By: ​Hilary Braaksma

"Pregnancy puts a lot of strain on your body, including at bedtime, which is why finding the best pregnancy pillow is so essential for many women.

Find a little relief for those aches and pains by sleeping with a pillow that’s designed to cradle and comfort your pregnant shape. The latest pregnancy pillows come in a wide array of sizes and shapes to fit your particular needs, whether you’re looking to alleviate back pain or to find a positioning solution as a stomach sleeper

From full-body styles to wedges, the options are plentiful. Some favorite brands include Boppy and Leachco, but they’re not the only brands to shop for some of the best pregnancy pillows available in 2020. Below are seven pregnancy pillows we recommend for an amazing night of sleep."

Moonlight Slumber Comfort-U Total Body Support Pillow​

"​The Comfort-U Pillow by Moonlight Slumber cushions every curve of your aching body with Fusion Foss fiber. It feels soft and stays soft, but it also provides support where you need it most with its classic “U” shape. This is the perfect pregnancy pillow if you want to feel like you’re engulfed in a giant cloud. ($99.95; amazon.com)"

​Boppy Total Body Pillow in Ringtoss

By: Cedars-Sinai Staff| October 21, 2019​

"The biggest misconception women have about exercising while pregnant is that they can't do it at all, says Dr. Keren Lerner, OB-GYN at Cedars-Sinai. "It's not uncommon for women to wonder if working out during pregnancy will put the baby at risk," says Dr. Lerner. "I get asked that a lot."

Not only is it safe for pregnant women to exercise, but engaging in physical activity while pregnant can be beneficial for the health of a woman and her baby.
It can reduce the risk of preeclampsia, gestational diabetes, and hypertensive disorders during pregnancy. It can also minimize discomfort.
The American Pregnancy Association recommends at least 30 minutes of physical activity every day for women who have a normal, healthy pregnancy. 

The best types of workouts for pregnant women
It's important to know that not all pregnancy workouts are created equal. 
Dr. Lerner says workouts like Barre and Pilates are great because they focus on core strength, which can make the delivery and recovery process easier. 
"Prenatal yoga classes can be great for mind, body, soul, and core," Dr. Lerner says, as long as women are careful not to overextend their backs with deep bends or twists.
She also recommends swimming, especially in the third trimester.
"When there's more weight being carried, a lot of women end up with back pain," Dr. Lerner says.
"Because gravity is less of an issue in the water, women tend to be more comfortable in the pool."
No matter what workout they choose, pregnant women should drink plenty of water and take a rest if they start to feel dizzy or lightheaded while exercising.

​Workouts to avoid when pregnant
All pregnant women should avoid contact sports, as well as activities like skiing, snowboarding, rock climbing, horseback riding, and scuba diving.
If the pregnancy is high risk, women should talk to their doctor about their workout options.
Women should also seek medical advice if they get injured while exercising.
While 30 minutes of daily activity during pregnancy is recommended, women who enjoy working out aren't limited to this, Dr. Lerner says.
"Certainly those who are used to working out or have active jobs or lifestyles can endure more," Dr. Lerner says.
"They just need to be sure they're listening to their bodies." 

"Lifestyle changes to improve and prevent symptoms of depression and anxiety." 

By: Sarah Greenberg, MFT

• "Lifestyle changes can help people manage anxiety and depression, and take charge of their mental wellbeing.
• Some behaviors that are linked to improving or preventing anxiety and depression include addressing sleep issues, connecting with others, eating a nutritious diet and exercising.
• Change can be hard, especially for those with anxiety or depression, so it's important to be kind to yourself. 
• The best way to care for your mental health is the approach that works best for you. In some cases, professional help may also be needed."

"When Roy came to see me for longstanding symptoms of depression and anxiety (they often co-occur), he was hesitant at best. He wanted to feel better, but “getting treatment” didn’t fit with his narrative for what he was “supposed to be doing as a grown man” in his culture. He had a decent, consistent job, but felt his life lacked meaning and joy. He was so hard on himself and avoided others for fear of judgement.

I knew he’d run the other way if I jumped too quickly into a medical referral or diagnosis, so we started with the most human approaches — connecting about what was really going on for him, and exploring readily available lifestyle changes that aligned with his interest, motivation, and values. Within weeks, his spark started to come back, and within months he felt he had a new lease on life. He wasn’t suddenly happy all the time. But he felt a new sense of his capacity to take charge of his mental health.

