Intersections of racism, disability, and postpartum depression in minoritized racial and ethnic populations

Purpose: Using an intersectional lens, this study examined the association between maternal reports of emotional distress due to racism (EDR) and postpartum depression (PPD) symptoms among persons with and without disabilities in minoritized racial and ethnic populations. Methods: An analysis of Phase 8 (2018–2020) data from the Pregnancy Risk Assessment Monitoring System (PRAMS) included 2,452 respondents with a recent live birth from three states (MO, GA, VA). We examined the association between EDR and PPD symptoms among respondents with and without disabilities using Pearson’s chi-square test. Multivariate regression models were used to further estimate the odds of PPD symptoms associated with EDR and to examine differences in this relationship by disability status. Results: EDR was significantly associated with PPD symptoms, with a higher prevalence of PPD symptoms among those with at least one disability (52.3%) compared to those without disabilities (19.9%). After adjusting for maternal demographics, EDR was significantly associated with PPD symptoms across disability groups. No significant interaction between disability group and EDR was observed, suggesting the association’s strength did not differ significantly by disability group in this study. In the fully adjusted model, history of depression attenuated the EDR-PPD association across disability groups, highlighting the effect of prior depressive episodes on PPD outcomes. Conclusion: EDR is significantly associated with PPD symptoms, and persons with disabilities in minoritized racial and ethnic populations may be particularly susceptible to EDR and PPD. Additional research using an intersectional perspective is needed to elucidate PPD disparities as related to multiple, intersecting social identities and experiences of discrimination.