"​Moms of color have an increased risk of experiencing PPD and related disorders than women in other ethnic groups, but fear is keeping them from getting the treatment they need. Here’s why, and how Black families can get the right mental health support."

"During her first year as a mom, Karen Flores, then 31 years old, was afraid she was not emotionally stable enough to take care of her daughter. On the particularly hard days, Flores would take a walk with her daughter on the beach. “Out of nowhere, this bizarre thought came to my mind ‘push the stroller over the rocks and see what happens,’” she wrote on the site Maternal Mental Health Now. “I was paralyzed by the thought but forced myself to keep on walking while wondering where it had come from—'Oh, My God, am I crazy?' I wondered.”

Flores, now 50, was not crazy. She was suffering from postpartum depression, a condition that affects up to one in seven women, according to the American Psychological Association. Flores didn’t immediately seek out help. “I was extremely anxious and ashamed thinking that I was losing my mind and that my baby would be taken from me,” she says. “I tried praying and did a lot of cardio.” Before her daughter’s second birthday, she began working with a therapist to manage the symptoms of her depression.

​Black women like Flores are less likely to get help for postpartum mental health issues compared to both white women and Latinas, according to a study published in the journal Psychiatric Services. Part of this hesitation is caused by fear—these women fear they will be considered unfit and have their children taken away from them by Child Protective Services. These fears are not unwarranted since one in nine Black children will spend time in foster care by the time they're 18, according to data from the Adoption and Foster Care Analysis and Reporting System. This is the second-highest risk racial/ethnic group to end up in the foster care system behind Native American children.

“There’s a lack of trust of medical practitioners within the Black mom community nationwide,” explains Shivonne Odom, LCPC, LPC, founder of Akoma Counseling Concepts, LLC, in Silver Spring, Maryland, who specializes in maternal mental health counseling for mothers with perinatal disorders. “Many medical practitioners are not trained to refer or treat perinatal mood disorders so when they hear patients report typical symptoms of postpartum depression, practitioners mistake the severity of the symptoms for abuse.” Odom, who is Black herself, adds that many practitioners do not recognize a difference in how perinatal mood disorders present among ethnic groups. “This leads to improper treatment or poor rapport between practitioner and client,” she says.

Postpartum depression, anxiety, and other perinatal mood and anxiety disorders can affect any mother and can manifest up to one year after delivery. However, there are cultural nuances during pregnancy, labor, and delivery that can increase the risks of experiencing PPD for Black mothers. Statistics show that Black women are three to four times more likely to die during or after delivery than white women. From 2011 to 2015, there were 42.8 deaths per 100,000 live births for Black non-Hispanic women—a higher ratio than any other ethnic group. “These statistics along with birth trauma and untreated mental health issues prior to and during pregnancy may lead to postpartum depression,” Odom says.

Suffering in silence

Odom says she often sees the same themes preventing Black mothers from seeking mental health therapy. First, there’s the fear of losing control, independence, respect from others, or mental sanity. “Sometimes holding in this fear leads to a manifestation of irrational thoughts—'I’m not a good mom,’ ‘I feel empty,’ ‘I’m not emotionally connecting to my baby,’” she says. “The belief that something is wrong, which must mean I’m doing something wrong and I’m a bad mom is an extension of these irrational thoughts.”

Then she often hears that these women would prefer to seek help from their friends, family, and church rather than a mental health professional. “There’s definitely a cultural stigma discouraging mental health counseling in the Black community,” Odom explains. “Some believe that if you go to therapy you have to be admitted to a psychiatric hospital or will be required to take addictive prescription medications. Some people’s religious beliefs also shape their views on mental health and can impact their help-seeking behaviors.” There’s also concern passed down from generation to generation that mental health practitioners are suspicious of Black mothers."

By: Shanicia Boswell | August 26, 2020

"​Raising awareness about the history of Black breastfeeding and the factors that contribute to low rates of Black mothers breastfeeding is an important way to close the gap."

"I sat on the sofa crying silently between my mother and my fiancé. Tears spilled over my cheeks as we watched a movie and I held my newborn daughter. I was three days postpartum and my breasts were painfully engorged with milk. How was this happening? I had survived a med-free labor and delivery. This was supposed to be the easy part. Looking back nearly eight years ago at my breastfeeding journey, I always remember this day. I was a first-generation breastfeeder.

​That day and many other days, I sat between people I loved the most and felt completely alone and isolated. My partner could not help me with breastfeeding because he was a man who had no experience around breastfeeding. My mother could not help me because she had not breastfed me or my brother. My friends could not help me because I was the only one in my friendship circle who had a baby. Like many Black millennial women, I was embarking on this journey alone.

