Over the past year, I’ve made it a point in my advocacy efforts to focus more on women of color, talking with them about their mental health experiences during pregnancy and the postpartum period. Based on those conversations and my own personal experience, I’ve become especially interested in how perinatal mood disorders and their symptoms impact and manifest in our lives, what culturally specific barriers to support and treatment we encounter, and what mental health advocacy efforts are being made to remove those barriers for us. Here’s what I’ve learned from research, Postpartum Progress’ current survey on mothers of color and their experience with perinatal mental health, conversations I’ve had with fellow mothers of color, and from what I’ve seen in the mental health advocacy space.
- We are woefully underserved by mental health professionals and social services that reside in our communities-for a variety of reasons. Many of the women I spoke to were dismissed, rebuffed, or had their mental health concerns during pregnancy and the postpartum period downplayed by their doctor, pediatrician, pastor, and/or social worker.
- Women of color are either without health insurance, or have insurance plans that do not cover mental health services, especially during pregnancy. Medicaid, for example, often lapses in many states six weeks after pregnancy, leaving many without continued coverage and access to mental health care.
- We are not informed or aware of what places us at a particular risk for developing one of these illnesses compared to Whites.
- We simply aren’t aware of the symptoms of perinatal mood disorders.
- Stigma around mental illness is prevalent in our cultures but this is especially true when it comes to motherhood. Our cultures place a significant emphasis on us being silent about our struggles, taking care of everyone else before ourselves, turning to religion in an effort to overcome, and on being strong in the face of adversity-particularly in the face of oppression, racism and other socioeconomic stressors. Seeking the help of a professional, and disclosing our symptoms is seen as a sign of weakness so much so that we ignore the need to make our mental health a priority. Health advocacy efforts focus solely on physical illnesses such as diabetes, heart disease, stroke, infant mortality, and cultural disparities in breastfeeding rates. The latest statistics show that women of color and those living at or below the poverty line have a higher rate of occurrence, yet none of the national organizations dedicated to empowering and serving minorities discuss maternal mental health and the disparities that exist in regards to diagnosis, support, and treatment. This is preposterous and negligent considering our rate of occurrence is 1 in 4.
- Our reasons for not discussing it publicly are a significant barrier to raising awareness and seeking treatment. We face racial and gender discrimination in our places of employment so as you can imagine, disclosure of a postpartum mood disorder can increase the risk of losing our jobs significantly. Many of the women I’ve spoken with have expressed this fear, with several stating it was the sole reason they didn’t seek treatment either during pregnancy or when their symptoms peaked during their child’s first year. Support from family and friends is often minimal due to culture specific stigma and ignorance surrounding mental illness. Many of us living at the poverty line or who are in the lower-income bracket utilize the help of social services such as SNAP, WIC, and TANF; speaking from personal experience, I can say being under scrutiny from social workers and the state triggers fears of losing your children for being seen as unfit to care for them.
- Lack of research. I’ve grown incredibly frustrated in my efforts to find consistent research on this issue because, quite frankly, it’s pretty scant. Most of the research that focuses solely on women of color and perinatal mental health is also out of date, with data from the late 90’s and early 2000’s.
- Lack of targeted advocacy. We do not see women who look like us in literature doctor’s offices, or on websites that talk about perinatal mental health. There are very few if any advocacy campaigns or outreach targeted specifically towards us, like there are for other health issues and breastfeeding. Advocacy organizations often focus on minority mental health only during designated months once or twice a year, instead of on a consistent basis. Many organizations simply focus on all pregnant and new mothers, which is fine, but such a general scope ignores our unique experiences with mental health. Our disparities in support and treatment due to socioeconomic stressors, our particular needs, the risk factors we face, as well as the role culturally specific stigma plays as a barrier are not taken into consideration when calls to action are given. They are mentioned as an afterthought, a sentence or two in a post or article. The results of such inattentiveness are programs and initiatives that are not inclusive of our unique needs. Finally, we lack support groups in our own communities as well as safe spaces online to talk with other women like us who understand our unique struggles as mothers, which for many of us creates a very isolated existence.
This has to change. It’s unacceptable and as a woman of color and survivor of postpartum depression and anxiety, it hurts my heart to know our maternal mental health isn’t being actively prioritized, much less thought of. While I fully understand that postpartum mood disorders don’t discriminate in terms of who they impact, and that the need to help pregnant and new moms is great all across the board, I also know that efforts are seriously lagging behind when it comes to the maternal mental health of women of color. We MUST do better. Later this week, I will talk about how we can but for now, I’m interested to hear your thoughts. Mothers of color, what has your experience been, and what kinds of supports and programs do you think would serve us better? What kind of improvements would YOU like to see?