This article originally appeared on Shape.com
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 Glow
3. Put your family on alert.
“Many women don’t recognize that they have issues like postpartum depression. It takes other people to see it. To partners or family members, I usually say, ‘Hey, you are going to be somebody who’s instrumental in knowing whether this woman is suffering.’ Educating family members and partners about symptoms to look out for is important.” —Heather Irobunda, M.D., a board-certified ob-gyn based in New York City.
4. Find a provider who looks like you.
“This person most likely has a first-hand understanding of ancestral baggage, cultural needs, environmental challenges, and social determinants of health. Black mothers must have a provider that they know and trust, with emphasis on trust—someone who listens to all of your concerns, values your opinion, respects your decision, welcomes open dialog, and promotes shared decision making; a provider who is culturally competent and comfortable addressing more than just your obstetrical needs.”
“Pregnancy and new parenthood are transitions like no other. They have multifaceted, life-altering components, and like any new phase in our lives, there is an adjustment period where we sit on a mental and emotional seesaw, trying to balance this new chapter in our lives. Black women bring so much more to the preverbal table than just the pregnancy: generational baggage, health inequities, implicit bias, racial disparities, and social injustices. Any of these things can weigh heavy on the heart, soul, and mind, negatively affecting physical and mental wellbeing. It would be best if you had a provider who’s ready, willing, and, more importantly, able to care for you holistically, including knowing when to call in a consultant or refer you to a perinatal mood disorder therapist.”—Venus Standard, M.S.N., C.N.M., A.P.R.N., L.C.C.E., an assistant professor at the University of North Carolina School of Medicine’s department of family medicine
5. Don’t be ashamed or afraid to step forward.
“Black women, in general, struggle to make time to take care of themselves, but research has shown that Black females may struggle to seek help for mental health issues during and post-pregnancy because of the fear that they may not be viewed as adequate caretakers and that their child may be taken away. They may feel ashamed of their psychological state during this ‘happy time’ or they may not be able to recognize the reason for their emotions or psychological turmoil. It is crucial for all Black women, but especially those in low-income neighborhoods, to feel that they have support in the medical community and their children will not be taken away from them by seeking assistance for a common disorder that they have no control over. They need to know that with counseling and treatment, their mental health can improve, and they do not need to suffer in silence or sacrifice their psychological well being and desire to care for their families.”—Magdalena Cadet, M.D., a rheumatologist and internist at NYU Langone Medical Center
6. Your genes are not your destiny.
“Through a process called epigenetics, or gene expression, you have the power to shape how your genes express themselves to produce your mental and physical health. You can suppress or activate the expression of your genes through what you think, what you consume, how you move your body, and how you connect with other humans and nature. If you have a genetic predisposition to depression, you can help to suppress the expression of those genes. If you have a genetic tendency toward being focused and energetic, you can fuel the expression of those genes. I want every Black woman to know about epigenetics and how we can shape the expression and quality of our genes because our experiences with racism and social marginalization become embedded in our DNA and get passed down generation after generation. I want you to know that you have the power within your mind, body, and spirit to help to intercept this process that has been handed down for generations.”—Cleopatra Abdou-Kamperveen, Ph.D., a psychologist and assistant professor at the University of Southern California
7. Schedule “me time.”
“It’s better than being on autopilot all day and being at your wit’s end by bedtime. Relax and recognize when you need to take a step back and refocus. Protect your peace.”—Asia Toure, a community health worker in New York, who serves prenatal and postpartum populations to increase the awareness of maternal health, nutrition, and safety
(Related: 5 Ways New Moms Can Carve Out More “Me Time”)
8. Ask about culturally-tailored mental health support services.
“More than 15 percent of Black women experience some form of postpartum depression (more than non-Hispanic white women), but most don’t follow up with referrals for mental health services. There is still a huge stigma regarding mental health in some Black communities. I have found success in linking my patients to Black female mental health providers who provide culturally-tailored, sensitive support. My patients have been more likely to attend those mental health visits. Doulas are also great for working with women during and after pregnancy. They form a bond of trust with pregnant women and can help educate women about questions to ask to make sure their voices are heard.”—Madeline Sutton, M.D., a board-certified ob-gyn, medical epidemiologist, and public health expert
9. Remember that asking for help is not a sign of weakness.
“No one can do this alone and things are much better when there is someone to help carry the load. Asking for help can look many different ways. It can be for the pregnant mom who needs to sort out her feelings and concerns about her pregnancy or other issues. It can be for the pregnant woman who feels she is not being heard at her doctor’s visits and asks for someone to come with her. It can be for the postpartum mom who is stressed, overwhelmed, and needs support so she can get rest. Asking for help is not a sign of weakness but one of strength. In many cases, it can be the difference between life and death, especially as it relates to the maternal mortality rates of Black women in this country. Asking for help provides an opportunity for a woman to advocate for herself and her unborn child. It creates a space for vulnerability and authenticity which can spur a mom to seek out therapy for postpartum mental health struggles.”—Richelle Whittaker, L.P.C.-S., P.M.H.-C., an educational psychologist specializing in maternal mental health in women of color
10. Find community.
“While pregnant, one of the first things you can do is recruit people ahead of time. Society has led us to believe we can do it on our own and that’s absolutely false. We don’t know how much help we need until we need it. Come postpartum, most moms feel overwhelmed and stressed, not realizing that what they are experiencing happens to 80 percent of new moms. Setting yourself up for help is the first step. Help should not just be help with baby, but also gentle education, validation, reassurance that you’re doing it right, and conversations with other moms who have gone through the same thing (tears and all). Joining a group with other pregnant moms and women with babies is a good first step. I recommend something like a LaLeche meeting/meet-up. Most pregnant women have no exposure to ‘mom life’ and don’t have a practical view of what having a baby entails.”—Ruth Gordon-Martin, a licensed postpartum doula, and founder of CODDLE, a postpartum self-care company
11. Return to the village mentality.
“For generations, Black women have had to be superwomen and super mamas. We have grown accustomed to doing everything ourselves. We’ve never been shown what it looks like to have support, help, or a village [behind us]. We place unrealistic expectations on ourselves and then beat ourselves down when we can’t reach them. For generations, we have gotten further and further away from our cultural traditions with family during pregnancy and postpartum. By creating a support team of family, friends, doulas, seasoned mothers, and supportive providers, Black moms will be empowered to advocate for themselves. By having support in life, Black women carry less stress which is related to underlying health conditions that are passed from generation to generation. As we bring back the village, we allow the mother to enjoy the journey with the support she needs.”—Raven Thomas, R.N., a holistic doula and certified breastfeeding specialist