How We Can Help Black Mothers Get the Maternal Care They Need?
In the United States, 700 to 900 women die from pregnancy or childbirth-related causes annually, and approximately 65,000 experience serious, near-fatal complications. Even more sobering, the Center for American Progress (CAP) reports that Black women are three to four times more likely to die from childbirth than non-Hispanic white women, regardless of socioeconomic status and education. There are a variety of factors influencing these dynamics, all of which have a major impact on the physical and mental health of Black women during and after pregnancy.
The Toll of Pregnancy for Black Women
While pregnancy-related risk factors such as hypertension, anemia, and gestational diabetes can affect any expecting mother, Black women often experience these conditions more acutely. CAP notes that “racial disparities in risk factors related to pregnancy … exist and are exacerbated by stress related to racial inequality and often inadequate health care, which is not in tune with African American women’s needs.”
A recent post by Counseling@Northwestern the online Master of Arts in Counseling program from The Family Institute at Northwestern University, discusses these dynamics in the context of physical and mental health. Serious challenges that many Black women face during their pregnancies are often dismissed, minimized, or invalidated by health care professionals. Such trends are supported by anecdotal evidence, as well as research that highlights the effect of discrimination on maternal health.
- In 2017, a survey on discrimination from National Public Radio, the Robert Wood Johnson Foundation, and Harvard T.H. Chan School of Public Health (PDF, 1.2 MB) found that a third of Black respondents said they were personally discriminated against in a hospital or clinic.
- A study published in the journal Medical Care shows that mothers who perceived they had been discriminated against were twice as likely to skip postpartum visits with clinicians.
Dr. Tonya Davis, Clinical Training Director for the Counseling@Northwestern program, points out in the post that when health care professionals stereotype, make assumptions, and/or believe that Black women are over-exaggerating about their symptoms, these actions can leave room for dangerous health consequences if left unchecked or unchallenged.
The mental health of Black mothers can suffer as well: Researchers in JAMA Psychiatry found that up to one in seven women experiences perinatal depression in the first postpartum year; they also reported that women who screened positive for depression “were more likely to be younger, African American, publicly insured, single, and less well educated.” To improve outcomes, the U.S. Preventive Services Task Force recommends pregnant women and new mothers receive depression screenings. However, just as Black women experience barriers in getting the physical care they need, gaining access to effective mental health care can be a challenge, too.
Dr. Davis recommends that counselors should “become aware of the person sitting in front of you. Don’t overgeneralize or assume. Don’t think that because you know something about a particular race, ethnicity, or religion that you know everything.” Ensuring that counselors are culturally competent is key in creating safe spaces for individuals to feel valued and heard.
Identifying the Need for More Help
In a report titled Battling Over Birth: Black Women and the Maternal Health Care Crisis in California, researchers found that “physical changes, recovery, and side effects from medical procedures, mental health challenges, birth trauma, and relational and environmental concerns have a complex and interlocking impact on postpartum recovery for Black women.” As a result, many participants weren’t prepared for the challenges they faced in the postpartum period: “Women in the study needed additional support in relation to physical recovery, mental health challenges, socio-economic concerns, intimate violence, and breastfeeding problems.”
One of the first steps toward getting needed help to address mental health challenges is identifying whether an issue exists. Here are common signs that mental health care may be needed:
- Frequent crying
- Trouble sleeping (even when tired) or sleeping too much
- Loss of interest in self-care (e.g., dressing, bathing, fixing hair)
- Loss of appetite or overeating
- Trouble concentrating or remembering things
- Lack of interest in everyday tasks
- Showing too much (or not enough) concern for the baby
- Loss of pleasure or interest in things you used to enjoy (including sex)
- More severe symptoms require urgent attention:
- Extreme confusion
- Seeing things or hearing voices that are not there
- Cannot sleep (even when exhausted)
Finding the Right Help
Recommendations from the Battling Over Birth report include the need for Black women to have more access to holistic prenatal care that is based on principles of autonomy and empowerment, which can be enabled by educating health care providers and exploring strategies for increasing access to midwifery, doula care, birth centers, and other services. One organization that can help with such efforts is Shafia Monroe Consulting, which provides consulting and training in a variety of formats to help health professionals improve cultural competency and birth outcomes for Black women.
Another report recommendation highlights the need to prioritize a woman’s emotional and psychological needs—which is where counselors play a key role. Dr. Davis, shares how counselors can support new and expectant Black mothers:
- Help women understand the changes going on in their bodies.
- Help women understand the changes within the mind regarding emotions.
- Normalize experiences that may be new to women, allowing them to adjust to changes.
- Process the concept of familial normalcy; what it looks like now versus what it could look like.
- Conceptualize what their new role as mother will look like and operationalize the concept of being a mom.
- Compare and contrast expectations of pregnancy and motherhood in conjunction with potential realities.
Armed with a deeper understanding of the unique challenges that Black women encounter during pregnancy and a commitment to eliminating barriers to care, we can begin to address racial disparities in maternal health care and ensure Black women get the care that they deserve.
Alexis Anderson is a Sr. Digital PR Coordinator covering K-12 education at 2U, Inc. Alexis supports outreach for 2U’s school counseling, teaching, mental health, and occupational therapy programs. Find her on Twitter @HeyLexHey.
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