By: Cassie Shortsleeve| July 07, 2020
"Black maternal health providers share the advice they give their own patients that any Black expectant or new mom can learn from."
"Pregnancy is a life-changing event. But for Black women, this time in their lives comes with uniquely concerning health issues and added layers of struggle.
In the U.S., Black women are two to three times more likely to die from pregnancy-related causes than white women. That figure is even larger in metro areas such as New York City where Black women are up to 12 times more likely to die during pregnancy and childbirth. And while about one in seven women in this country experience a perinatal mood and anxiety disorder (PMAD), Black women suffer at higher rates—and are less likely to receive treatment.
Black moms and moms-to-be also face the biases of a mostly-white medical field, not to mention systemic racism, and stigma in and out of doctors' offices, say experts. But there are ways to prioritize yourself and protect your mental wellness (or help an expectant friend) in the journey to motherhood.
Here, Black doctors, therapists, doulas, and other maternal health experts share the words of wisdom they'd give to Black moms everywhere.
1. Prioritize emotional wellness.
"Given that Black women are at higher risk for pregnancy-associated mortality when compared to non-Black pregnant women, it is important that Black women empower themselves with knowledge about the importance of maintaining emotional wellness so that they take the steps necessary to advocate for their mental health needs during their pregnancy. If you're experiencing significant anxiety, disclose your distress to friends and family. If social support is not sufficient, talk to your healthcare provider about different treatment options."—Christine Crawford, M.D., M.P.H., an assistant professor of psychiatry at Boston University School of Medicine and an adult, child, and adolescent psychiatrist at Boston Medical Center.
2. Find the mental health support you need (even if it's virtual).
"Mental health support during the prenatal period is important especially during a time like this when women have the extra stress of the consequences of COVID-19 and racial injustice and protests. Black women are less likely to receive care for depressive symptoms and are often under-diagnosed. If you have symptoms, find a provider that you feel comfortable with, whether on a mental health app, one-to-one talk-therapy, or group therapy. Another great tool I love for moms is meditation apps. They can help with grounding during times of great stress. If the new mother has access to mental health support during the prenatal period, the risks for postpartum depression decrease."—Latham Thomas, founder Mama"
By Juli Fraga and Karen Kleiman|July 5, 2020
"Soon after her first baby was born in 2014, Crystal McAuley started having catastrophic thoughts about her infant’s health. Throughout the day, random thoughts popped up like tiny speech balloons, each one filled with a newfound fear: “What if the baby overheats?” “What if he stops breathing?” “What if he falls out the window?”
McAuley, 38, shared her concerns with her husband, who told her the baby was healthy. His reassurance, however, didn’t shut down the worry-filled thoughts that looped over and over in her mind. “It was hard to make them stop,” McAuley recalled. And then they changed course: “I started having visions of pulling my car into the opposite lane of traffic, but I didn’t want to die or harm my infant.”
McAuley was experiencing intrusive thoughts, which are unwelcome, negative thoughts, or images that seem to come out of nowhere and are highly upsetting, psychologists say.
“Occasionally, everyone experiences senseless intrusive thoughts,” said Jonathan Abramowitz, Ph.D., a professor of clinical psychology and an anxiety researcher at the University of North Carolina at Chapel Hill. On a turbulent flight, for example, we may see images of the plane crashing, even if we’re not afraid of flying. If we’re driving a friend’s new car, we may have thoughts about getting into an accident.
Most times, we don’t give those thoughts much attention, but when stress arises and responsibilities mount, it can be harder to ignore them, Dr. Abramowitz explained. And with the added strain of the Covid-19 pandemic, many parents are preoccupied with worries about their children becoming ill and dying from the virus, he said.
McAuley said the pandemic has sent her anxiety into a tailspin. “I feel like a new mom again. At unpredictable times, I imagine one of my children falling down a steep ravine or dying in a violent accident.”
While intrusive thoughts can be a sign of a perinatal mood disorder, such as postpartum anxiety or postpartum obsessive-compulsive disorder, a 2006 study conducted by Dr. Abramowitz and his colleagues followed 85 participants (43 mothers and 42 fathers) from the second trimester of pregnancy to three months postpartum. Of those who participated in the study, 91 percent of mothers and 88 percent of fathers experienced upsetting intrusive thoughts about their newborn.
According to Dr. Abramowitz, it’s not uncommon for new parents to think of the baby falling down the stairs, choking or drowning in the bathtub. One parent told Dr. Abramowitz he imagined “sticking a pencil in the soft spot of his baby’s head.”
