INTERSECTING INEQUITIES: MULTIPLE SCLEROSIS, POSTPARTUM DEPRESSION, AND THE ETHICAL IMPERATIVE TO SUPPORT BLACK WOMEN IN THE POSTPARTUM PERIOD

For the longest time, chronic illnesses have disproportionately affected the Black community, yet our healthcare system has failed to appropriately address these discrepancies until more recent decades. Multiple Sclerosis (MS), a chronic, debilitating neurological disease has been inappropriately addressed and diagnosed amongst minority groups with the focus primarily on young, White women due to past years of poorly investigated and generalized research studies. It is widely known at this point that chronic illnesses unequally affect minority groups, specifically Black Ameiricans, due to an amalgam of social, political, genetic, and environmental factors; thus, focusing on MS, a disease recently wrongfully thought to primarily affect White over Black patients, is important to investigate modern day, especially when diagnoses and treatment rely on speciality neurologists and expensive drugs difficult to be covered by insurance companies (which are just few examples of the numerous socioeconomic barriers minorities face today in the public health system). In this way, it is imperative for the health system, specifically the neurological sciences, to address these disparities in care and treatment to a particularly vulnerable patient population and advocate for proper and equal care for all affected persons. What makes MS also of particular interest when examining this illness in the context of racial and socioeconomic disparities (a point which will be further explained later in this paper), is the sensitive time period postnatally for potential relapse and progression of the disease. Again, it is already well known at this point the significant disparities in maternal morbidities and mortalities between Black and White pregnant persons, thus making this period amongst MS patients principally important to examine and address for Black peripartum patients. An important comorbidity at this time, affecting up to a third of women, is postpartum depression (PPD). For this reason, this paper aims to examine a unique but important gap in current literature: the relationship between multiple sclerosis, race, and postpartum depression. This paper will describe the importance of extra care towards the Black peripartum MS patient and call for the US health system to better address racial and socioeconomic barriers contributing to disease progression in order to achieve healthcare justice. This thesis argues that structural, emotional, and environmental barriers to postpartum care place Black MS patients at increased risk for both disease progression and postpartum depression. Addressing these disparities is not only a clinical necessity but a bioethical imperative grounded in justice, equity, and the moral responsibility to deliver inclusive, responsive neurological care.