Perinatal depression at the intersection of race/ethnicity and disability

Perinatal depression disparately impacts diverse groups, with marginalized populations often facing greater vulnerability. While previous research has highlighted disparities in perinatal depression by race/ethnicity and by disability status independently, there is a lack of research examining the intersectionality of these social identities and their combined association with perinatal depression. Therefore, this study adopts an intersectional lens to explore variations in perinatal depressive symptoms associated with the combination of race/ethnicity and disability status in a nationally representative sample of women who had recently given birth.

We conducted a cross-sectional secondary data analysis using 2019-2020 data from the Pregnancy Risk Assessment Monitoring System (PRAMS), including a sample of disabled and non-disabled individuals across 22 sites. We used logistic regression analyses to estimate associations of race/ethnicity and disability status with perinatal depressive symptoms, performing separate analyses for the antenatal and postpartum periods. In adjusted regression models, we controlled for other sociodemographic characteristics.

Our analysis included 33,854 individuals, including 31,480 (93%) without a disability and 2,374 (7%) with at least one disability. Women with disabilities reported higher prevalence of antenatal (42.7%) and postpartum (33.1%) depressive symptoms compared to non-disabled women (14.1% and 12.1%, respectively). Antenatal depression was most common among disabled Non-Hispanic (NH) White women, while prevalence and odds of postpartum depression were highest among disabled NH American/Indian Alaska Native and disabled NH Black women.

Our findings emphasize the need for perinatal depression screening for disabled women, as well as culturally appropriate interventions to support the mental health of diverse women with disabilities throughout the perinatal period.