Will everyone have an outcome like Roy from lifestyle changes? Definitely not — anxiety and depression are complex conditions with tremendous individual variation, varied underlying causes, and varied levels of severity. But can everyone benefit from learning the foundation for how to care for their mind either separately or as an adjunct to professional treatment? I believe so.

The following seven health behaviors are key ones linked to prevention or symptom improvement of anxiety and depression. 

While everything on this list is simple, it’s far from easy. Change is hard. And if you currently have depression or anxiety, it can be especially challenging. That’s why one of the key behaviors is being kind to yourself. 

If moved to do so, choose one area to work on at a time, perhaps an area you feel especially motivated or confident to address, or an area that feels aligned with your most important values. Then take it one step at a time. The funny thing about change is we often don’t know it’s happening, we just keep rowing in the right direction, and usually after a few, or a few thousand, twists and turns, we look back in awe at how far we’ve come. 

1. Sleep 

While 10-18% of adults in the U.S. experience chronic sleep issues, this number jumps to 65-90% of those with depression, and over 50% of those with generalized anxiety disorder. Of those with depression, 65% had sleep issues first. Addressing sleep issues can alleviate symptoms of mental health conditions, and given sleep problems are a risk factor for mental health conditions, can also help protect your mental health. 

There are many resources to help improve your sleep, such as this free app.

2. Self-Compassion

A disposition that tends towards self-critical, or perfectionistic, can be a risk factor for anxiety and depression. This can include feeling like you must be perfect to be accepted, an inability to accept flaws within yourself, intense self-scrutiny, or an unrealistic sense of others’ expectations and your capacity to meet them. 
​
Despite the fear of many who have this characteristic, the antidote to perfectionism isn’t letting it all go, or saying goodbye to standards – it’s self-compassion. According to researcher Kristen Neff, self-compassion has three components: self-kindness vs. self-judgment, common humanity vs. isolation, mindfulness vs. overidentification. How we treat ourselves through the ups and downs of life can have a tremendous impact on health and mental health.

3. Social Connection

From the time we are born, we need social connection in order to thrive. 
A recent study lead by researchers at Harvard sought to understand what could most protect us from depression that is within our control. After analyzing over 100 potential factors, they found that social connection was by far the most important protective factor. 
​
It’s been a lonely year for many. And many are anxious at the prospect of going back to normal. But connection doesn’t mean a big party or bustling office. It can be confiding in one trusted person about how you’re really doing, listening to how someone else is really doing, giving a meaningful thank you, or having a (safe) visit with any family member or friend. If this feels out of reach, try making a short list of people who at any point have given you a sense of belonging. Other studies have shown that just calling positive relationships to mind can have a positive impact on our capacity to tolerate stress."

"​In just 5 minutes you can reset your day in a positive way."

"Women who had Covid while expecting experienced guilt, shame and unhealthy levels of stress."

"Kate Glaser had chalked up her exhaustion to being 39 weeks pregnant and having twin toddlers in the house. She also wondered whether her flulike symptoms were a sign that she was about to go into labor. But when she woke up one morning with a 100.4-degree fever, she called her doctor and got a rapid Covid-19 test.

Two nurses came to deliver her results to her in the waiting room. They were dressed in full gowns, masks, face shields and gloves.

“I knew by the eerie silence and the way they were dressed that I was Covid positive,” she said. “It was an emotional moment; I felt really disappointed and shocked and, as a mom, I felt a lot of guilt. What did I do wrong?”

Glaser, who lives in the Buffalo, N.Y., area, returned home and isolated from her husband and the twins in her bedroom, where she spent hours mentally replaying all her activities leading up to the positive test result. She also made a public post on her Facebook page about her positive status, and what she was feeling — guilt, embarrassment and panic. The post went viral, and Glaser started hearing from women around the world who were pregnant and worried about Covid-19. The majority of the of the 2,300 comments she received were supportive; a few were harshly critical.

“I was going down a rabbit hole of guilt and stress,” Glaser said, adding that for her, as much as the physical symptoms were bad, the mental stress of Covid was much worse.

Prolonged stress can have real consequences on pregnant people even outside of a pandemic and has been tied to low birthweight, changes in neurological development and other health impacts in children. And the pressure associated with a positive Covid-19 test increases these mental health risks.

The anxiety is not without reason. As of November 30, there have been more than 42,000 cases of coronavirus reported in pregnant women in the U.S., resulting in 57 maternal deaths. U.S. health officials have said pregnancy increases the risk of severe disease for mother and child, and being coronavirus-positive in late pregnancy may increase the rate of preterm birth.