Disturbing thoughts and images like these can bewilder new parents. Not to mention, mothers who envision harming their babies may misinterpret their thoughts as ominous signs about their mothering abilities. “I felt like a prisoner inside my own mind,” said McAuley, who worried that if she told her doctor what she was thinking, her baby would be taken away.
While intrusive thoughts can be terrifying, the problem lies in how we interpret them, Dr. Abramowitz said. Labeling such notions as “negative” causes the brain to give them more weight, which is why parents who judge their invasive thoughts often struggle to let them go.
Dr. Abramowitz and his colleague, Nichole Fairbrother, Ph.D., a psychologist and researcher at the University of British Columbia, said intrusive thoughts pop up in new parenthood for a reason. In their research, the psychologists found that the immense responsibility parents feel for keeping their newborns alive can bring on disturbing thoughts about harm striking their babies, especially during the first six months of their children’s lives.
Dr. Fairbrother said: “I remember gazing at my baby’s delicate hands and thinking, ‘I could just cut those right off with the garden clippers,’ but because I’m an anxiety researcher, I wasn’t upset by it.”
Even though intrusive thoughts might seem puzzling, Dr. Fairbrother said, they’re often adaptive. “If a mother worries about the stroller rolling into traffic, she’s going to grip the handle more tightly,” she explained.
For parents bothered by their intrusive thoughts, certain exercises and steps can reduce the anxiety they create. A few suggestions:
Distance yourself from the emotions
One way to disarm intrusive thoughts is to recognize that they don’t define who you are. Repeating the bothersome thought in a singsong voice or saying it aloud, over and over again can help, said Stefan Hofmann, Ph.D., a clinical psychologist and anxiety researcher at Boston University. This behavioral technique, known as distancing, can unhook thoughts from emotions, helping the mind to change direction. No longer seeing the thoughts as a threat, parents begin to realize that “thoughts are nothing more than just thoughts,” Dr. Hofmann explained.
“A mother may think about pushing the stroller down the stairs, but that doesn’t mean she’ll act on it,” he said."
"Our struggle is not an emotional concern. We are not burned out. We are being crushed by an economy that has bafflingly declared working parents inessential."
By: Deb Perelman
"Last week, I received an email from my children’s principal, sharing some of the first details about plans to reopen New York City schools this fall. The message explained that the city’s Department of Education, following federal guidelines, will require each student to have 65 square feet of classroom space. Not everyone will be allowed in the building at once. The upshot is that my children will be able to physically attend school one out of every three weeks.At the same time, many adults — at least the lucky ones that have held onto their jobs — are supposed to be back at work as the economy reopens. What is confusing to me is that these two plans are moving forward apace without any consideration of the working parents who will be ground up in the gears when they collide.
Let me say the quiet part loud: In the Covid-19 economy, you’re allowed only a kid or a job.
Why isn’t anyone talking about this? Why are we not hearing a primal scream so deafening that no plodding policy can be implemented without addressing the people buried by it? Why am I, a food blogger best known for such hits as the All-Butter Really Flaky Pie Dough and The ‘I Want Chocolate Cake’ Cake, sounding the alarm on this? I think it’s because when you’re home schooling all day, and not performing the work you were hired to do until the wee hours of the morning, and do it on repeat for 106 days (not that anyone is counting), you might be a bit too fried to funnel your rage effectively.
For months, I’ve been muttering about this — in group texts, in secret Facebook groups for moms, in masked encounters when I bump into a parent friend on the street. We all ask one another why we aren’t making more noise. The consensus is that everyone agrees this is a catastrophe, but we are too bone-tired to raise our voices above a groan, let alone scream through a megaphone. Every single person confesses burnout, despair, feeling like they are losing their minds, knowing in their guts that this is untenable.
It should be obvious, but a nonnegotiable precondition of “getting back to normal” is that families need a normal to return to as well. But as soon as you express this, the conversation quickly gets clouded with tangential and irrelevant arguments that would get you kicked off any school debate team.
“But we don’t even know if it’s safe to send kids back to school,” is absolutely correct, but it’s not the central issue here. The sadder flip side — the friend who told me that if their school reopens, her children are going back whether it’s safe or not because she cannot afford to not work — edges closer.
Why do you want teachers to get sick?” isn’t my agenda either, but it’s hard to imagine that a system in which each child will spend two weeks out of every three being handed off among various caretakers only to reconvene in a classroom, infinitely increasing the number of potential virus-carrying interactions, protects a teacher more than a consistent pod of students week in and out with minimized external interactions.
