Maternal and Child Health Journal

, Volume 12, Issue 6, pp 699–707 | Cite as

Postpartum Depression: Racial Differences and Ethnic Disparities in a Tri-racial and Bi-ethnic Population

  • Guo WeiEmail author
  • Linda B. Greaver
  • Stephen M. Marson
  • Cynthia H. Herndon
  • James Rogers
  • Robeson Healthcare Corporation


Objectives This research investigated the differences and disparities of postpartum depression in a sample of African American, Hispanic, Native American, and White women. Methods A sample of 586 women were administered the Beck-Gable PDSS at 6-weeks postpartum. Factor analysis was applied to analyze the similarities among African American, Hispanic, Native American, and White participants. Confidence intervals of the rates of depression by group were estimated, followed by statistical tests to determine the differences among these rates. Risk assessment was performed with factor analysis and correlation methods. Results Hispanic women had a remarkably lower depression rate (2.5%) than other groups (P-values < 0.05). Significant differences for major depression were not found among African American, Native American, and White women; but Whites had higher minor depression (P-values < 0.05). Native American women had the highest rate of major depression (18.7%) and an average minor depression (10.5%). Although Whites had the second highest major depression (17.6%) and the highest minor depression (19.6%), their average full score (76.1) was noticeably lower than that of Native Americans (82.9) and slightly lower than that of African Americans (78.9; major and minor depression rates: 14.8% and 9.9%). The sample also demonstrated strong associations of depression with depression history and breastfeeding. Conclusion Statistically, postpartum depression can be ranked from high to low as Native Americans, Whites, African Americans and Hispanics (Hispanics have remarkably lower depression rates). This information is critically important to clinicians, researchers, agency administrators and social workers who work with these populations.


Postpartum depression Racial-ethnic prevalence and disparities Factor analysis Correlation 



This research was approved and supported by the University of North Carolina at Pembroke and the Healthy Start Corps Project “Eliminating Disparities in Perinatal Health”. The Healthy Start Corps project is funded by the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services (Grant Number: H49MC00068-05-00). The authors state that this paper represents original work that has not been published elsewhere. In particular, the authors thank all the three reviewers for their valuable comments and detailed suggestions that help us achieve this significantly improved paper.


