A special series on African-American, Asian-American and Latin-American women with postpartum depression.

PPD & Immigrant Life: When Your Village Is Far Away

[Editor’s Note: Today’s guest post comes from an immigrant Warrior Mom from Pakistan. A practicing Muslim, her family doesn’t discuss mental health, so she struggled to make sense of what was happening after her baby was born. -Jenna]

PPD & Immigrant Life: When Your Village Is Far Away

It does not give you a warning, it does not hold back any punches, and it definitely does not allow for clear thinking. For me postpartum depression was the most excruciating, humiliating, and traumatic experience of my life so far, thankfully. I have nothing else to compare it to, for which I am constantly grateful.

I had a worry free pregnancy. I worked until the day my water broke, albeit a little before my due date. I thought I was fairly prepared and could handle this baby birthing thing. Sure, I had a natural fear of the pain and anguish involved, but I was clear in my head that I would plow through it and all will be well.

I had done my share of extensive research on pregnancy, healthy eating, development milestones, and so on, and my bedside table was piled high with books with titles like working mother’s pregnancy guide and such. When I think back on those days, I realize that all those books didn’t have a lot of information on postpartum depression; they did not seem to red flag it. Even my OBGYN didn’t feel the need to fill me in.

Perhaps I was just unlucky.

I had a painfully long, induced labor, but my son was born after only four pushes, and then, it was done. He was healthy, and I was in a daze of happiness, elation, and perhaps relief. In the recovery room, a lot of information is thrown at you in a short span of time, and you are expected to absorb it, and leave in a day to start the most important journey of your life.

For me it meant I reached home and the panic hit me. I remember looking at my tiny tiny baby and wondering, what now? My husband on the other hand seemed to be happy and excited, not panicky at all.

From that moment on, I lost the ability to sleep and eat and as a result to think straight. I would meticulously feed him, note down the exact minutes and seconds he fed, how much he spit out and how much he slept. I would panic each time he would latch on and off, worrying if he was getting anything.

I would not sleep even when he would sleep because I had to keep an eye on him. I had to wake him up every other hour to feed him just in case he was hungry. I could not leave his side, and on top of it all, I could not eat. Not one bite.

I would keep asking my husband why the baby was sleeping too much and if I should wake him up. His pediatrician recognized on our first well visit that I was definitely not okay even though the baby was thriving perfectly. She told me I needed to relax and seek help.

Of course I did not do those things since in my culture. I am from Pakistan and a Muslim by faith. Women are taught sometimes consciously and mostly unconsciously that mental health issues are trivial pursuits and even taboo topics; you just bear your burden as best you can and carry on. We’re also taught that motherhood is the most natural thing in the world, so you are somehow hardwired to excel at it, with no setbacks.

I come from a fairly liberal background and studied law not only in Pakistan but also in the United Kingdom as well. I worked in a law firm for a few years, so I was not really subject to most of these cultural nuances, but I did grow up in that society and some things just latch on to you.

My husband finally did some research and diagnosed me with postpartum depression and tried to be understanding, most of the time. It was rough for him to see me melt into this puddle of confusion and incoherence. I always had my shit together, always. But now my thoughts and fears were paralyzing me.

However on my husband’s coaxing, I did try calling a helpline once or twice and was told of resources I could turn to (reading materials and maybe therapy if my insurance covered it) once they determined that I was not suicidal. I was not suicidal; I was just not myself.

The thought of navigating the internet for resources or finding a therapist covered by my insurance seemed like insurmountable tasks. I was just so tired, too tired to think. I could not remember how to make my go-to recipes. I could not watch TV. I just just did not know how to navigate through this fog.

I finally went to my OBGYN and asked her for anything to clear my head while in tears. She on the other hand told me I needed to hand the baby to my husband, sip a glass of wine, and just sleep for a few hours (forgetting that I was a practicing Muslim and could not have alcohol). That all made sense, but it felt like she was trivializing a disorder I so clearly had.

By this time my mother in law was with us looking after the baby, so my doctor suggested I should be grateful that I had help which she never had and I should snap out of it. That conversation made me feel even worse since now I was acutely aware of the fact that perhaps I was inviting God’s wrath by not being grateful and pulling myself together. But I had no idea how to get out of the haze that seemed to follow me everywhere.

My mind has always been my strength. I talk myself out of stressful situations. I enjoyed reading. I enjoyed cooking, but now I was incapable of seeing any silver lining, any sunshine, and it was killing me from the inside.

