Stress during pregnancy: Disparities in mental health

July 19, 2019

Most of us have experienced stress at some point in our lives. Things like work deadlines and sitting in traffic are part of everyday stress. These are things that in general, most people can manage. However, high levels of stress that continue for a long time may cause health problems, like high blood pressure and heart disease. In pregnant women, high levels of stress can increase the risk of having a premature birth (birth before 37 weeks of pregnancy) or a having a low-birthweight baby (weighing less than 5½ pounds).

Serious stress and pregnancy

During pregnancy there are lots of changes happening all at once. Your body, your emotions, and your family are all going through a big change—it’s hard not to feel overwhelmed! But too much stress, especially serious types of stress, can have a big impact on your health and your baby’s health.

Serious types of stress include:

  • Long-lasting stress. This type of stress can be caused by having financial problems, being abused, having serious health problems or being depressed.

  • Pregnancy-related stress. Some women may feel serious stress about pregnancy. They may be worried about miscarriage, the health of their baby or about how they’ll cope with labor and birth or becoming a parent. If you feel this way, talk to your health care provider.

  • Racism. Some women may face stress from racism during their lives. This may help explain why African-American women in the United States are more likely to have premature and low-birthweight babies than women from other racial or ethnic groups.


Mental health awareness and disparities in mental health care

In observance of July being National Minority Mental Health Awareness Month, it’s important to highlight some of the disparities (differences) in mental health and mental health care. The U.S. Department of Health and Human Services (HHS) Office of Minority Health has reported that people from racial and ethnic minority groups are less likely than people who aren’t part of these groups to get treatment for mental health conditions, like anxiety and depression. Some reasons behind this difference include:


  • Social determinants of health. These are conditions in which you’re born, grow, work, live and age that can affect your community, education, income and your relationships with your partner, family and friends.

  • Access to mental health services. According to the Agency for Healthcare Research and Quality (AHRQ), racial and ethnic minority groups in the U.S. are less likely to have access to mental health services than other groups and are more likely to receive lower quality care.

  • Cultural beliefs and traditions. Some people may be afraid to talk to their health care provider or to ask for help because it is not traditionally part of their culture and beliefs.


Stress and depression

We don’t completely understand the effects of stress on pregnancy. But we do know having stressful conditions in your life is a risk factor for depression. Depression is also called depressive disorder, major depression and clinical depression. It’s a condition that causes feelings of sadness and a loss of interest in things you like to do. It can affect how you feel, think and act and can interfere with your daily life. It needs treatment to get better.

Perinatal depression is depression that happens during pregnancy or in the first year after having a baby. It’s one of the most common complications of pregnancy and affects up to 1 in 7 women (about 15 percent). It includes postpartum depression (also called PPD), which is depression that happens after pregnancy.

Getting help

Depression is a medical condition that needs treatment to get better. Depression is not your fault. If you think you’re depressed, tell your health care provider right away. Here are a few other things you should know:


  • If you’ve had depression before, you’re more likely than other women to have depression during pregnancy.

  • If you’re pregnant and taking an antidepressant, tell your provider right away. Don’t stop taking it without talking to your provider first.

  • Learn the signs and symptoms of depression and postpartum depression.

  • If you’re thinking of hurting yourself or your baby, call emergency services (911) right away. You can also contact the National Suicide Prevention Lifeline, 800-273-TALK (8255).