​Without the proper resources, my breastfeeding journey only lasted six months. I felt defeated. In fact, the statistics show that Black women are less likely to start breastfeeding than any other race of mother and even less likely to continue breastfeeding for six months. Only 69 percent of Black women initiate breastfeeding compared to 85 percent of white women. The question that is often asked after hearing statistics is why? There are many reasons. There are unfortunate events deeply connected to our race as a people: a history of wet nursing, oversexualization, lack of economic and familial support, are a few. For me, the question became how do we raise the numbers?

This is where Black Breastfeeding Week comes in. Black Breastfeeding Week is August 25 to 31, 2020, and is a campaign that has been part of National Breastfeeding Month for the past eight years. This year, through virtual events, Black mothers, lactation experts, and public health professionals have space to discuss their breastfeeding journeys, raise awareness, and explore public policies that address the disparities in statistics around Black maternal and infant care. Black Breastfeeding Week has become even more controversial this year because we are in a time where extreme emphasis has been placed upon race and it creates a space where white mothers feel isolated. White mothers are asking why Black women are choosing to segregate themselves, even down to the topic of breastfeeding. 

As the creator of Black Moms Blog, a collaborative blogging platform for mothers of color, I am no stranger to the "why aren't we included" questions from white mothers. The truth is, weeks like this should not have to exist. Platforms like mine should not be a necessity—but they are. The needs of Black mothers as well as the specific barriers we face are left out of the overall breastfeeding conversation. The historical and cultural context as to why is important.

​The History of Black Breastfeeding

Cultural reference should always be considered when discussing breastfeeding. During slavery, Black women were used as wet nurses. A wet nurse is someone who breastfeeds another woman's child. The true definition of a wet nurse states "employed," but replace that word with "forced," and the reality becomes clear. It is generational that Black women have developed a disdain for breastfeeding due to our historical relationship with wet nursing. Because of wet nursing, many Black women were unable to breastfeed their own children. Can you imagine the psychological effect that must have had on a moment that every mother should enjoy?"

"The coronavirus pandemic has brought on a slew of challenges for expecting women and new parents. With so much uncertainty, women must take care of their mental health. Because COVID-19 has disproportionally affected people of color, mothers in these communities need more support than ever, as people of color have less access to mental health services compared to white people. Moreover, when they do receive care, it is likely to be of poorer quality.

​In honor of National Pregnancy and Infant Loss Awareness Month, we spoke with Shonita Roach, executive director and spokesperson for the 2020 Multicultural Maternal Mental Health Conference, to learn why discussing issues that directly affect maternal mental health will positively impact women of color.

"This awareness month is very dear to my heart, as I also lost my son to an accidental death nearly 18 years ago, and I suffered postpartum depression and even contemplated suicide," Shonita told POPSUGAR. "Through extensive therapy, parenting classes, and spiritual healing, I have been able to thrive, create a loving family with my three boys, and serve as an advocate for women and mothers."

How a Lack of Diversity in the Medical Field Is Affecting Black Maternity Health

It's widely known that Black women experience higher chances of maternal health complications than white women in the US, and unfortunately, the lack of diversity in healthcare professions isn't making it any easier for women of color to get the help they need.

"When you talk about mental health or seeing a therapist or even taking medication for the condition, there is a lot of judgment and misnomers," Shonita told POPSUGAR. "So when you take into account the implicit (and explicit) bias against Black women and healthcare, it makes it especially challenging. The lack of multiculturalism in mental healthcare, from a discrepancy in diverse professionals to the lack of community-based services, creates a major barrier that is difficult to overcome."

Additionally, having more nonwhite doulas and medical professionals can have a positive, lasting impact on maternal health across the board. "Studies show that having doulas of diverse backgrounds contributes to reducing maternal and infant mortality rates," she explained. "What I love about doulas is that they are community-based and do a lot more intimate, one-on-one work with women. They fill the gap where the traditional healthcare system lacks."

How COVID-19 Has Negatively Impacted Black Maternal Health

COVID-19 has disproportionately affected communities of color, and in turn, has extended to Black maternal healthcare. While Shonita is encouraging families to do whatever they can to limit their exposure to the virus, she knows that can be difficult to do when you're pregnant or have just welcomed a child.

"It's important that communities everywhere practice the safety precautions to reduce the spread of this deadly virus," she explained. "However, those same precautions, such as reducing the use of public transportation unless absolutely necessary, isolating yourself, and staying home puts further strain and stress on expecting and postpartum women."
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"Not only that, the acceleration of the need for accessible technology and internet services proves to be paramount during the pandemic," she continued, noting how access to telehealth is a privilege and can be a challenge for marginalized communities. "The pandemic is also very isolating when it comes to prenatal visits: women are having to attend these alone without their partner or support system. Also, your friends and family are no longer allowed to visit the hospitals during and after delivery. The entire situation is so unfortunate and does not create a conducive environment for a healthy state of mind as you transition into motherhood, whether you're a first-time mom or a mother to multiple children."