I come from a culture where depression or any sort of mental issues are not discussed or even acknowledged, at least for my mother’s generation. She would call (from Pakistan), and I would cry and she did not understand why, saying time and time again that as long as my baby was well, there was no reason to feel this way. But I had no choice in the matter. I tried to make her see that I was trying to find a way out, that I could not help how I was feeling, but to her it just seemed I was over reacting and just thinking too much and perhaps this state of mind was somehow a western phenomenon.

She even suggested that people had babies all the time and they all turn out okay and it should all come naturally to me. At some point the people around me, mostly family, started to blame breastfeeding for my state of being, thinking and suggesting out loud that formula feeding would solve the issue. I knew it would not.

In our culture, a woman is expected to receive 40 days of absolute rest and pampering after child birth. During this time, she is fed certain foods known to heal the body (and perhaps the mind, unknowingly) and is surrounded by family members who offer all kinds of advice and practical tips for taking care of the new baby.

I did have my mother-in-law living with us who tried to help in every way she could despite the fact that she had never heard of postpartum depression, so her help tended to constitute of constantly suggesting formula as opposed to nursing so I could get some rest and sleep. I know it must have been very hard for her seeing me in such a state and not having a clue as to how she could help.

It truly does take a village and being an immigrant in a foreign country meant my village was very very far.

I want to mention here that the constant portrayal of a “perfect” new mother with a sparkling house, a smiling baby and manicured nails in the media does not help an average new mother, not one bit. We end up feeling unnecessary pressures and focusing on all the imperfections around us and in us instead of using that time to bond with our precious babies.

I chugged along in a haze of anxiety trying to hide my fears, dismissing them as irrational and crying all the time praying to God to help me feel better. I so desperately wanted to be happy and not be plagued by dark thoughts. I resorted to simply not discussing myself every time my mother called. I would hide from my mother in law and cry my eyes out. In a way I felt sad that I had to hide this way from the women closest to me just so I would not have to explain what I had no idea how to explain.

Fast forward to about three months later, my fog cleared (somewhat) in the most bizarre way. I was struggling to get in touch with the state disability office while battling engorged painful breasts by heating up a pad to place over them. I was literally in tears of exhaustion standing by the ironing board.

I lifted the iron while holding the phone in my other hand and instead of placing the phone on my ear, I almost put the iron on my cheek. I stopped in time but just about. Somehow this jolted me in a way I did not expect. Coupled with the fact that my maternity leave was ending and I had to get back to work, my mind set shifted, perhaps the hormones balanced out, or I just got lucky.

I did struggle (still do) with balancing work, pumping, nursing and a baby (notice how I did not even count a house or my husband). Now I tell my story every chance I get. I am not ashamed or embarrassed one bit. Every woman needs to know about this crippling phase, just so she doesn’t feel punched in the stomach when a baby doesn’t come with rainbows and unicorns.

To all those who suffered and are suffering, please know that this foggy version of you is NOT you. Reach out to everyone and anyone, speak about it, discuss it and know that there is help and just take each day one day at a time.

~Jehanara Haider

Steps for Mothers of Color to Improve Their Maternal Mental Health

Steps for Mothers of Color to Improve Their Maternal Mental Health

We know that women of color, particularly Black women, do not have the support and treatment they need in order to achieve recovery after suffering through postpartum depression and anxiety. We know that the system doesn’t support the well-being and wholeness of Black women. More than simply stating the problem, Postpartum Progress is committed to making changes in a system that oppresses and harms extremely vulnerable people.

Our first step to providing change is equipping Black women from all ethnic backgrounds with a tool for seeking help. Our second step is to provide access to mothers of color to tell their stories through the platform we’ve built.

We know that mental wellness happens when we are in the context of community and do not feel alone. Our Black Diaspora Checklist is designed to provide language that is reflective of the Black experience. Postpartum Depression and anxiety show up differently for Black women and women of color.

Because so much of the Black experience can include environmental trauma from systemic racism, it is vital to engage in self-care regularly. As you are facing your experience around postpartum depression, remember that recovery is a process. Below are some steps to help you as you evaluate the best way to obtain support.

Process

Think through how feel. Many women feel increased shame once they realize they have symptoms of postpartum depression. Don’t stuff your feelings. All yourself to move through the emotions. Avoiding your emotions or assigning value to them (ex: I am a bad mom for being angry at my baby) creates internal pain and suffering. Allow yourself space to experience whatever emotions come up.

