Background: From a generational health perspective, perhaps no population’s health is more critical to safeguard than that of delivering women. We set to examine the effect of race and ethnicity on birth outcomes.

Methods: We studied a sample of 3,282 women. Using propensity score matching (PSM) procedures, a sub-sample of Black or Latinx individuals (“minority”) were matched to non-Hispanic white women on sociodemographic factors.

Results: 29% of minority individuals had traumatic stress response to childbirth indicative of risk for posttraumatic-stress-disorder and 45% had postpartum depression symptoms suggesting provisional diagnosis. This group was nearly 3 and 2 times more likely to endorse these maternal morbidities, respectively, in comparison to white women, for traumatic stress, χ 2=14.87, odds ratio, OR (95% CI) = 2.67 (1.59, 4.5), p < .001, for depression, χ 2=8.62, OR (95% CI) = 2.67 (1.21, 2.72), p < .01. Differences even remained controlling for prior mental health, abuse history, and obstetrics complications. Minority women were less likely to engage in immediate postpartum bonding behaviors, i.e., skin-to-skin (OR=0.47) and breastfeeding (OR=0.67).

Conclusions: Our findings document disproportionate maternal psychiatric morbidities among Black and Latinx individuals not explained by sociodemographic disadvantage. Major efforts are needed to support underrepresented minority individuals through improvements in practice and public policy.