Prenatal care and birth plans are also disrupted by a positive test result. “Women are expressing so much fear about being infected, but also about going to the hospital, delivering and being separated from their child,” said Laura Jelliffe-Pawlowski, an epidemiologist who is the primary investigator of HOPE COVID-19, a new study that focuses on the well-being of women who are pregnant during the pandemic.

The study launched in July and will follow more than 200 women around the world, from pregnancy to 18 months postpartum, to understand how Covid-19 and the pandemic response impacts pregnancy and infant health outcomes.

Dr. Jelliffe-Pawlowski and her team have analyzed the data from the first group of women, and they are finding “absolutely incredible” levels of stress and anxiety. “Sixty percent of women are experiencing nervousness and anxiety at levels that impede their everyday functioning,” she said, citing preliminary data. “There are a number of women, particularly lower-income women, expressing how hard it is to choose to stay in a job that puts them at risk versus quitting the job and not having enough food for their baby.”

Nearly 70 percent of the participants reported feeling worried about decreasing family income and more than 22 percent worried about food insecurity (though none had experienced it at the time of the survey). Dr. Jelliffe-Pawlowski worried that women were not necessarily getting the psychological care they needed: “If you can’t feed your family, seeking out mental health care is not your top priority.”

She also said more than 84 percent of women reported moderate to severe anxiety about giving birth during a pandemic. “Many women do not want to get tested because they will be stigmatized or separated from their baby or not allowed to have people in the room to support them,” she said. She added that similar visiting rules often hold true for babies in the NICU after being born preterm during the pandemic: Only one parent can be present in a 24-hour period. “It’s heart-wrenching to see families go through those choices.”

Dr. Jelliffe-Pawlowski is particularly interested in how stress impacts births and long-term outcomes for children as psychological stress is highly associated with preterm birth. After the attacks of September 11, 2001, the risk of preterm births almost doubled for people living near or working at the site of the fallen towers. She’s also concerned about long-term effects of stress and anxiety on maternal bonding during the pandemic.

Margaret Howard, a psychologist at Women & Infants Hospital in Providence and postpartum depression researcher at Brown University thinks it is absurd for pregnant women who test positive for an infectious virus to bear any guilt or stress associated with their diagnosis: “Are moms in a special category where they are expected to not get Covid? What about a sinus infection? Hay fever? Cancer? Why is Covid a moral failing for mothers?”

When Erica Evert, a pregnant mom in northern Virginia, received her postive Covid-19 test result, it didn’t make sense. She was near the end of her pregnancy, and hadn’t left the house in four and a half months, except for ob-gyn appointments to check on the baby.

“My first thought was, is this a false positive? I feel fine. And my second reaction was to start bawling,” said Evert. She was scheduled to have a cesarean section with her second baby and the test was merely a formality — until it was a life-changing event.
​
The hospital gave her a choice: She could deliver the next day and be treated as a Covid-19 patient — separated from her baby with no skin-to-skin contact, per the hospital’s policies. Or she could wait 10 days from the date she received the positive test result and deliver with her regular plan. She had four hours to make a choice she wasn’t expecting. “I kept thinking: am I going to make a decision that results in my child dying?” said Evert."

"Registered Dietitian Tracy Lockwood Beckerman gives tips on the most nutritious foods to eat to support your baby in each trimester of your pregnancy."

"The best way to feel empowered during your pregnancy and birthing experience is through education on the process and exercising your right to choose. This starts with making your first prenatal appointment. Making that appointment is imperative, but can feel scary if you do not know what to expect. 

Here are eight steps to help you feel empowered during pregnancy and as you enter into parenthood.

Contact your Insurance Provider

If you do not have insurance at the time of pregnancy, you have options. Please reach out to your local social service agency for assistance with State Assisted Medicaid in order for you to have access to prenatal care.

If you already have health insurance, it is time to do some research. Contact your insurance provider to understand your benefits during pregnancy, which may cover the cost of a birthing center or doula support. Also, speak with your insurance company to discuss preferences for your doctor such as sex of the doctor, ethnic preference, language preference, location preference, etc. You have a right to request what you would like; do not be afraid to ask!

Prepare to Meet Your Provider

Now that your insurance has provided you with options and you have your first appointment scheduled, it’s time for a visit. When getting ready for your first appointment prepare some questions for your provider to help you determine if it’s going to be a good fit. The best way to do this is by having them prewritten on good old fashioned paper or on your phone.