“You shouldn’t have had kids if you can’t take care of them,” is comically troll-like, but has come up so often, one might wonder if you’re supposed to educate your children at night. Or perhaps you should have been paying for some all-age day care backup that sat empty while kids were at school in case the school you were paying taxes to keep open and that requires, by law, that your child attend abruptly closed for the year."
"The process of weaning involves hormonal, psychological, social, and physical changes."
By Cassie Shortsleeve| June 08, 2020
"Last month, one random morning while breastfeeding my 11-month-old daughter Sunday, she bit down (and laughed) then tried to latch back on. It was an unexpected snag in an otherwise smooth breastfeeding journey, but after some bleeding (ugh), a prescription antibiotic ointment, and shedding some tears, I decided it was also the end.
Not only did I beat myself up—I didn't make it to the (albeit self-imposed) one-year marker that I had set—but within days, those teary, dark moments that had been with me in the early postpartum period crept back up. I could almost feel my hormones changing.
If you just had a baby (or have new mom friends), you're likely aware of some of the mood changes that can accompany new parenthood, namely the "baby blues" (which impact some 80 percent of women in the weeks following delivery) and perinatal mood and anxiety disorders (PMADs), which impact some 1 in 7, according to Postpartum Support International. But mood issues related to weaning—or transitioning your baby from breastfeeding to formula or food—are less talked about.
In part, that's because they're less common than PMADs, such as postpartum depression. And not everyone experiences them. "All transitions in parenthood can be bittersweet and there is a wide array of experiences associated with weaning," explains Samantha Meltzer-Brody, M.D., M.P.H., director of the UNC Center for Women's Mood Disorders and a principal investigator in the Mom Genes Fight PPD research study on postpartum depression. "Some women find breastfeeding very satisfying and do experience emotional difficulty at the time of weaning," she says. "Other women do not experience emotional difficulty or they find weaning to be a relief." (See also: Serena Williams Opens Up About Her Difficult Decision to Stop Breastfeeding)
But mood changes related to weaning (and *everything* breastfeeding, TBH) make sense. After all, there are hormonal, social, physical, and psychological changes that take place when you stop nursing. If symptoms crop up, they can also be surprising, confusing, and occur at a time when you may have *just* thought that you were out of the woods with any postpartum woes.
Here, what's going on in your body and how to ease the transition for you.
The Physiological Effects of Breastfeeding
"There are basically three stages of hormonal and physiological changes that allow women to produce breastmilk," explains Lauren M. Osborne, M.D., assistant director of the Women's Mood Disorders Center at The Johns Hopkins University School of Medicine.
The first stage happens in the second half of pregnancy when the mammary glands in your breasts (which are responsible for lactation) begin to produce small amounts of milk. While you're pregnant, super high levels of a hormone called progesterone produced by the placenta inhibit the secretion of said milk. After delivery, when the placenta is removed, progesterone levels plummet and levels of three other hormones—prolactin, cortisol, and insulin—rise, stimulating milk secretion, she says. Then, as your baby eats, the stimulation on your nipples triggers the release of the hormones prolactin and oxytocin, explains Dr. Osborne.
"Prolactin brings a feeling of relaxation and calmness to mom and baby and oxytocin—known as 'the love hormone'—helps with attachment and connection," adds Robyn Alagona Cutler, a licensed marriage, and family therapist who specializes in perinatal mental health.
Of course, the feel-good effects of breastfeeding are not just physical. Nursing is an extremely emotional act in which attachment, connection, and bonding can be cultivated, says Alagona Cutler. It's an intimate act where you're likely snuggled up, skin-to-skin, making eye contact."
Pregnant women and new moms are experiencing 'shocking' rates of anxiety and depression during the pandemic
By Anna Medaris Miller| June 19, 2020
"Pregnant women and new moms are experiencing higher rates of depression and anxiety amid the coronavirus pandemic, a new study suggests.
In the study, researchers asked 900 women – 520 of whom were pregnant and 380 of whom had given birth in the past year – about their depression and anxiety symptoms before and during the pandemic. They found that the crisis elevated depression symptoms from 15% to 41%. Moderate- to high-anxiety symptoms went from 29% to 72%.
Pre-pandemic, about one in seven, or just under 15%, of women experienced such symptoms during the perinatal period.
"I was pretty shocked at the magnitude of the increases," said Margie Davenport, a co-author of the study and associate professor of the pregnancy and postpartum health program at the University of Alberta, Canada.
A number of factors – like physical isolation, increased household and childcare duties, and fears about the state of the world – have contributed to the higher rates of mental health issues among pregnant women and new mothers, a demographic that was already susceptible to developing perinatal and postpartum depression disorder.
