Oppression Based Traumatic Stress As a Predictor of Post Partum Depression Among New Mothers after Controlling for Race, Income, Age, and Mental Health Diagnosis

Postpartum depression (PPD) is a significant public health concern in the US, with research estimating 15% of new mothers experience impactful symptoms of PPD. Consequently, research that identifies potential antecedents of PPD symptoms may have value in driving more effective interventions to reduce their severity. Feminist theory suggests that structural inequality, in the form of sex-based discrimination against women, is a contributing factor to many negative public health outcomes for women. Sex based discrimination, i.e. sexism, manifests itself within society through discriminatory policies in additional to discriminatory institutional norms. To test whether feminist theory can potentially explain in part a potential driver of PPD symptoms, we performed a nationwide survey study of new mothers (N = 194) using the Oppressional Based Traumatic Stress Inventory (OBTSI) and the Edinberg Postnatal Depression Scale (EPDS). The OBTSI was designed to measure traumatic stress symptoms resulting from systemic discrimination, such as racism, sexism, and poverty. To test the potential influence of oppression-based traumatic stress on PPD symptoms, we employed a hierarchical regression model with EPDS scores as the dependent variable. A hierarchical regression model allowed us to examine the unique contribution of oppression based traumatic stress to PPD after adjusting for the influence of the covariates of race, age, income, and presence of a mental health diagnosis. The covariates were chosen based on existing research that supports each plays a role in influencing PPD symptoms. In step 1 of the model, the covariates accounted for significant variance in PPD (R² = .107), with lower income and the presence of a mental health diagnosis contributing most strongly to greater PPD symptoms. In step 2, we entered OBTSI scores into the model, with the result being that OBSTI scores accounted for statistically significant and robust variance (ΔR² = .376; p < .001) in PPD over the covariates. The relationship was positive, meaning greater OBTSI scores were correlated with greater PPD. The effect size of the relationship between OBTSI scores and greater PPD symptoms was approaching “large” (β = .557; p < .001) The results suggest that the experience of oppression based traumatic stress among women has a sizable relationship with greater PPD symptoms. From a feminist perspective, the association between OBTSI scores and higher PPD symptoms indicates that PPD symptoms are not solely an intrapsychic or biological condition, but a socially produced response to gender-based oppression. Based on the large correlation between oppression based traumatic stress and PPD, social work practitioners interested in further reducing PPD symptoms should consider directed greater public health resources at reducing structural inequalities within society.