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Blog 8 May 2025

Unheard Cries: Postnatal Depression, Addiction, and the Mental Health Crisis Facing Black Mothers (Maternal Mental Health Awareness Week 2025)

By By Ania Couchinho, Black Maternal Health Specialist and The Forward Trust’s Research and Impact Lead
Ania Couchinho, Forward’s Research and Impact Lead and expert in Black maternal health, highlights the importance of providing mental health and addiction support for all women this Maternal Mental Health Awareness Week 2025 (5-11 May).

The birth of a child is often described as one of life’s most joyful milestones. But for many Black women, this experience is accompanied by a silent struggle with postnatal depression (PND) – a condition that can become even more complex when combined with the weight of addiction.

Mental health support for new mothers is not one-size-fits-all. For Black women, cultural, social, and systemic factors often shape how depression is experienced and whether it is treated or overlooked. When mental health needs go unmet, some women turn to substances to numb the pain. In this blog, we dive deeper into the intersection of PND and addiction among Black mothers and why addressing both is essential.

Understanding Postnatal Depression (PND)

PND is a mood disorder that affects women after childbirth, marked by persistent sadness, anxiety, exhaustion, and difficulty bonding with the baby. It affects around 1 in 7 women, but Black women are far less likely to receive a diagnosis and treatment.

The overlap between PND and addiction

Mental health and addiction are deeply interconnected. When PND goes untreated, some women, especially those with limited access to emotional support or therapy, may turn to substances like alcohol, cannabis, or prescription medications to cope. This self-medication can quickly spiral into dependency.

Why is this particularly relevant for black women?

  • Unaddressed pain

    Due to stigma, cultural expectations, or mistrust in the medical system, many Black women do not receive mental health care for PND. The emotional pain doesn’t disappear – it gets buried, often under substances used to dull its edges.

    • Stigma of ‘being a bad mother’

      Black women face increased scrutiny in motherhood. Admitting to struggling emotionally or with substance use can carry fears of judgment, shame, or even involvement from social services. This leads many to suffer in silence.

      • Historical over-policing of black mothers

      The criminalisation of substance use in motherhood disproportionately affects Black women. While white women may receive referrals to treatment, Black mothers are more likely to face punitive action. This discourages many from seeking help for addiction or PND in the first place.

      • Generational trauma and coping mechanisms

      Generations of racial trauma and systemic stress often result in maladaptive coping mechanisms being passed down. Addiction is rarely just about the substance; it’s about survival in a system that routinely fails Black women.

      Barriers to recovery and healing

      • Lack of dual-diagnosis care

      Many addiction treatment programmes do not address co-occurring mental health disorders like PND. Without addressing the root cause, recovery is incomplete, and relapse is more likely.

      • Limited cultural competency in services

      Black women often report feeling misunderstood or stereotyped in traditional recovery settings. Cultural shame around addiction and mental health can also be a deterrent to seeking support.

      • Why this matters: the cost of silence

      When PND and addiction intersect, the consequences can be devastating for the mother, the child, and the family as a whole. These conditions affect maternal bonding, increase the risk of child neglect, and can lead to long-term mental health issues for both mother and child.

      But this isn’t just a personal health issue – it’s a social justice issue. Black mothers deserve the same access to compassionate, effective, and culturally aware care as anyone else.

      What needs to change

      • Integrated mental health and addiction support

        Services must offer trauma-informed, culturally competent care that treats both PND and substance use disorders together.

        • Policy reform

        Decriminalising substance use during pregnancy and instead promoting treatment-based approaches can help protect Black mothers and keep families together.

        • Community-led solutions

        Programmes led by Black women, like maternal support groups, peer recovery networks, and culturally relevant doulas, can break through barriers of stigma and build trust.

        • Public Awareness

        Normalising conversations about both PND and addiction within Black communities is essential to dismantling shame and opening pathways to healing.

        Black mothers deserve to be heard and healed

        The path from PND to addiction isn’t paved by weakness. It’s paved by neglect, silence, and unmet needs. Black women are fighting for their mental health in a world that often refuses to see their pain. To support them, we must listen, advocate, and build systems that prioritise healing over punishment, understanding over judgment.

        The journey to motherhood should not come at the cost of a woman’s mental health or dignity. It’s time to rewrite the story – one that centres Black women’s voices, experiences, and power to heal.

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