Mother’s Day, coming this weekend, is supposed to be a celebration of maternal love, but for too many Black women who have just delivered a baby, an ongoing health crisis overshadows the holiday.
Compared to white women, Black women are still far more likely to suffer pregnancy-related complications or die than the overall population in the United States.
The numbers, tracked by the Centers for Disease Control and Prevention and others, tell a stubborn story about a country that has not solved its maternal mortality problem. And increasingly, that story is as much about mental health as it is about physical care.
“For me, the headline is always: we have to wake up and pay attention to mental health when it comes to parents,” says Dr. Joy Baker, an OB-GYN practicing in rural Georgia.
“There’s so much happening with mental health among parents,” says Baker, one of the first physicians in the U.S. to earn special certification in perinatal mood and anxiety disorders, as well as treatment of addiction in pregnancy.
“We tend to focus more on the maternal component, but we also know that up to 75% of partners who are partnered with a person experiencing a mental health disorder will also have experienced a mood disorder,” she says.
The data backs her up. A Centers for Disease Control and Prevention Maternal Mortality Review Committee found that deaths tied to mental health conditions rose from 22.7% in 2021 to 27.7% in 2022. Suicide now accounts for roughly one in five pregnancy-related deaths, making it one of the leading causes of maternal mortality. For Black women, almost 17% of pregnancy-related deaths were due to mental health conditions–which is roughly double the rate from the year before.
At the same time, those same reviews found that nearly 18% of maternal deaths were linked to discrimination. That finding lands hard in a system where Black women already face higher risks than white women at nearly every stage of pregnancy and postpartum care.
The trend is unfolding alongside a broader, troubling shift. Even as white women still die from suicide at higher overall rates, the suicide rate among Black women is rising — particularly among younger women.
Still, the deeper story sits beneath those comparisons. Studies show Black women report suicidal thoughts at roughly twice the rate in the months after childbirth, while facing steeper barriers to diagnosis, treatment, and consistent care.
Experts say those gaps—paired with unequal access to health care and higher exposure to violence—are fueling a crisis that is both underrecognized and accelerating. The danger is often greater and harder to see until it is too late.
Word In Black spoke with Joy Baker, an OB-GYN practicing in rural Georgia, about how mental health, systemic barriers, and access to care shape outcomes for mothers, particularly Black women.
The conversation has been edited for clarity.
Word In Black: What do you think should be the headline of this story?
Dr. Joy Baker: For me, the headline is always the same: we need to raise awareness and sound the alarm about the fact that mental health disorders and substance use are the number one cause of [maternal] death across the country. We’re having so many more readmissions due to mental health issues and also medical issues that mental health disorders contribute to.
If you think about preeclampsia — or folks who are having uncontrolled anxiety with abnormal heart rates and rhythms — we’re doing all of these million-dollar workups, and then we conclude that this may actually be due to untreated anxiety.
WIB: You mentioned rural health as something we didn’t cover. How does geography play a role?
Baker: I’ve been in small towns and rural settings for my entire career since finishing training in Atlanta. Rural [communities] lend themselves to more isolation, less support, and more difficulty seeking the care patients need.
Although in this particular study, folks in rural settings did not seem to suffer from the same health disparities in terms of readmission rates, I can tell you from having worked in several rural communities that we certainly did see higher rates of folks dealing with perinatal mood and anxiety disorders.
WIB: What should we know about the significant increase in suicidality in Black women?
Baker: Suicidality in Black women increased by about 10 times, which is startling. Substance use disorder goes hand in hand with all of this, because people are just self-medicating. I do a lot of substance use disorder treatment in my practice, and it’s a big deal.
WIB: Beyond the mental health component, what is the intersection between mental health and physical health and what are some potential solutions?
Baker: When we think about it physiologically, we’re thinking about how anxiety and depression affect the actual physiology of the body. Especially in pregnancy, you can see increased risk of preterm birth, low birth weight, hypertensive disorders of pregnancy, and diabetes in pregnancy. Living in that high-cortisol state when folks have really high anxiety is not healthy for the body. That’s one of the key factors in a condition known as “weathering,” in which the body ages due to living in traumatic, stressful situations. That compounds all of the other factors.
At my hospital, several years back, we were looking at folks who had mood or anxiety disorders diagnosed during pregnancy and examining rates of substance use among those individuals. I worked with a data analyst who gathered the C-section rate, and it tended to be higher among folks who had perinatal mood and anxiety disorders.
That is really fascinating because we also know that a C-section delivery increases your risk of severe morbidity by nearly a hundred times. Is it that we’re having trouble getting into an adequate labor or birth pattern because we’re dealing with mood and anxiety disorders, and ending up with a cesarean delivery? There’s so much at play here.
Q: What should family members, friends, and loved ones do if someone who has recently delivered a baby is struggling?
If they’re seeing physical signs of distress — heavy bleeding, swelling, headaches that don’t go away with rest or Tylenol or Motrin, shortness of breath, or chest pain — those can all point to physical problems for newly delivered moms. But mental health is just as important.
If someone is not sleeping or sleeping too much, not eating or eating too much, no longer taking pleasure in things they used to enjoy, having crying spells that last longer than the first two weeks, or not wanting to bond with their infant — those are all signs that they need to have some diagnostic testing done, whether that’s a depression scale or a conversation with their clinician. If you’re able to get in front of these issues early, you can prevent some of the problems we’re seeing with substance use disorders and suicide.
Q: When you say ‘two weeks,’ are you referring to two weeks of symptoms, or two weeks after delivery?
Most people may have some emotional lability during the first two weeks after delivery — they may be up and down. We think postpartum blues should be gone within the first two weeks, but honestly, I see patients who are already struggling before they deliver. In that case, those folks need to be followed closely and treated prior to delivery or as soon as diagnosed, and we need to watch them more closely postpartum, because once they have that huge hormonal shift after giving birth, it can really throw off their ability to respond to stressors — not getting enough sleep, not having enough help or support, a brand new baby, trying to breastfeed, trying to take care of themselves. There’s so much stress that comes with a newborn.
I talk to my patients a lot about this. Everybody wants to come and visit the baby — tell them to pick up laundry detergent. Ask somebody to stop by and get dinner. Don’t feel like you have to be entertaining them. We talk a lot about engaging your support network, and I think the message we have to start giving our community is: what can you do to hold this mama, hold these parents, and help with the baby?
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