You might be wondering what to ask. Here are a few questions to start:

• Is there a nurse line that I can call if I have questions?
• If I experience bleeding or cramping, do I call you or the nurse?
• What do you consider an emergency?
• Will I need to change my habits regarding sex, exercise, nutrition?
• When will my next prenatal visit be scheduled?
• What type of testing do you recommend and when are they to be done? (In case you want to research the tests to decide if you want them or not.)

Know Your Rights

You made it to your first visit, and the receptionist gives you a clipboard to complete information and documents to sign. Be sure to read the informed consent and pay close attention to your rights as a patient. Learn what to do if you ever need to file a grievance, feel pressured by the doctor, midwife, or staff to participate in testing, or if someone refuses to explain procedures. You have a right to file a complaint with your insurance company and with your state’s medical board if the violation you experienced is egregious.

Ask for Clear Explanations of all Procedures

Now that you have read your informed consent and have your prepared questions for your provider, they will call you back to your appointment. Once you go behind that closed door, ask your provider to explain what will be done during this appointment. It is important for medical professionals to explain what procedures will be done during the visit.
If at any time you feel uncomfortable, please speak up! If you plan to bring a support person such as a partner, friend, or family member to this first visit, it might be helpful to think of a code word beforehand, so your support person can speak up for you if you become overwhelmed.

Don’t forget to ask the questions that you prepared. Feel free to take notes as they answer your questions. Notice how they respond to questions. Do you feel heard or is the provider rushing you? After the visit, take time to reflect on whether or not you felt comfortable with the provider during your appointment. This is a huge deal because if you are not comfortable, it is going to be hard to ask questions or feel as though you are receiving quality care. If you did not feel comfortable, it is okay to search for a different provider. You will be in the care of this individual for 9 months, so it is important to have the right team of people supporting you. You want to feel empowered during your pregnancy.

Bottom line: Tune in to how you feel. As a birthing person, you have choices and rights no matter what birthing environment you choose. If you don’t feel comfortable at any point during your pregnancy, it’s not too late to find a new environment or provider. 

Take Advantage of Opportunities for Education

What creates an empowered pregnancy? Education, education, education! Education allows you to make the best decisions for yourself and your family. Search online for different birth techniques and methodologies, and then find a class at your hospital, with a local organization, or even online!

Take time early in pregnancy to think about how you want your labor and delivery to go. Do research on classes that are in alignment with what you desire during the birthing process. There is something out there for whatever you want your birth to look like. Attending various classes can help you learn about different decisions you will have to make once the baby is born. Classes can help you think through decisions like knowing when you want to cut the cord, what newborn procedures you want your baby to have, when to do baby’s first bath, and infant feeding. Education allows space to have conversations and ask for help where needed so you can have an empowered pregnancy.

​Find a Community of Support for an Empowered Pregnancy

Nothing says empowerment like community. Join a group in your local community or online for additional support. Find a group of expecting pregnant people so you can add to your support team. Every new parent needs support, so do not be afraid; get involved. There is so much power in feeling understood by someone who has been through what you’re experiencing.

Prioritize your Physical Health

Proper nutrition before, during, and after pregnancy can improve birth outcomes and has significant implications for maternal health. Focusing on whole foods especially fruits and vegetables, eating enough protein and limiting processed food can play a role in reducing the risk of pregnancy-related complications, such as preeclampsia. Preeclampsia is a condition that disproportionately impacts Black pregnant people and can be a result of the long-term psychological toll of racism as well as current systemic barriers to proper treatment that delay the diagnosis or treatment of the condition. If this all sounds like a daunting task, you are encouraged to seek guidance from your doctor, midwife, doula, or support team.

Doulas can support your nutrition by offering suggestions for healthy meals and providing accountability and support. They can also make sure you’re being monitored for early warning signs of pregnancy-related complications.

Last but not least, physical exercise is another important aspect of prioritizing your physical health. Yes, it is safe to exercise while pregnant! Walking regularly, stretching, and yoga have been found to have significant benefits during pregnancy for both you and your baby. Being idle and sedentary during pregnancy presents its own risks, so do not be afraid to get your body moving. There are modified workouts that are readily available to pregnant persons. It is important for pregnant persons to speak with their provider about exercises that are safe for them.

If you need help finding easy, delicious recipes that focus on healthy fats, protein, and fruits/vegetables, check out our 5-ingredients or less recipe generator. Click to learn more about the benefits of doing a Whole30 while pregnant!