Evaluate

Determine if any of the things you feel require action. If you realized you were feeling deep shame while in the processing stage, does that require action? Some feeling are just feelings. Understand that they are not facts and they do not have inherent value other than to inform you of what you experienced. If emotions you experienced were linked to a need (ex: I feel angry because I am tired and drained) it may be necessary to move to the next stage and make a plan for your well-being.

Plan

Once you recognize that your emotional experience was informing something you need to take action on, it is time to plan. What is your goal? How will you achieve that goal? Do you need support achieving that goal? Create steps for yourself and make self-care through a plan with concrete steps a requirement.

Act

This can be the most difficult step. Form a support team who can help you be accountable to your well-being. Understand that you cannot pour anything out of an empty vessel. Recognize that the well-being of your child is directly linked to how well you take care of yourself.

A History of Mistrust

A History of Mistrust

As we continue the Maternal Mental Health conversation for Minority Mental Health Month, we understand that Black women seek help from doctors at a much lower rate. We know that they do so because of the lack of access to resources. Women of color are often in the lower socio-economic levels, which also lowers the likelihood of seeking help.

What is often not talked about concerning Black women and our lack of trust around medical institutions is the long history of distrust developed around Black bodies and the medical sciences. While America’s memory is often short, Black America’s memory has not faltered.

For centuries the prevailing zeitgeist of the medical community was shaped by evil practices like the 1928 Tuskegee syphilis experiment. 399 men who had syphilis were held against their will and studied for 40 years, without treatment, while their families were left to suffer the pain of not knowing were they were.

Black people were used as a resource for horrific experimentation, and so much of the mistrust and unwillingness to seek medical attention is birthed from the understanding that the medical community participates in the systemic oppression of the Black well-being.

Many folks reflect with gratitude upon the medical advances in obstetrics and gynecology. We’ve come a long way concerning the treatment and interventions that often save the life of baby and mother. These advancements, however, were established due to merciless experimentation on Black women.

There are significant accounts of Black women and women of African ancestry being forced to undergo grotesque gynecological experimentation. Black women are at higher risk of unnecessary medical intervention during the birth process. Black women in the United States have the poorest pregnancy-related outcomes.

“African-American women are often made to feel marginalized, stigmatized, and stereotyped because of racism practiced against them,” the authors of a paper on African-American women’s childbirth preparation argue. “Especially important is identifying ways to decrease racism’s negative impact on childbearing families and their preparation for birthing.”

So we cannot talk about maternal mental health without talking about birth and the medical community. And we cannot talk about birth and the medical community without talking about the history of systemic violence enacted upon Black women throughout America’s history.

In order to be a competent advocate for women of color in the maternal mental health space, one must seek to understand the full history of our experience with medical providers. Interpersonal trust between physician and patient is vital to determine quality care.

 

Read more on Minority Mental Health Month:

#NoShameDay

Today we stand with the Siwe Project in the midst of Minority Mental Health month and proudly proclaim today #NOShameDay. The Siwe Project envisions a world in which people of African descent can openly share their experiences with mental health challenges and feel supported in seeking treatment without shame.

#NoShameDay by the Siwe Project

We’ve written many times before about the extra challenges Black moms find in both admitting and seeking treatment for maternal mental illnesses. Jasmine Banks, our Climb Out Manager, is currently writing a series for Minority Mental Health Month, focusing on the issues moms of color face when they battle postpartum mood and anxiety disorders.

Her first piece addresses the racial and ethnic disparities of identifying and treating postpartum depression. She then wrote about stigma and the strong Black woman. Tomorrow she’ll share more about the history of mistrust and why Black people seek treatment at a lower rate than their white counterparts.

We encourage our mothers of color to join in the discussion on Twitter (currently trending), Facebook, Instagram and where ever else you use social media with the hashtag #NOShameDay. You can also participate in a Twitter Chat tonight.

You don’t have to feel shame for experiencing a postpartum mood and anxiety disorder. Postpartum depression happens to 1 in 7 women, and that’s just the reported cases. We also now know that postpartum anxiety happens more frequently than PPD.

You’re simply not alone.

We thought we’d share this beautiful spoken word poem by Bassey Ikpi shared by Siwe Project which speaks volumes about mental illness.

“This is about humility and admitting that you need help, and sleep, and hugs, and permission to cry despite the strength you are often accused of.”

You are not alone.