Low-income women are frequently trapped in a cycle of poverty, unable to advance, affecting their ability to access and receive quality healthcare to diagnose and treat postpartum depression.Studies have also shown a correlation between a mothers race and postpartum depression. African American mothers have been shown to have the highest risk of PPD at 25%, while Asian mothers had the lowest at 11.5%, after controlling for social factors such as age, income, education, marital status, and babys health. The PPD rates for First Nations, Caucasian and Hispanic women fell in between.Migration away from a cultural community of support can be a factor in PPD. Traditional cultures around the world prioritize organized support during postpartum care to ensure the mothers mental and physical health, wellbeing, and recovery.One of the strongest predictors of paternal PPD is having a partner who has PPD, with fathers developing PPD 50% of the time when their female partner has PPD.Sexual orientation has also been studied as a risk factor for PPD. In a 2007 study conducted by Ross and colleagues, lesbian and bisexual mothers were tested for PPD and then compared with a heterosexual sample group. It was found that lesbian and bisexual biological mothers had significantly higher Edinburgh Postnatal Depression Scale scores than did the heterosexual women in the sample. Postpartum depression is more common among lesbian women than heterosexual women, which can be attributed to lesbian womens higher depression prevalence.
Although the emotional numbing component was excluded in the DSM-5 criteria for posttraumatic stress disorder, research has shown that when studying mothers who have been exposed to trauma, emotional numbing is more predictive of parenting stress than other posttraumatic stress disorder symptoms. Although this assessment shows strong reliability (Cronbachs alpha = 0.92), and participants from the pilot study found the measure to be easy to understand, this assessment is still not used in clinical or medical settings as often as it is used in research settings. The researchers that have utilized the CTSB have been able to identify various limitations with the pilot study, including the lack of diversity in the sample demographic characteristics (93% White postpartum women) as well as the self-report nature of the assessment which could lead to underreporting of symptoms. Another assessment that has also been used in research more often than in clinical or medical settings is the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ), which has since been modified into the Perinatal Posttraumatic Stress Disorder Questionnaire-II (PPQ-II), with the modified version being a 14-item scale which does not address all the necessary diagnostic criteria. Further research and development are needed to create a more accurate assessments and screening tools that can differentiate among posttraumatic stress disorders, postpartum/childbirth-related posttraumatic stress disorder, and postpartum depression so that the most adequate treatment interventions and options can be implemented as quickly as possible.