Prioritize your Mental Health

Focusing on your physical health during pregnancy is important; however, do not neglect your mental health. Venturing into parenthood is wonderful and stressful at the same time. If you are feeling overly anxious or depressed, ask for help.
Mental health professionals can equip you with tools for how to manage your stress, learn how to better communicate with your partner, heal emotional wounds, and help you replace toxic thoughts with more positive ones. Look for a trained perinatal mental health professional."

Opinion| Megan Markle: The Duchess of Sussex

"Perhaps the path to healing begins with three simple words: Are you OK?"

"It was a July morning that began as ordinarily as any other day: Make breakfast. Feed the dogs. Take vitamins. Find that missing sock. Pick up the rogue crayon that rolled under the table. Throw my hair in a ponytail before getting my son from his crib.

After changing his diaper, I felt a sharp cramp. I dropped to the floor with him in my arms, humming a lullaby to keep us both calm, the cheerful tune a stark contrast to my sense that something was not right.
I knew, as I clutched my firstborn child, that I was losing my second.

Hours later, I lay in a hospital bed, holding my husband’s hand. I felt the clamminess of his palm and kissed his knuckles, wet from both our tears. Staring at the cold white walls, my eyes glazed over. I tried to imagine how we’d heal.
I recalled a moment last year when Harry and I were finishing up a long tour in South Africa. I was exhausted. I was breastfeeding our infant son, and I was trying to keep a brave face in the very public eye.

​“Are you OK?” a journalist asked me. I answered him honestly, not knowing that what I said would resonate with so many — new moms and older ones, and anyone who had, in their own way, been silently suffering. My off-the-cuff reply seemed to give people permission to speak their truth. But it wasn’t responding honestly that helped me most, it was the question itself.

“Thank you for asking,” I said. “Not many people have asked if I’m OK.”

Sitting in a hospital bed, watching my husband’s heart break as he tried to hold the shattered pieces of mine, I realized that the only way to begin to heal is to first ask, “Are you OK?”

Are we? This year has brought so many of us to our breaking points. Loss and pain have plagued every one of us in 2020, in moments both fraught and debilitating. We’ve heard all the stories: A woman starts her day, as normal as any other, but then receives a call that she’s lost her elderly mother to Covid-19. A man wakes feeling fine, maybe a little sluggish, but nothing out of the ordinary. He tests positive for the coronavirus and within weeks, he — like hundreds of thousands of others — has died.

A young woman named Breonna Taylor goes to sleep, just as she’s done every night before, but she doesn’t live to see the morning because a police raid turns horribly wrong. George Floyd leaves a convenience store, not realizing he will take his last breath under the weight of someone’s knee, and in his final moments, calls out for his mom. Peaceful protests become violent. Health rapidly shifts to sickness. In places where there was once community, there is now division.

On top of all of this, it seems we no longer agree on what is true. We aren’t just fighting over our opinions of facts; we are polarized over whether the fact is, in fact, a fact. We are at odds over whether science is real. We are at odds over whether an election has been won or lost. We are at odds over the value of compromise.

That polarization, coupled with the social isolation required to fight this pandemic, has left us feeling more alone than ever.

When I was in my late teens, I sat in the back of a taxi zipping through the busyness and bustle of Manhattan. I looked out the window and saw a woman on her phone in a flood of tears. She was standing on the sidewalk, living out a private moment very publicly. At the time, the city was new to me, and I asked the driver if we should stop to see if the woman needed help.

He explained that New Yorkers live out their personal lives in public spaces. “We love in the city, we cry in the street, our emotions and stories there for anybody to see,” I remember him telling me. “Don’t worry, somebody on that corner will ask her if she’s OK.”
​
Now, all these years later, in isolation and lockdown, grieving the loss of a child, the loss of my country’s shared belief in what’s true, I think of that woman in New York. What if no one stopped? What if no one saw her suffering? What if no one helped?

I wish I could go back and ask my cabdriver to pull over. This, I realize, is the danger of siloed living — where moments sad, scary or sacrosanct are all lived out alone. There is no one stopping to ask, “Are you OK?”
​
Losing a child means carrying an almost unbearable grief, experienced by many but talked about by few. In the pain of our loss, my husband and I discovered that in a room of 100 women, 10 to 20 of them will have suffered from miscarriage. Yet despite the staggering commonality of this pain, the conversation remains taboo, riddled with (unwarranted) shame, and perpetuating a cycle of solitary mourning."

"​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."