Maternal Depression In Women of Color
Emptiness. Loss. A heavy feeling in your core and the Sahara Desert in your throat. Depressive episodes alter our emotional, physical, and mental states. For women having just given birth, a depressive episode is most likely “maternal depression.” Women of color are especially susceptible to its effects, yet there’s a significant gap in diagnosis and treatment within the WOC community.
What Is Maternal Depression?
Maternal depression consists of a range of conditions. It can affect women during pregnancy, immediately after childbirth, or even up to a year after. When left untreated, maternal depression may affect a woman’s physical, mental, and emotional health. This could also affect the child’s development, learning, and lifelong success.
Family history, life stressors, and difficulty during childbirth are some key factors. Maternal depression can also stem from substance and alcohol abuse, maternal age, and lack of family planning. Treatment options include therapy and prescription antidepressants.
Types Of Maternal Depression
Maternal depression presents in four different forms:
- Prenatal Depression occurs during pregnancy. Symptoms include: crying, sleep problems, fatigue, appetite change, anxiety, loss of enjoyment for activities, and irritability
- Baby Blues appears within the first few weeks after delivery. It usually goes away within two weeks. Symptoms include crying, irritability, anxiousness, mood swings, insomnia, fatigue, and strong empathy.
- Postpartum Depression is the most known and, like baby blues, appears immediately after delivery. The main difference is that it stays for 2-3 months. It can include the symptoms above, as well as: poor concentration, forgetfulness, guilt, insomnia, inability to care for one’s self, the newborn, and the family. Also, physical symptoms like chest pain, loss of pleasure, and suicidal ideation.
- Postpartum Psychosis happens anytime during the first year. It is characterized by hallucinating sounds and visions, hopelessness, anger, deliria, confusion, mania, suicidal or homicidal delusions, and an urge to harm the infant.
Recognizing the type of depression a woman is experiencing helps to identify the best form of treatment. When it comes to communities of color, however, diagnosis and treatment become challenging.
Facing The Reality Of The Research Data
Studies have indicated that women of color are at a higher risk for postpartum depression (PPD) than white women. African American women are twice as likely to experience PPD compared to white women, and Hispanic women doubling that statistic. Non-Hispanic Black, Latina, and Native American mothers statistically experience higher rates of divorce, homelessness, domestic violence, and other “toxic stressor landscapes.” These issues stem from stressors like unemployment, lack of insurance, and segregation.
Though it seems easy enough to blame money for the high numbers of PPD in Black and Hispanic women, it isn’t the whole picture.
The same study found that non-Hispanic Asian women, who on average experience a higher SES relative to other women of color, experience depression disproportionately. PPD differs based on ethnicity, with ethnically Chinese and Indian women experiencing lower rates of depression compared to Filipina women experiencing the highest. Low SES is a strong suspect, but it isn’t the only player in the game.
Addressing The Lack Of Diversity In Healthcare
The lack of diversity in healthcare can become detrimental in diagnosis and treatment, and maternal depression is no exception. Between various ethnic groups, physicians may misinterpret symptoms or lack culturally sensitive training. Language barriers play a large role in miscommunication. Even between native-English speakers, “mental illness” is communicated differently. Black women, for example, don’t typically say “depression,” but just that they “don’t feel like themselves.” Patients also prefer clinicians who have similar backgrounds to build a sense of trust and reliability.
Additionally, the stigma around mental health in many communities remains strong. Almost 50% of women don’t report PPD, with anecdotal evidence indicating Black women typically avoid this topic out of embarrassment, shame, and anxiety about discrimination. “Mental Health” sounds dirty and “depression” doesn’t exist to traditional thinkers in the community. Intersect this stigma with the public image that mothers are community strongholds—and shame around vulnerability rears its ugly head.
A case study by Kaiser Health News interviewed Portia Smith, who at 18 years old, was juggling two children with little help. In the article, she admitted she didn’t breastfeed her youngest to avoid connecting with her (a symptom of PPD!).
“You’re young and you’re African American, so it’s like [people are thinking], ‘She’s going to be a bad mom’,” Smith admits.
Being vulnerable about mental health was a challenge for Portia. She not only experienced PPD but recognized the impact on her daughter’s development. The causes and effects of this case show the importance of seeking, and getting, quality, healthcare and changing the community’s conversation around mental health.
Inadequate Insurance Coverage Widens The Gap
Another challenge mothers face with PPD is inadequate insurance plans. Remember when I said low socioeconomic status isn’t the only factor? It still isn’t, but it does make up a large component of it, and that is through employer-provided insurance. In low-income communities, jobs are already hard to come by, and positions with quality benefits are even more difficult to catch. Plus, insurance companies, are notoriously bad at providing behavioral healthcare coverage. Black women in particular are disproportionately less likely to have their pregnancy covered by Medicaid. Low-income mothers are removed from the program within 60 days postpartum if they don’t reach the income criteria. (Sidenote: how does that even make sense??!). Even if a woman of color overcomes the economic and cultural barriers, she faces an inefficient insurance system.
Making Moves To Destigmatize
Women of color experiencing maternal depression can’t catch a break. Money, cultural differences, and unacceptable insurance policies create a doom-and-gloom outlook to an already cloudy situation. But it’s not all despair. Coalitions, such as the Maternity Care Coalition in Philadelphia, are seeking better ways to treat and diagnose our mothers.
At MCC, their free incubation program paired moms with Marriage and Family Therapy graduate students. For Stephanie Lee, this program was game-changing. She accessed appropriate mental health care in her own home, removing the stigma-related anxiety. No one knew she was going to therapy, and on top of that, she didn’t have to pay for it. By working with the cultural limits and overcoming one, if not all three, of the factors, MCC was able to provide quality care.
Maternal depression should never be ignored, regardless of which
“type” a woman is experiencing. And regardless of her skin color, race, or ethnic background, all mothers should be able to recognize the symptoms of maternal depression and have various opportunities to treat it. Not only does it save mom’s life, but it saves her children, too.
If you or someone you know is experiencing maternal depression, read up on more information in https://www.postpartum.net/ or call the crisis hotline at 1-800-PPD-MOMS
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