With May being Mental Health Awareness Month, it’s critical to raise awareness around disparities in mental health treatment. A recent study published in JAMA Psychiatry shed light on the role mental health plays in maternal mortality, particularly impacting Black mothers.
The report revealed that mental health issues accounted for a significant portion of maternal deaths, comprising a staggering 1 in 4 cases. These issues ranged from suicide to drug overdoses, marking a rate twice as high as maternal deaths caused by postpartum hemorrhage, the second leading cause.
Furthermore, the findings underscored how various factors such as prenatal stress, financial instability, and environmental conditions significantly influence pregnancy outcomes, all of which Black women are more likely to encounter at elevated rates.
Black women are also reported to experience mortality rates 2.6 times higher than white women. Additionally, while Black mothers are twice as likely as their white counterparts to face maternal mental health conditions, they are only half as likely to receive treatment. It’s also revealed that approximately 40% of Black mothers are affected by maternal mental health issues, according to the Maternal Mental Health Leadership Alliance.
Dr. Judith Joseph, a multi-faceted leading board certified Psychiatrist, Media Consultant and award-winning Content Creator has lended her expert advice to curate an in depth list of 10 ways Black mothers can nurture and cultivate their mental health in honor of Mother’s Day:
1. Know Your History
First, if you have preexisting mental health conditions, acknowledge that before you deliver and have a plan for that. Within the Black community, there’s so many types of traumas that we experience from a collective standpoint, like microaggressions daily. Also, acknowledging that we have the highest rates of PTSD of all groups. That in itself is a helpful predictor. The number one thing you can do is know your past, know your history, and then bring that to the table with your provider.
2. Physical Medical Conditions
When you’re coming up with your plan, think about things from different buckets. Always think of conditions as being biopsychosocial, that’s like a medical model. If you want to look at one as being biology, what are your medical conditions that put you at risk for depression? Do you have a history of high blood pressure? Do you have a history of asthma? These are things that can cause a worsened mental health state. Make sure to get those medical conditions under control.
3. Identifying Coping Mechanisms
If you’re someone who’s never been in therapy, enroll in a therapy or get into a group support, you know. If you don’t want to do one on one therapy, there are group dynamics you can do. Those include the psyche aspect of the bio psychosocial model. The social model is what are the things in your environment that add stressors to you.
If you’re someone who is in a high stress job and you’re going into this phase of life where you’re going to have to return to work as a working mom, maybe you want to think about not having those full hours. Maybe you want to think about asking for support from your coworkers. And if that is not an option, you may want to think about whether or not that job is something that you can do long term.
We don’t want to invalidate. The reality is that most people can’t, they really can’t. They may say they can, but the pressures are the reason that we have these alarming numbers. Other things in the social component are substance use. If you’re someone who used to cope with stress, before you had your baby, with booze, drinking a lot of wine or like having a couple of drinks, that’s not something that is going to sustain you. If you’re going to be breastfeeding, and returning back to work, you can’t you can’t do that.
If you’re someone who smokes excessively, like if you used to cope by smoking weed, also something you really can’t do when you’re breastfeeding and want to take care of a baby. So these are the social components you want to think of. What are ways to cope that don’t involve maladaptive coping mechanisms? What are things in your environment? Who are places where you can seek support?
4. Asking For Help In Advance
Start planning ahead and asking people for help in advance. Think about who you helped when they had a baby. You may say to them, listen, I’m someone who’s going to need support when the baby comes around. Do you think that you can return the favor or is it possible for you to come by once a week to help me so I could take a nap?
If you’re someone who has a lot of other duties at home, you may want to ask someone to come and help you with laundry. Someone to help you with meal prep. You know, these are things people women don’t ask for. We just assume that we’re supposed to do it all, but those things just don’t get done. Then we feel like we’re bad mothers. We feel like we’re not doing what we’re supposed to be doing. So we just quietly suffer in shame. But having these open discussions and saying, ‘it’s okay to ask for help’ goes a long way.
5. Researching Lactation Consultants
We all assume that once you have a baby it’s healthy, but that’s not always the case. Sometimes babies have a hard time breastfeeding. And in my practice, what I do is I, in advance, ask my clients to reach out to a lactation consultant on their insurance plans to have an appointment set up. I know it sounds a little proactive, but I can’t tell you how many people end up utilizing it. They say thank you for recommending this because I just thought that breast milk would just flow and the baby would latch and things would go well. But that is a huge source of stress for women. And again, we don’t talk about it because there’s this underlying belief that like, oh, there’s something wrong with me. I must have done something wrong because I’m not producing milk or my baby’s not latching. But that’s not true.