  1. 1.
    Steiner, M. (1998). Perinatal mood disorders: Position paper. Psychopharmacology Bulletin, 34(3), 301–306.PubMedGoogle Scholar
  2. 2.
    Wisner, K. L., & Stowe, Z. N. (1997). Psychobiology of postpartum mood disorders. Seminars in Reproductive Endocrinology, 15(1), 77–89.PubMedCrossRefGoogle Scholar
  3. 3.
    Cox, J. L., Murray, D., & Chapman, G. (1993). A controlled study of the onset, duration and prevalence of postnatal depression. The British Journal of Psychiatry, 163, 27–31.PubMedGoogle Scholar
  4. 4.
    Cooper, P. J., Campbell, E. A., & Day, A., et al. (1988). Non-psychotic psychiatric disorder after childbirth. A prospective study of prevalence, incidence, course and nature. The British Journal of Psychiatry, 152, 799–806.PubMedCrossRefGoogle Scholar
  5. 5.
    O’Hara M. W., Zekoski, E. M., & Philipps, L. H., et al. (1990). Controlled prospective study of postpartum mood disorders: comparison of childbearing and nonchildbearing women. Journal of Abnormal Psychology, 99(1), 3–15.PubMedCrossRefGoogle Scholar
  6. 6.
    Bryan, T. L., Georgiopoulos, A. M., & Harms, R. W., et al. (1999). Incidence of postpartum depression in Olmsted County, Minnesota. A population based, retrospective study. The Journal of Reproductive Medicine, 44(4), 351–358.PubMedGoogle Scholar
  7. 7.
    Gaynes, B. N., Gavin, N., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner, G., Brody, S., Miller WCb (RTI—University of North Carolina Evidence-based Practice Center). Perinatal depression: prevalence, screening accuracy, and screening outcomes. Rockville (MD): Agency for Healthcare Research and Quality; 2005 Feb. Evidence Report/Technology Assessment NO. 119. Contract No. 290–02–0016.Google Scholar
  8. 8.
    O’Hara M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression—a meta-analysis. International Review of Psychiatry, 8, 37–54.CrossRefGoogle Scholar
  9. 9.
    Llewellyn, A. M., Stowe, Z. N., & Nemeroff, C. B. (1997). Depression during pregnancy and the puerperium. Journal of Clinical Psychiatry, 58(Suppl 15), 26–32.PubMedGoogle Scholar
  10. 10.
    Yonkers, K. A., Ramin, S. M., & Rush, A. J., et al. (2001). Onset and persistence of postpartum depression in an inner-city maternal health clinic system. American Journal of Psychiatry, 158(11), 1856–1863.PubMedCrossRefGoogle Scholar
  11. 11.
    Beck, C. T. (2003). Recognizing and screening for postpartum depression in mothers of NICU infants. Advances in Neonatal Care, 3(1), 37–46.PubMedCrossRefGoogle Scholar
  12. 12.
    Amankwaa, L. C. (2003). Postpartum depression among African-American women. Issues in Mental Health Nursing, 24, 297–316.PubMedCrossRefGoogle Scholar
  13. 13.
    Beck, C. T. (1995). The effects of postpartum depression on maternal–infant interaction. Nursing Research, 44(5), 298–304.PubMedCrossRefGoogle Scholar
  14. 14.
    Baker, L., Cross, S., Greaver, L., Wei, G., & Lewis, R. (2005). Healthy Start CORPS. Prevalence of postpartum depression in a Native American population. Maternal and Child Health Journal, 9(1), 21–25.PubMedCrossRefGoogle Scholar
  15. 15.
    Beck, C. T., Gable, R. K. (2002). Postpartum depression screening scale, 1st ed. Los Angeles: Western Psychological Services.Google Scholar
  16. 16.
    Dillon, W. R., & Goldstein, M. (1984). Multivariate analysis. New York: John Wiley & Sons.Google Scholar
  17. 17.
    Hair, JF, Anderson, R. E., Tatham, R. L., Black, W. C. (1992). Multivariate data analysis, 3rd ed. New York: Macmillan.Google Scholar
  18. 18.
    Spearman, C. (1904). General intelligence, objectively determined and measured. American Journal of Community Psychology, 15, 201–293.Google Scholar
  19. 19.
    Cattell, R. B. (1950). Personality: A systematic, theoretical, and factual study. New York: McGraw Hill.Google Scholar
  20. 20.
    Morrison, D. F. (1990). Multivariate statistical methods. New York: McGraw-Hill.Google Scholar
  21. 21.
    Campbell, S. B., & Cohn, J. F. (1991). Prevalence and correlates of postpartum depression in first-time mothers. Journal of Abnormal Psychology, 100, 594–599.PubMedCrossRefGoogle Scholar
  22. 22.
    Berle, J. O., Aarre, T. F., Mykletun, A., Dahl, A. A., & Holsten, F. (2003). Screening for postnatal depression. Validation of the Norwegian version of the Edinburgh Postnatal Depression Scale, and assessment of risk factors for postnatal depression. Journal of Affective Disorders, 76(1–3), 151–156.PubMedCrossRefGoogle Scholar
  23. 23.
    Beck, C. T. (2001). Predictors of postpartum depression: An update. Nursing Research, 50(5), 275–285.PubMedCrossRefGoogle Scholar
  24. 24.
    Markides, K. S., & Coreil, J. (1986). The health of Hispanics in the southwestern United States: An epidemiologic paradox. Public Health Reports, 101, 253–265.PubMedGoogle Scholar
  25. 25.
    Arbisi P. A. (2005). Postpartum depression screening scale: A review. In: R. A. Spies & B. S. Plake (Eds.), The sixteen mental measurements yearbook (pp. 794–796). Lincoln: The Buros Institute of Mental Measurement.Google Scholar
  26. 26.
    Walcott D. D. (2005). Postpartum depression screening scale: A review. In: R. A. Spies & B. S. Plake (Eds.), The sixteen mental measurements yearbook (pp. 796–799). Lincoln: The Buros Institute of Mental Measurement.Google Scholar
  27. 27.
    Kadane J. B. (Ed). (1996). Bayesian methods and ethics in a clinical trial design. New York: John Wiley & Sons.Google Scholar
  28. 28.
    Epperson, N. C. (1999). Postpartum major depression: Detection and treatment. American Family Physician, 59(8), 2247–2262.PubMedGoogle Scholar
  29. 29.
    Nezu, A. M., Ronan, G. F., Meadows, E. A., & McClure, K. S. (2000). Practitioner’s guide to empirically based measures of depression. New York: Kluwer Academic/Plenum Publishers.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Guo Wei
    • 1
    Email author
  • Linda B. Greaver
    • 2
  • Stephen M. Marson
    • 3
  • Cynthia H. Herndon
    • 4
  • James Rogers
    • 2
  • Robeson Healthcare Corporation
    • 5
  1. 1.Department of Mathematics and Computer ScienceUniversity of North Carolina at PembrokePembrokeUSA
  2. 2.Regional Center for Economic, Community and Professional DevelopmentUniversity of North Carolina at PembrokePembrokeUSA
  3. 3.Department of Social WorkUniversity of North Carolina at PembrokePembrokeUSA
  4. 4.Department of NursingUniversity of North Carolina at PembrokePembrokeUSA
  5. 5.Perinatal ProgramsRobeson Healthcare CorporationFairmontUSA

Personalised recommendations