in postpartum care turnout. Highest in symptom burden. Lowest in receiving treatment.
It was difficult to ignore the pattern, no matter which end of the spectrum, Black women were too often on the end associated with the worst outcomes. For me, it also raised a deeper question about what we have learned as a culture to endure before we ever say we need help. As a Black woman, I understand how deeply the expectation to be “strong” can become woven into the way we navigate the world.
Sitting in that class and seeing it presented that way did not sit well with me. Maybe because I too am a Black woman. Maybe because I am a mental health provider. Maybe because I have decided to make maternal mental health my niche, and the more I learn about it, the more I realize just how much work there is still left to do.
Whatever the reason, I could not just hear those numbers, write them down, and move on. They stuck with me.
Asking the right questions
And suddenly, the question was no longer simply, How many Black women are experiencing perinatal mental health symptoms? The question became: What is happening to them after those symptoms appear? Do we hear them? Do we screen them? Do we believe them? And most importantly, do we make sure they receive care?
I think what resonated with me most is knowing that somewhere behind each of those numbers is a woman. A woman who may have said she was tired when she was overwhelmed. A woman who may have smiled, gone to work, cared for her baby, cared for everyone else, and continued to push through while quietly falling apart.
And maybe that is where the real work begins, not simply teaching Black women to recognize when they are struggling but creating a system where they can trust what happens when they finally say, “I’m not okay.”
What can we do next?
For Black mothers during pregnancy and postpartum:
Give yourself permission to speak honestly about how you are feeling, even when you cannot fully explain it. You do not have to wait until you are in crisis to ask for help. If something feels different, heavier, or harder to manage, tell someone you trust and talk with a healthcare professional.
For partners, family members, and friends:
Listen without immediately trying to fix, minimize, or compare her experience. If she tells you she is struggling, believe her. Offer practical support, help her connect with professional care when needed, and continue checking in after the initial conversation.
For healthcare professionals:
Screen consistently and recognize that screening is only the beginning. Ask follow-up questions. Consider cultural context and the ways symptoms may be described or masked. Take concerns seriously even when a woman appears high functioning. Most importantly, have a clear pathway for what happens after a positive screen such as referrals, treatment, follow-up, and continuity of care.
For all of us:
Challenge the idea that strength means suffering silently. We can celebrate the resilience of Black women without requiring resilience to become their survival strategy. The goal cannot simply be getting Black women to speak up. The goal must be to create a system that listens when they do.
If any of the above resonated with you or someone you love, reach out to Athena Care so we can help. You can contact us by filling out this short form or call/text us at +1 877-641-1155 or email [email protected].
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Janae Johnson, PMHNP-BC
Psychiatric Mental Health Nurse Practitioner
Committed to the field of mental health, Janae’s true passion lies in women’s mental health services, while professionally, she is dedicated to working with individuals across the lifespan. She is equipped at treating a wide range of mental health conditions and is always eager to provide compassionate and personalized care.
Meg Stein, CFP
Editor
Meg is a certified mindfulness instructor and works at Alive and Aware Practice in Durham, NC. She has over ten years of experience as a content creator and marketing consultant, working in mental healthcare and social justice.