Black Women's Struggle With Accessing Reproductive Healthcare

We would be remiss if we didn't mention some of the historical and cultural reasons that Black women have struggled to get adequate access to reproductive healthcare in the US.
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"Medical experimentation on the bodies of women of color and the oversexualization and degradation of Black breasts — which contributes to negative stigmas on Black breastfeeding — are just two examples of why it negatively impacts the sexual and reproductive health of Black women," she said. "This creates barriers of mistrust, misinformation about our bodies. All of this plays into the current disparities and stigmas surrounding reproductive health in marginalized communities."

By: Jessica Grose | December 23, 2020

"When I spoke to Dr. Stephanie Whitener, 41, an anesthesia critical care physician and mother of two, the parent-teacher organization at her son’s elementary school was planning an in-person happy hour for teachers. “I spent yesterday trying to rally all the parents I knew in health care to stop it, because of the risk to them, and also to in-person learning,” said Dr. Whitener, who lives in Charleston, S.C.

Though they did end up canceling the happy hour, “it feels like I live in two different realities,” she said, one where people take the virus seriously, and another where they don’t. That dichotomy can make the emotional and psychological toll of treating Covid-19 patients even harder to bear.

As this strange and difficult year draws to a close, I wanted to highlight the experiences of parents who are medical workers — and thank them for their service. Like so many other essential workers, they have put their physical and mental well-being on the line in 2020 to do their jobs. These frontline workers are at greater risk for burnout and PTSD than the general population. Some have been separated from their children for weeks at a time, communicating only on Zoom.

Like all parents, they’re worried about their own kids, socially, academically and emotionally — while also fretting about the children who are falling behind in school because of the barriers to remote learning, and who may be grieving over family members lost to the virus. And even after more than 300,000 deaths in the United States alone, some health care workers are still trying to convince their communities that the virus is a real threat.

“Some of the first deaths I experienced were people only 5 to 10 years older than me, not 70-year-olds,” said Brianna Tremblay, a 36-year-old I.C.U. nurse practitioner in northern New Jersey. She is also the mom of a 3-year-old and pregnant with a baby due in January. Her distress was especially overwhelming in March and April, when the first surge of the virus was hitting the New York City region. “I came home from work every single night and cried with my husband,” Tremblay said.

“When a patient would crash, we would spend hours in the room trying to save them, and then have to call the family,” to give them the bad news, Tremblay said. Her I.C.U. had a mortality rate of 80 to 90 percent in March and April for Covid-19 patients. “It truly was a war zone.”

Several of the workers I spoke with caught the virus themselves. Cecilia Duran, a 38-year-old midwife in New York City, fell ill in March, when she was 10 weeks pregnant. In addition to fairly intense symptoms — “worse than the flu,” she said — she was also dealing with the nausea and fatigue of early pregnancy. “I was quarantining with my toddler, who was also sick, and my husband was trying to figure out his working from home situation in a small New York apartment,” she said. “It was complete insanity.”
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Dr. Mary Thomas, a pediatrician in New Jersey, said that she’s much more worried about many of her young patients than she is about her own three children (her whole family already had the virus and recovered). “I’m seeing so much anxiety and depression, and a lot of it has to do with this terrible year,” Dr. Thomas said. “Parents are unemployed or losing money or stressed on top of it, and kids are on screens for hours a day.”

By Cory Turner| October 29, 2019

"Childhood anxiety is one of the most important mental health challenges of our time. One in five children will experience some kind of clinical-level anxiety by the time they reach adolescence, according to Danny Pine, a child and adolescent psychiatrist at the National Institute of Mental Health and one of the world's top anxiety researchers. Pine says that for most kids, these feelings of worry won't last, but for some, they will — especially if those children don't get help.

Here are six takeaways that all parents, caregivers and teachers can add to their anxiety toolkits, including information on how anxiety works, how parents can spot it and how to know when it's time to get professional help.

1. Anxiety is a fear of the future and all its unpredictability.

"The main thing to know about anxiety is that it involves some level of perception about danger," says Pine, and it thrives on unpredictability. The mind of an anxious child is often on the lookout for some future threat, locked in a state of exhausting vigilance.

We all have some of this hard-wired worry, because we need it. Pine says it's one of the reasons we humans have managed to survive as long as we have. "Young children are naturally afraid of strangers. That's an adaptive thing. They're afraid of separation."

