Black Maternal Mental Health: What You Should Know & What You Can Do As An Expecting Mother
Author: Afton Jones, LCSW, PMH-C
Pregnancy and childbirth bring many mothers feelings of happiness and joy, but for some it can also bring feelings of fear, anxiety, and trauma. This is especially true for Black women who have the highest rates of mortality, and are more likely to develop a perinatal mood or anxiety disorder than the rest of the US population. Black Maternal Mental Health Week which takes place during the week of July 19th-25th, aims to raise awareness about maternal mental health issues and how they impact Black women.
According to the Black Maternal Mental Health factsheet https://blackmamasmatter.org/wp-content/uploads/2022/08/Factsheet-Black-Maternal-Mental-Health.pdf from Black Mamas Matter Alliance, maternal mental health symptoms are experienced by 40% of Black women, and pregnancy related deaths are 3-5 times more likely for Black women as compared to White women. In addition to these alarming statistics, Black women are less likely to receive treatment.
So why are the numbers significantly higher for Black women? Why are Black women less likely to receive treatment? Some of the reasons include, but are not limited to:
Systemic racism
Lack of awareness and knowledge about maternal mental health and maternal health
Lack of knowledge about available resources
Cultural reasons (use of faith and prayer vs use of a mental health professional)
Fear of judgement and stigma associated with having a mental health diagnosis
Lack of access to care (lack of insurance, low income, transportation issues, etc.)
What are Perinatal Mood & Anxiety Disorders?
Perinatal- pregnancy and postpartum period
Disorder- impacts what is considered normal daily functioning
symptoms persist longer than 2 weeks
There is an increased risk for these disorders during the perinatal period. Symptoms may present differently than they would outside of the perinatal period.
Perinatal Depression
Symptoms may include feeling hopeless, sadness, irritability, loss of interest in baby or things you used to enjoy. Symptoms can also include feelings of guilt, a significant increase or decrease in appetite/weight, and changes in sleep (difficulty sleeping or oversleeping). Thoughts of self-harm or harm to baby can also be present.
Perinatal Anxiety
Symptoms include persistent worries or scary thoughts. Usually these thoughts are related to the health and safety of the baby ("what if I drop my baby when going down the stairs, fear that you and baby will get hit by a car when out for a walk). Panic attacks, sleep disturbances, racing thoughts, inability to relax, and feeling on edge are also symptoms of perinatal anxiety.
Perinatal Obsessive-Compulsive Disorder
PPOCD is sometimes confused with Perinatal Anxiety, but there are some key differences. Someone who has PPOCD will experience repetitive scary intrusive thoughts and mental images. The thoughts are ego-dystonic meaning that they do not align with the person's core beliefs or characteristics (ex: what if I push my baby's stroller into a busy street?). They are very unlikely to act on these thoughts. Someone with PPOCD can have excessive "what if" thinking that does not subside with reassurance or fact calling, and will engage in compulsions to lessen the anxiety that is felt as a result to the scary and intrusive thoughts/images. Ex: Avoiding their baby or not wanting being left alone with baby out of fear that they may them, or obsessively cleaning or sterilization of bottles. Contamination and fear of deliberate harm are two of the most common presentations in PPOCD.
Postpartum Post-Traumatic Stress Disorder
PPTSD is caused by a traumatic experience that occured before, during, or after childbirth. Symptoms may include anxiety, flashbacks and or nightmares of the traumatic event, sleep disturbances, hypervigilance (increased alertness), being easily startled, avoidance of people, places, smells, or any other things associated with the event, or feeling detached.
Bipolar Mood Disorders
Someone with a Bipolar Mood Disorder will experience lows (depression) and highs (mania or hypomania). It is not uncommon for birthing people to be diagnosed with a bipolar disorder for the first time during pregnancy or postpartum. Sometimes, a person with severe episodes of mania or depression has psychotic symptoms such as hallucinations or delusions.
Postpartum Psychosis
PPP symptoms usually start within the first two weeks postpartum and should be treated as a medical emergency. Symptoms may include hallucinations (seeing and or hearing thing or images that others can't), paranoia, and delusions (belief in things that are not true). Ex: my baby is a possessed demon. Unlike Perinatal OCD the thoughts one may experience are ego-syntonic. This means that they believe the thoughts are reasonable and rational and a chance that they will act on them. They may also have periods of confusion and memory loss, and seem manic. Those experiencing PPP may not have the awareness that the thoughts they are experiencing are irrational. PPP is temporary and it is treatable.
I'm a Black woman, who is an expectant mother. What can I do now to support my mental health?
