Objective <p>Black women who report higher levels of disorder and crime in their neighborhoods have higher levels of depressive symptoms during pregnancy. Our objective was to examine the mediating effect of avoidance coping on the association of neighborhood disorder and neighborhood crime with depressive symptoms during pregnancy among Black women.</p> Design <p>The Biosocial Impact on Black Births (BIBB) study is a prospective study.</p> Sample <p>A sample of 599 Black pregnant women.</p> Measurements <p>Women completed questionnaires about disorder and crime in their neighborhoods, avoidance coping, and depressive symptoms.</p> Results <p>The participants had a mean maternal age of 27&#xa0;years and a mean gestational age of 18&#xa0;weeks. Women who reported higher levels of neighborhood disorder and neighborhood crime also reported higher use of avoidance coping and higher levels of depressive symptoms. Higher use of avoidance coping related to higher levels of depressive symptoms. Analyses demonstrated that avoidance coping mediated the effects of neighborhood disorder and neighborhood crime on depressive symptoms among women in our study.</p> Conclusion <p>Interventions that alter coping styles to move women away from avoidance coping may mitigate the association between adverse neighborhood conditions and depressive symptoms during pregnancy.</p>