Full-blown anxiety happens when these common fears get amplified — as if someone turned up the volume — and they last longer than they're supposed to. Pine says separation anxiety is quite common at age 3, 4 or 5, but it can be a sign of anxiety if it strikes at age 8 or 9. According to research, 11 is the median age for the onset of all anxiety disorders.

A bundle of factors contributes to a child's likelihood of developing anxiety. Roughly a third to half of the risk is genetic. But environmental factors also play a big part. Exposure to stress, including discord at home, poverty and neighborhood violence, can all lead to anxiety. Research has shown that women are much more likely than men to be diagnosed with an anxiety disorder over their lifetime and that anxiety, as common as it is, appears to be vastly underdiagnosed and undertreated.

That's why it's important for parents, caregivers and teachers to spot it early. Be on the lookout for how long anxious feelings last. A few weeks, Pine says, usually isn't a cause for concern. "It's really when it goes into the one- to two-month range — that's where parents should really start ... worrying about it."

Here's another red flag: "Are there things that the child really wants to do or needs to be doing, and they can't do those things?" asks Krystal Lewis, a colleague of Pine's and a clinical researcher at the National Institute of Mental Health who provides therapy to anxious children. "If you feel you're hitting a wall in terms of trying to get the child to do those things, that might be another indicator that potentially, you know, we should get some help."

We all have some of this hard-wired worry, because we need it. Pine says it's one of the reasons we humans have managed to survive as long as we have. "Young children are naturally afraid of strangers. That's an adaptive thing. They're afraid of separation."

Full-blown anxiety happens when these common fears get amplified — as if someone turned up the volume — and they last longer than they're supposed to. Pine says separation anxiety is quite common at age 3, 4 or 5, but it can be a sign of anxiety if it strikes at age 8 or 9. According to research, 11 is the median age for the onset of all anxiety disorders.

A bundle of factors contributes to a child's likelihood of developing anxiety. Roughly a third to half of the risk is genetic. But environmental factors also play a big part. Exposure to stress, including discord at home, poverty and neighborhood violence, can all lead to anxiety. Research has shown that women are much more likely than men to be diagnosed with an anxiety disorder over their lifetime and that anxiety, as common as it is, appears to be vastly underdiagnosed and undertreated.

That's why it's important for parents, caregivers and teachers to spot it early. Be on the lookout for how long anxious feelings last. A few weeks, Pine says, usually isn't a cause for concern. "It's really when it goes into the one- to two-month range — that's where parents should really start ... worrying about it."
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Here's another red flag: "Are there things that the child really wants to do or needs to be doing, and they can't do those things?" asks Krystal Lewis, a colleague of Pine's and a clinical researcher at the National Institute of Mental Health who provides therapy to anxious children. "If you feel you're hitting a wall in terms of trying to get the child to do those things, that might be another indicator that potentially, you know, we should get some help."

​2. Be on the lookout for the physical signs of anxiety.

The worried feelings that come with anxiety can seem hidden to everyone but the child trapped in the turbulence. That's why it's especially important for grown-ups to pay close attention to a child's behavior and to look for the telltale signs of anxiety in children.

Anna, of Brampton, England, remembers when her 7-year-old son started having trouble at school. (We aren't using parents' full names to protect their children's privacy.)

"He was just coming home and saying his stomach hurt. He was very sick," Anna says. When she followed up with him to try to get to the root of his stomachache, she says, "he did tell me he was worried about school, and he told me specifically it was a teacher that he was worried about."

A stomachache, headache or vomiting can all signal anxious feelings, especially as a child gets closer to the source of the anxiety.

"You'll see that they'll have a rapid heartbeat. They'll get clammy, you know, because their heart is racing," says Rosemarie Truglio, the head of curriculum and content at Sesame Workshop. "They'll become tearful. That's another sign. ... Anxiety is about what's going to be happening in the future. So there's a lot of spinning in their head, which they're not able to articulate."

It's near this point of panic that Pine says a child's anxiety is most visible: "So you can see it in their face. There is a certain way the eyes might look. You can see it in behavior in general. People tend to either freeze, be inhibited not to do things when they're anxious, or they can get quite upset. They can pace. They might run away."

Rachel, of Belgrade, Mont., says her 6-year-old son really doesn't want to swim or go to their local splash park.

"He just says there's too many kids in there. And he cries, and I've tried to go early in the morning when there's no one there. I mean, I've lost count of how many times we've driven by just to see if I could get him out of the car and he won't. And I'm not going to drag him."
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We heard this from so many parents: My child is terrified to do something that I know won't hurt them, that they might actually enjoy. What do I do?"