High levels of stress have been
consistently associated with a wide variety
of negative health behaviors, including smoking, drinking, drug use and physical inactivity.
When women experience acute and chronic life stressors during pregnancy, maternal mental health issues can arise.33 Yet differences in maternal mental health are also not enough to explain the gap in birth outcomes, as African American women have not
consistently reported
higher levels of stress during pregnancy.34 However, women
of color are not typically aware
of mental health symptoms experienced during pregnancy and in the postpartum period.35 This is due to a lack
of knowledge regarding the signs and symptoms associated with mental health challenges.
Past research relying on either cross-sectional or main effect models makes the assumption that low
levels of perceived control will uniformly and
consistently predict
higher levels of depressive symptoms without taking into account contextual and environmental factors such as
stress (see Alloy et al. 1988).