My method for expecting mothers is to PEARS: PLAN, EDUCATE yourself, ADVOCATE for yourself, identify RESOURCES, and identify SUPPORTS. Here's what this looks like:
PLAN
Find a therapist ahead of time
Work with a therapist to identify a plan that is tailored to you
Identify support persons
Research which resources are available
What will you do in the event of a mental health emergency?
EDUCATION
Being knowledgeable about childbirth and maternal mental health is key to being able to make informed decisions.
Attend childbirth classes
Work with a therapist to get an understanding for any warning signs and symptoms you should be aware of
Be sure that support persons are educated about childbirth and maternal mental health
ADVOCATE
Do not be afraid to ask questions when there is something you do not understand or something that poses a red flag to you
Identify what your options are
Get a second opinion
Have support persons who are willing to advocate for you in the event that you are not able to
RESOURCES
Identify and utilize resources that are available to you
Ask friends, family, practitioners, your therapist about available resources that are accessible to you
SUPPORT
Identify people who will help support you throughout your maternal journey
Educate support persons on the best ways to support you and any warning signs they should be aware of
Work with a licensed therapist if you are experiencing any symptoms of a perinatal mood and anxiety disorder
In addition to seeing a therapist, support groups, listening to insightful/educational podcasts, self help books, and talking with friends and family can also be helpful
What resources are available that support Black maternal mental health ?
Black Girls Smile
Black Girls Smile Inc. was founded in 2012, by Lauren Carson. The organization aims to support Black women and Black girls by providing them with mental health resources. Black Girls Smile Inc. offers The Therapy Assistance Program. This program helps address the financial barrier to getting mental health treatment for Black women and girls.
Birth Trauma support for Black, Indigenous, Person of Color (BIPOC) Birthers
The Birth Trauma support group for BIPOC is for Black, Indigenous, or Persons of Color who have experienced mental or physical trauma during childbirth or trauma due oppression, discrimination, racism, etc. The group meets every 4th Wednesday at 7:30PM (EST)/4:30PM (PST) and is run by trained peer facilitators.
Black Moms Connect
The Black Moms Connect support group meets every Tuesday 7:30pm ET/4:30pm PT. The group is for mothers who identify as Black or African American who are pregnant or postpartum (up to two years). The group is a space for Black mothers to connect to provide support, resources, and insight to one another.
Black Moms in Loss Support Group
The Black Moms in Loss Support Group is for persons who identify as Black mothers who are experiencing grief related to a pregnancy loss or the loss of an infant. The Black Moms in Loss Support Group meets on Thursdays at 8pm EST.
Loveland Therapy Fund
The Loveland Therapy Fund makes mental health treatment more accessible by providing financial assistance to Black women and girls to engage in therapy. The application for the therapy fund is open on a quarterly basis.
Therapy For Black Girls
https://therapyforblackgirls.com/ Therapy For Black Girls offers an online directory and a podcast which is aimed to encourage Black women and girls to engage in mental health support and to decrease the stigma associated with mental health issues.
Melanin & Mental Health
https://www.melaninandmentalhealth.com/ Melanin & Mental Health helps connect Black and Latinx/Hispanic communities by use of an online directory to therapist who are culturally competent therapists.
Shades of Blue
https://www.shadesofblueproject.org/ Shades of Blue offers support to women of color during the perinatal period. You can complete an online assessment to engage in online support groups, and also fill out a request to receive baby supplies.
Postpartum Support International (PSI) Helpline
https://www.postpartum.net/get-help/psi-helpline/ The PSI helpline is toll free and can be accessed via phone call or text. Persons who contact the helpline can obtain resources, and general information. Helpline calls are returned daily. between the hours of 8:00am and 11:00pm. The helpline is not to be used for emergency situations.
Phone: 1-800-944-4773 (4PPD) Press 1 for Spanish, Press 2 for English
Text: English: 800-944-4773/Spanish: 971-203-7773
National Maternal Mental Health Hotline
1-833-TLC-MAMA (1-833-852-6262) (Call or text) The National Maternal Mental Health Hotline offers support 24/7 to persons before during or after pregnancy. Counselors provide callers with referrals and resources and can provide interpreter services in 60 languages.
National Suicide Prevention Hotline
https://988lifeline.org/ Call, text, or chat 988
Available 24/7
National Crisis Text Line:
Text HOME to 741741 from anywhere in the United States 24/7 for any crisis. Text are received via a secure platform and responded to by a live crisis counselor.
Hi! I'm Afton, a licensed therapist, and I help mamas navigate the challenges and changes that come with motherhood before and after birth.
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