April 11-17, 2025  is Black Maternal Health Week. For more information and resources, please see here.

By Isha Weerasinghe

The prenatal and postpartum periods are some of the most vulnerable times a person can experience, and the shift in roles and responsibilities can cause a great deal of stress and anxiety. These periods can bring new perspectives and symptoms to parents that they may not have been prepared for, including complications in pregnancy and delivery leading to a demanding recovery; being unable to breastfeed or afford baby formula; and a significant lack of sleep, among other difficulties. Any of these factors can significantly contribute to adverse impacts on a new parent’s mental health. The Trump Administration’s recent cuts to federal agency staff and elimination of diversity, equity, and inclusion (DEI) programs will only compound these challenges.

The administration’s actions around DEI, cutting grants, and consolidating federal departments are already having significant effects on health funding. States are experiencing the results of cutting more than $12 billion in federal grants related to the impacts of COVID-19, resulting in potential cuts of millions of dollars for mental health services in states like New York, Utah, and Wisconsin. Significant changes and eliminated departments within the U.S. Department of Health and Human Services’ (HHS), including firing staff in the Substance Abuse and Mental Health Services Administration, Centers for Disease Control and Prevention, and Health Resources and Services Administration and then shifting the agencies to the Administration for a Healthy America umbrella; eliminating the Office of Minority Health; funding cuts to state and city offices including in the Office of Civil Rights; and eliminating regional offices that work to reduce health disparities all have severely negative impacts on mental health outcomes. Among the casualties will be less research into and data on how race, ethnicity, and gender factor into mental health outcomes; a reduction in funding for culturally responsive programming; little to no enforcement of antidiscrimination rules; and fewer resources to hire a diverse set of providers to serve people who are pregnant, both in terms of expertise/experience and cultural background. All of these elements are critical to address maternal mental health inequities.

As it stands, pregnant women[1] of color often feel high levels of distrust with health systems. This is due to high maternal mortality rates among Black and Indigenous women, known past and present sterilization practices across the country, and stories of children being taken away from their parents. Implicit bias among providers, well known among many communities of color, also affects the communication between provider and patient and impacts the quality of care. For many immigrant communities with limited English proficiency, cultural and linguistic barriers between pregnant women and their providers can make prenatal care, delivery, and postpartum care more complicated.

All of this can lead to increased stress and anxiety throughout pregnancy and the postpartum period. Twenty-nine to 44 percent of Black women experience postpartum depressive symptoms, and very few report accessing necessary mental health services. Indigenous women have 87 percent higher odds of developing postpartum depression than white women. Collectively, about one in five American Indian,[2] and Alaska Native, Asian, or Pacific Islander,[3] and Black women report symptoms of perinatal depression compared to one in ten white women. Hispanic women[4] experience postpartum depression at around 12 percent, although rates are significantly higher among certain populations within the identity, and not enough recent data exists to accurately determine inequities within Hispanic populations. All of these rates are likely underestimates because many communities of color experience fear and stigma and do not want to highlight concerns in their medical records out of fear of increased scrutiny, discrimination, and/or jeopardizing their health or their children’s ability to live within the same household.

Pregnant immigrants—both those with and without legal documentation—are impacted by the onslaught of anti-immigrant policies and mass deportations threatening and hurting their communities. People who are pregnant may refuse to visit a health care facility for prenatal care or during labor out of fear of arrest and deportation, which could impact their baby’s health as well as their own physical and mental health. Some immigrant communities are becoming increasingly fearful of the health system, even delaying or avoiding care to deliver their babies, which increases adverse mental health conditions. Coupled with mental health stigma, immigrant parents will not receive the critical mental health care they need during the prenatal and postpartum periods.

In addition to attacks from the executive branch, there are serious legislative threats in the pipeline. House Republicans aim to cut $880 billion from the Medicaid program through the budget reconciliation process. Medicaid funds four in 10 births in the U.S. and is the single largest payer of mental health care services. If these cuts are passed into law, they would have significant impacts on state budgets, putting states at a crossroads to cut key health programs and coverage. Programs providing key clinical outpatient services for pregnant women with low incomes are deeply concerned about these cuts, as Medicaid often provides the funding to pay providers and keep these essential programs alive. Cuts to Medicaid will also likely impact postpartum Medicaid coverage, currently available in 48 states and Washington, D.C..

It is critical for us to understand the links between these policy and funding changes and how they will impact perinatal and postpartum services. We have to let our legislators and policymakers know why these recent administrative and federal legislative directives are deeply concerning. Collectively, we must support and uphold the need for these critical services during the incredibly vulnerable time before and after delivery. Remaining silent means that positive health outcomes for marginalized people will be in jeopardy, and maternal morbidity and mortality rates will rise.

April 11-17, 2025 is Black Maternal Health Week. For more information and resources, please see here.

[1] CLASP recognizes that people of all genders can be pregnant and give birth. Some use the terms “birthing people” and “pregnant people” to capture this. In most cases, we have chosen to use “women” to be consistent with the terminology used in the statistics throughout this piece. 

[2] The Center for Law and Social Policy (CLASP) uses the term Indigenous, but for the sake of continuity with national datasets, is noting American Indian and Alaska Native here. 

[3]  CLASP uses the term Asian American, Native Hawaiian, or Pacific Islander, but for the sake of continuity with national datasets, is noting Asian and Pacific Islander here. 

[4] CLASP uses the term Latino, but for the sake of continuity with national datasets, is noting Hispanic here.