Davenport suspects the rates are even higher in people who already face healthcare and social disparities.
"I'm worried that this [data] is potentially underestimating the effects on women who've lost their jobs, and women who don't have secure housing and secure healthcare," she said.
Most participants were white, employed, partnered, and living in a single-family home — in other words, had the types of supports that would typically put them at a lower risk for perinatal mental-health issues. Davenport fears the effects of the pandemic, and now racial justice issues, on pregnant women and new moms in more marginalized communities may be even worse."
"Women exposed to high temperatures or air pollution are more likely to have premature, underweight or stillborn babies, a look at 32 million U.S. births found."
By Christopher Flavelle| June 18, 2020
"WASHINGTON — Pregnant women exposed to high temperatures or air pollution are more likely to have children who are premature, underweight or stillborn, and African-American mothers and babies are harmed at a much higher rate than the population at large, according to sweeping new research examining more than 32 million births in the United States.
The research adds to a growing body of evidence that minorities bear a disproportionate share of the danger from pollution and global warming. Not only are minority communities in the United States far more likely to be hotter than the surrounding areas, a phenomenon known as the “heat island” effect, but they are also more likely to be located near polluting industries.
“We already know that these pregnancy outcomes are worse for black women,” said Rupa Basu, one of the paper’s authors and the chief of the air and climate epidemiological section for the Office of Environmental Health Hazard Assessment in California. “It’s even more exacerbated by these exposures.”
The research, published Thursday in JAMA Network Open, part of the Journal of the American Medical Association, presents some of the most sweeping evidence so far linking aspects of climate change with harm to newborn children. The project looked at 57 studies published since 2007 that found a relationship between heat or air pollution and birth outcomes in the United States.
The cumulative findings from the studies offer reason to be concerned that the toll on babies’ health will grow as climate change worsens.
Higher temperatures, which are an increasing issue as climate change causes more frequent and intense heat waves, were associated with more premature births. Four studies found that high temperatures were tied to an increased risk of premature birth ranging from 8.6 percent to 21 percent. Low birth weights were also more common as temperatures rose."
June 17, 2020| Produced by Meg Dalton| Hosted by Tanzina Vega
"As the coronavirus pandemic continues, some experts worry about the impact it will have on the mental health of new parents, especially those who have recently experienced childbirth. According to the American Psychological Association, one in seven people who have given birth experience symptoms of postpartum depression.
For more on this, The Takeaway spoke to Kelly Glass, a freelance journalist whose interests focus on the intersections of parenting, health, and race. She recently wrote about the mental health toll on new parents for The Washington Post.
Check out our ongoing coverage of the COVID-19 pandemic here.
Click on the 'Listen' button above to hear this segment. Don't have time to listen right now? Subscribe for free to our podcast via iTunes, TuneIn, Stitcher, or wherever you get your podcasts to take this segment with you on the go."
By Cassie Shortsleeve| May 6, 2020
"This is Real Women, Real Bodies: Your destination for trusted health and wellness advice, reflecting the untold experiences of people like you. This month, we’re exploring maternal mental health, including the myths and misconceptions surrounding motherhood.
As soon as she delivered her daughter in 1983, Shoshana Bennett, Ph.D., a clinical psychologist in Orange County, CA knew something was terribly wrong.
She started seeing horrifying images of someone stealing her newborn, a nurse suffocating her baby, or she envisioned herself dropping her baby, seeing the head smashed and blood on the ground.
When she returned home with her daughter, even innocuous objects around the house — the microwave, a vacuum cleaner cord, the dishwasher — seemed like potential weapons. Every 15 seconds or so, she’d imagine someone or something hurting her baby. Worse, with little, horrifying video clips on replay in her mind, she’d see that she was the perpetrator.
She didn’t tell her husband what was happening. She didn’t tell anyone what was happening. Instead, she spiraled into deeper, scarier thoughts. Her pain continued for years. “I missed the infancy and toddlerhood of my firstborn,” she tells InStyle. “It was just one long nightmare."
When she experienced similar symptoms after having her son a few years later, a psychologist made her feel even more scared and confused by making incorrect assumptions about her own childhood, predicting a negative bond for her and her baby. Her ob-gyn dismissed her experience as normal.
She gave up trying to find help. This would be the rest of her life, she assumed. She became suicidal.
What Bennett didn’t know at the time — what she came to understand in years to come — is that she was suffering from postpartum obsessive-compulsive disorder (OCD), the most misunderstood and misdiagnosed of the perinatal mood and anxiety disorders (PMADs)."
