When I ask new mothers in my practice how they’re doing, I’m stunned by how often the answer is the same: I’m the first person who’s asked. People are often so focused on the baby’s needs that the mother herself gets missed, by her family, her friends, sometimes her own providers.

For many Black mothers, pregnancy and postpartum bring joy, pride, love, and connection. They can also bring anxiety, depression, intrusive thoughts, grief, exhaustion, birth trauma, and a sense of losing oneself. Many are praised for being strong while their own needs go unnoticed.

During Black Maternal Mental Health Week, we are making space for a different conversation; one that centers the Black mother, her emotional well-being, and her right to receive compassionate, culturally responsive care.

The Mental Health Impact of Motherhood

Maternal mental health conditions are among the most common complications of pregnancy and childbirth. Approximately 1 in 5 women experience a mental health condition during pregnancy or within the first year after delivery¹.

Black mothers may face even greater risks, with as many as 40% experiencing maternal mental health conditions². This is likely because of barriers such as access to care, medical racism, birth complications, financial strain, lack of childcare, and the pressure to keep functioning no matter how they feel. Research shows Black women often carry more signs of physical stress during pregnancy and face more discrimination, both of which are linked to worse mental health outcomes.

These challenges are not a reflection of weakness. They reflect the strain of parenting within a system that doesn’t hold space for her full experience.

Struggling Might Not Always Look Like Sadness

A mother can love her baby deeply and still struggle with her mental health. She may continue working, caring for her family, attending appointments, and appearing ‘fine’ while privately feeling anxious, overwhelmed, numb, angry, guilty, or disconnected.

Signs that it might be time to seek support include:

• Persistent sadness, hopelessness, or emotional numbness
• Intense anxiety or fear that something bad will happen
• Panic attacks or racing thoughts
• Irritability, anger, or feeling constantly overwhelmed
• Difficulty sleeping, even when given the opportunity to rest
• Feeling disconnected from the baby or from oneself
• Frightening or unwanted intrusive thoughts*
• Excessive guilt or feeling like a bad mother
• Loss of interest in previously enjoyable activities
• Difficulty completing basic daily responsibilities
• Hiding how you feel out of fear of being judged

*A note on intrusive thoughts: these can occur during pregnancy and postpartum and do not necessarily mean someone wants to act on them. However, they should be discussed with a qualified mental health professional so the person struggling can receive support, reassurance, and appropriate treatment.

If any of these sounds familiar, I’d encourage you to reach out. You do not have to wait until symptoms are severe before seeking help.

Ways to Support Your Mental Health

Speak up early

Tell your obstetric provider, primary care clinician, therapist, psychiatric provider, or another trusted professional when something does not feel right. If you don’t feel you’re being taken seriously, ask to speak to another provider.

Protect your rest & ask for (specific) support

Sleep deprivation can intensify depression, anxiety, irritability, and emotional exhaustion. Accepting help with feedings, household tasks, meals, or childcare is not selfish. Instead of trying to manage everything alone, tell loved ones exactly what would help to have taken off your plate. Rest is part of our health, and we were never meant to do this alone.

Name a Check-In Friend

Just as you have someone tracking the baby’s milestones, name at least one person, a partner, friend, family member, or provider, whose job it is to check on you. Tell them directly: ‘Ask me how I’m really doing, not just how the baby is.’ Knowing someone is looking out for you can make you feel less alone. 

How Loved Ones Can Show Up

Supporting a Black mother means doing more than reminding her that she is strong.

Next time you have the chance, try asking:

• “How are you feeling emotionally?”
• “Do you feel like yourself?”
• “Are you getting enough rest?”
• “What can I take off your plate this week?”
• “Would you like help finding a provider or attending an appointment?”

Avoid minimizing statements such as:

• “At least the baby is healthy.”
• “Every mother feels this way.”
• “You should be grateful.”
• “You are strong. You will get through it.”

A mother can be grateful and still be struggling. A baby can be healthy while the mother is not okay. Both deserve care.

How Lavender Can Help

At Lavender, culturally responsive care isn’t an add-on. It’s built into how we hire, how we train, and the diversity of our care team. Our psychiatric nurse practitioners provide virtual evaluations, medication management, and ongoing support throughout pregnancy, postpartum, and beyond.

Seeking help doesn’t mean you’re weak. It means you’re giving yourself the same care you give everyone else.

This Black Maternal Mental Health Week, let us continue asking an important question:

Who is caring for the mother?

Black mothers deserve to feel safe to ask for help. When they do, they should know that they will be heard and believed. Their experiences of motherhood should be more than survival; they deserve the support, care, and resources needed to thrive.

If you are pregnant or postpartum and need immediate emotional support, call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262). If you are experiencing thoughts of suicide or self-harm, call or text 988. Call 911 or visit the nearest emergency department if there is an immediate risk of harm.

References

¹ Fawcett, E., Fairbrother, N., Cox, M., White, I., & Fawcett, J. (2019, July 23). The prevalence of anxiety disorders during pregnancy and the postpartum period: A multivariate Bayesian meta-analysis. The Journal of Clinical Psychiatry. Retrieved April 23, 2023, from https://pubmed.ncbi.nlm.nih.gov/31347796/.

² UPMC Health Beat (2020, July 23). Black maternal mental health: The challenges facing Black mothers. Retrieved May 1, 2023 from https://share.upmc.com/2020/07/black-maternal-mentalhealth