There are many places in the world where a third of the babies don’t breastfeed because of that issue. So again, not blaming your body, not blaming yourself and setting up these rescue measures in place because that’s an area where your insurance will cover it. There’s also these groups, one of the ones in New York is called La Leche League. But they have branches all around where there are groups of women who get together to give advice with regards to lactation.
6. Prepping For Anxiety – Overcoming Fear Of Medications
A lot of my patients who become pregnant after they’ve started using an antidepressant for anxiety or for depression, think that they have to come off of that. That is a complete falsehood. There’s a lot of data that shows that these antidepressants are safe and you can continue taking them during pregnancy, but people feel shamed and they feel like if I take a medicine that could impact my child. Well, think about not being on that medication and having those high stress levels, having poor sleep and then having depression. That’s impacting your child, too.
When you think about medical conditions, if you are on your high blood pressure medicine and let’s say that medicine could potentially impact a child’s development, your doctor would just switch it to a different low pressure medicine. I think that preparation is really important and it’s a taboo topic, and people don’t like talking about it, but it’s really important to know that medications can be safe and you can continue these medicines during pregnancy.
7. Birthing Classes
Many women do not take these birthing classes because they think that, oh, like, those are old school. But I think they can be very beneficial because human brains are totally afraid of the unknown. If they don’t know what to expect, then they imagine the worst. We imagine the worst, right? I think that these birthing classes are a form of exposure therapy. When you arm yourself with information and knowledge and you know what the steps are, you take steps to prepare for an event. You feel better about it. You feel a sense of empowerment. You feel more in control. I think it’s worth it to take these classes, and many are available online so you don’t have to leave your home.
8. Setting Realistic Expectations
We all have to have realistic expectations. If you are doing this on your own, if you’re a single mom, have a realistic expectation that it’s going to be difficult. If you’re doing this with a partner who is not supportive, have a realistic expectation that they’re not going to automatically change because a baby’s coming into the picture. People are who they are, and they’ll continue to be who they will be. And many times they go worse. The negative side of their personalities get worse under stress. In fact, expect them to deteriorate. They will regress.
There are a lot of studies that show that many men go through something like a postpartum depression male depression. Some studies even link that to lower drops in testosterone in the same way that postpartum depression is due to a drop in progesterone in the brain for women. Many studies show that men have decreased testosterone when a new baby comes into the home. Some of them can go through a little adjustment period where they get depressed. So be realistic about it.
The first ever FDA approved medications for postpartum depression came out just within the past decade. I worked on those studies. I helped to get the study of those drugs approved. So there are new medications. Even the companies that manufacture medications have programs to help mothers who can’t afford to pay for them.
9. Addressing Postpartum OCD, Psychosis & Mania
Most of us think about postpartum depression, but there’s something called postpartum OCD. This happens when you obsess about your baby living. Obsess about your baby being clean. Obsess about germs. Obsess about whether or not you have something wrong with you. And in some cases there is something wrong, right? You want to check it out.
In other cases you’ve done your due diligence. You got to see the doctor. Everything’s fine. But you have these persistent ruminations that keep you up at night, that make you even start to feel like you’re losing touch with reality, they can cause suicidal thinking. I think postpartum OCD is something that’s largely overlooked, but it can be just as distressing as a postpartum depression.
There is also something called postpartum psychosis and postpartum mania. If you have a history of severe depression, you’re more likely to develop a psychosis where you start hearing things and seeing things, hallucinations and postpartum mania. People with a history of bipolar depression may have more manic episodes when they deliver. That’s why it’s important to know your history. These are all things that are important to bring to the table, to your provider when coming up with a treatment plan.
10. Do Not Fear Advocating For Yourself
Know that medical bias within medicine exists. Even discrimination within the Black community exists. Black doctors can discriminate against Black patients. If you’re not feeling heard, validated, seen and understood by your provider, get a second opinion. Switch. Because the reality is that the numbers are scary and they’re not looking good for us as Black women. This is life or death. In this day and age, you really are your best advocate.
Dr. Joseph concludes by emphasizing how important it is right now, more than ever for Black mothers to truly prioritize their mental health and well being.
“We are in a crisis. There’s no other way to sugarcoat it. Because of systemic bias within health care, we have to look out for ourselves. No one’s coming to rescue us, unfortunately. This is not just about you taking care of yourself. It’s about looking out for the mother who’s delivering next to you,” Dr. Joseph said.
“When you go to these clinic appointments, I remember when I was going through my fertility treatments and I was going through my labor and all of that, you have a choice. You can sit in a waiting area, mind your business, or you can create a sense of community. We can talk to each other. We can build and support each other. We can create online forums because that’s how movements begin. They begin with communities, especially with Black women and our help.”
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Hunter Gilmore
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