By: Ash Spivak Natalia Hailes
"It's no secret that the postpartum period is just hard. After growing and carrying a human for almost 10 months, you perform what is likely one of the most challenging physical and emotional feats of your life—birthing that baby. And then you find out you're just getting started!
During postpartum, you're healing physically and emotionally while a new, adorable human is entirely reliant on you (and requires way more work than while you were passively growing them). Add in little sleep, changing hormones and doing this all during a pandemic.
Becoming a parent forces us to confront some of our biggest fears—loss, lack of control, change, the unknown. But here's the thing about being in the postpartum period during this pandemic. You are sharing those fears with a whole lot of people out there: all of us are being forced to confront them.
It's like we're arriving at a jungle with no paths and no maps. But whether you recognize it or not, you are already starting to pave your way.
We have no control over how long this pandemic will last or what the outcome will be. The only thing we do have some control over is how we move through it.
One guaranteed way to move through postpartum during a pandemic with more grace and ease is to prioritize your own well-being. Taking care of yourself is taking care of your baby. The actions we are being asked to take to minimize the spread of COVID-19 mimic those that are necessary in the early postpartum days: stay home and slow down (if you have the privilege); care for yourself so that you can care for others. Just like on the airplane, you need to put your mask on first.
For some, circumstances will make this even more challenging (those who have lost jobs, are working full-time and homeschooling and in the postpartum period, those needing to return to the frontlines, and those in essential jobs). While our capacity may be great, we are also only human. We never really know the path. We can only focus on how we move through.
Here are some ways to prioritize your postpartum well-being right now, even during a pandemic.
Ask for help
You can't do it all on your own. While the physical isolation from your support systems is no joke, it's important to remember that you are not isolated in this experience. Even during these times there are ways for others to pitch in. Have someone set up a meal train or set up a fundraising page if you are in a tough financial time. Therapists, postpartum doulas and lactation consultants are all working virtually. Book appointments and put it all on your new baby registry—way better than another onesie!"
By Alice Broster| June 10, 2020
"It’s likely that over the last few months you’ll have had to adapt almost every aspect of your life because of Covid-19. For new families and parents-to-be, this has been especially uncertain. The pandemic has dramatically transformed giving birth and the postpartum period. Virtual care and video consultations have stepped up to replace face to face appointments to cut down on the people entering hospitals. A neonatologist explains how postpartum care has changed because of Covid-19 and, while virtual medicine has been good for this period, it will never replace the emotional support that new parents need in person.
Over the last three months, people have faced going to the hospital to give birth alone. Families haven’t been able to introduce their newborns to their loved ones because of Covid-19 and for doctors on the frontline, it’s been an incredibly stressful time trying to deliver a high standard of care while keeping patients safe. An increase in virtual medicine has meant patients have been able to access their doctors without leaving the house. However, it’s also meant some new parents have been left behind. “For the vast majority of new parents, they need hands-on help. You need a hug and you need someone who is going to be there when you’re emotional. Sadly, that’s not something you can totally get through a computer,” says Medical Director of Aeroflow Breastpumps and board-certified pediatrician and neonatologist Dr. Jessica Madden.
With people entering hospitals alone to give birth and clinicians not being able to do at home check-ups Dr. Madden fears that some families have fallen through the net. The six week period after giving birth is key for the physical and mental health of both parents and babies. According to research conducted by Aeroflow Breastpumps, 90% of new mums believe educating parents about what to expect postpartum needs to be improved. Three out of four said they weren’t given enough guidance and 66% said they found the postpartum period more difficult than they thought it would be.
While some checks can be done over a video call, Dr. Madden highlighted that some services can’t adapt as effectively. “For the most part, lactation consultants can’t come into the room after birth to provide guidance and support. Breastfeeding clinics haven’t been open in the same way and that’s a massive loss,” says she says, “there’s an extra layer of fear right now for new parents. A lot of people aren’t bringing their babies to see pediatricians and women are scared to access postpartum care because they’re scared they’ll get Covid-19 from the doctor’s office.”
Not being able to access care and support postpartum can have massive implications for new parents. In the U.S. an estimated 70% to 80% of women will experience the ‘baby blues’ after giving birth, with many experiencing more severe postpartum depression. The reported rate of clinical postpartum depression among new mothers is between 10% to 20%. “When you look at how life is for pregnant people right now there are so many more risk factors. People are isolated and there’s excess stress and fear. I don’t think we will really know the effects Covid-19 has had on postpartum depression and anxiety until we look back on it next year,” says Dr. Madden."