Disclaimer: Throughout this piece, the use of gendered language like “woman” and “mother” is intentional as we are speaking to the experience and challenges cis women face during and after pregnancy. While it’s true that not all people who give birth are cis women, “mother” and “motherhood” are the closest to capturing the research and expert input incorporated here. This is a limitation of language, but one we’re operating within in order to shine a light on what cis women of color in particular experience during this time of their lives.
Motherhood is typically portrayed as a magical time in a woman’s life—and for many women, it is. But what’s not talked about as often is how difficult it can be for new parents to adjust to this uncharted phase of their life. Hormonal changes, mental health concerns, and access to resources and support networks all have a big impact on how new moms might feel in the weeks and months following childbirth.
Despite our culture’s preoccupation with women becoming mothers, it’s not easy to be a mother in America. In fact, the US has the highest maternal and infant mortality rate of any developed country, and the worst national maternity leave policy at zero weeks of guaranteed paid leave. On top of that, 1 in 8 women experience postpartum depression.
These concerns are all exacerbated for women of color. Black mothers are three to four times more likely to experience complications during birth that can lead to death. According to Dr. Loree Johnson, an infertility therapist and coach in Los Angeles, “people of color are probably more likely to experience infertility or postpartum issues, and less likely to seek care for it.”
Normalizing the Experience of New Moms
It’s a huge transition to become a mother—yet people don’t always talk about just how challenging that transition can be.
Sherry Nafeh, MA, LMFT specializes in postpartum counseling and she says the thing she encounters most often in her practice is her clients struggling with “the transition from womanhood to motherhood.” She goes on to explain that “society tells us that this transition should be a natural thing, and we should just flow into it, but it doesn’t always work that way.”
Dr. Johnson and Nafeh both work extensively with women and their partners during pregnancy and postpartum. They both agree that normalizing the experiences of women during this time is the first step to providing better care.
Combatting the Shame New Moms Face
The first few weeks after childbirth are draining, regardless of how many children parents may have. This is especially true for new moms who are usually struggling with the pressure that comes with being wholly responsible for another person.
“There’s a subtle message in our society that the mother is responsible. So when you become a mom and you’re responsible for this tiny human, the expectations—and the pressure moms feel—are enormous,” Dr. Johnson says. Nafeh has encountered similar feelings in her clients as well. In her experience, parents struggle the most with the shame they feel when they think they can’t meet those expectations.
“Ultimately, every parent is just trying to do their best with the resources they have. So it doesn’t help to shame or judge parents for doing something they thought was best for their child,” she says. “The shame that mothers feel gets internalized, which is correlated with higher rates of anxiety, depression, eating disorders, even OCD.”
“It’s a disservice to not talk about how challenging this time can be for new moms.”
What Can Health and Wellness Professionals Do Better?
Dr. Johnson and Nafeh both try to combat these feelings of judgement and shame by telling new moms that they’re not alone.
“It’s a disservice to not talk about how challenging this time can be for new moms,” Dr. Johnson explains. In her practice, she makes it a point to remind new moms that their feelings are normal—whatever they may be—and that they can work together to address them. As an infertility specialist, she sees first-hand the pressure that childbirth and motherhood carry—and the pressure that comes along with not experiencing those things.
“In my practice, I work mostly with women who have been dealing with some kind of infertility for at least four years. When you’ve been on this path for that long, it’s emotionally draining,” she explains. “Data shows that anxiety and depression levels increase the longer treatments persist. There’s an emotional heaviness that goes along with treatment that some women haven’t been able to fully process.”
Dr. Johnson says that many women expect their feelings about infertility to just disappear after having a baby. But in reality, infertility can actually register as a trauma for women. She goes on to say, “there’s emotional fallout from that. And many women come to me because they’ve achieved their goal—they had their baby—but they’re not actually feeling any better.”
Create a Safe Space for New Moms
In many communities, particularly communities of color, there’s a stigma associated with asking for help. On top of those cultural strains, some new moms fear that if they tell someone they’re struggling, they’ll be judged as a bad mom—or even have their child taken away from them.
“A lot of new moms might be feeling too sad or too anxious to have the energy to take care of their babies,” Nafeh says. “But at the same time, they’re so scared that if they say anything, they’re going to have their baby taken from them. So instead, they just don’t talk about it at all.”
Nafeh goes on to explain that the most important tool a clinician has to combat this idea is to create a “safe haven” for their clients. “As clinicians, we need to be transparent with our clients, and make it really clear to them that you understand them, you’re there for them, and they can tell you anything without being judged,” she says.
Ask the Hard Questions
Dr. Johnson also focuses on creating a safe space for her clients—and for her, that means curating a space that allows for open and honest communication. “I know the climate right now doesn’t make it easy to have uncomfortable conversations, but we have to do it,” she says. “We have to be intentional about creating a space where we can ask our clients pointed questions. People are airing on the side of caution, and not staying curious. When we do that, we can’t connect with other people, and provide space for the experiences of other people.”
This, she says, is particularly damaging for clients of color. “What’s happening is we aren’t asking our clients pointed or difficult questions, so the experiences of these women aren’t ending up on our radar. For clients of color who need our help, that can make them feel invalidated or dismissed,” she explains.
“Women of color just don’t get screened for mental illness as often. Either because they don’t have access to it, or because they’re ignored and neglected by their providers.”
Be Aware of Language
Raising awareness and normalizing the experiences of pregnant and postpartum women is only part of the challenge. There are tangible medical systems in place that put women of color at a disadvantage when it comes to receiving postpartum mental health care—but Dr. Johnson and Nafeh both think those systems are changeable.
Dr. Johnson thinks that it’ll be a range of actions, rather than just an individual action, that’ll help address some of the systemic issues in the medical community. But there is one thing in particular she thinks is a good place to start—being aware of the language your clients use.
“Language is used differently among different racial or ethnic groups,” she says. “I’ve noticed that my clients of color don’t always come to me stating that they’re feeling depressed or anxious. They might say they’re feeling ‘off,’ or ‘down.’ So as clinicians, we have to be really careful about the screening and diagnostic tools we use. We might need to try things with our clients of color that might not necessarily be used the same way with other populations.”
Make Screenings Better and More Frequent
When asked what the health and wellness community can do to help women of color more, Nafeh had her answer ready immediately—more screening. “Women of color just don’t get screened for mental illness as often,” she explains. “Either because they don’t have access to it, or because they’re ignored and neglected by their providers.”
Dr. Johnson agrees. “This is where the medical profession can really come into the picture,” she adds. “They need to be doing more postpartum screenings, and not just looking for direct reports of anxiety or depression. They need to be looking for some of the somatic symptoms (like headaches or gastrointestinal issues) and then making the appropriate referral
Nafeh and Dr. Johnson both stress the importance of recognizing what having a child actually does to the body—both during childbirth and after. A holistic, interdisciplinary approach to postpartum care will help new moms get the care they need, and deserve.