Stressful Experiences and Postpartum Depressive Symptoms Among Asian and Pacific Islander Women in the U.S.: The Significance of Racial Discrimination

Asian and Pacific Islander (API) women are at higher risk of postpartum depression (PPD) compared with White, Black, and Hispanic women. However, research has rarely focused on investigating risk factors for PPD among API women in the U.S., nor has much research focused on the effects of racial discrimination on PPD. This study is one of the first to examine the association between multiple types of stressors and postpartum depressive symptoms (PPDS) among API women in the U.S., with a focus on the social stressor of racial discrimination. We analyzed data from 3,319 API women from Pregnancy Risk Assessment Monitoring System (PRAMS) who gave birth between 2012 and 2018. We conducted both multiple linear and logistic regression analyses to examine whether the three stressful experiences (racial discrimination, number of family stressors, and physical violence from an intimate partner) were each independently associated with more or elevated PPDS, and whether there was an interaction between number of family stressors or physical violence and racial discrimination on PPDS. The number of family stressors and racial discrimination were independently associated with PPDS, and these main effects were qualified by an interaction. Specifically, for those who experienced three or fewer family stressors (93.3% of the present sample), racial discrimination increased PPDS. For those who experienced four or more family stressors, racial discrimination did not have an effect. These results suggest racial discrimination does play an important role in PPD among API women. Future efforts should address racial discrimination of API women in the U.S. in order to decrease PPDS.