Cultural Beliefs that May Affect Asian American Moms’ Emotions After Birth

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Asian woman in New York City sad face

The title of “Mother” is a universal label suggesting that women who identify as mothers share the same personalities, characteristics, and preferences. Yet when we think about mothers, it is important to remember that each mother is an individual. How each woman approaches and embraces motherhood is largely informed by her familial and cultural lineage. Historical mothering practices are passed down through generations and shape her cultural narrative. These familial stories inform how she views her pregnancy, childbirth, and how she wishes to be cared for during the postpartum period.

Postpartum mood concerns are the number one complication of childbirth affecting between 15-17% of mothers. We know that perinatal mood concerns impact women of all cultural, educational, and socioeconomic backgrounds. Several variables, such as hormonal changes, sleep deprivation, social support, and one’s own personal and family mental health history can impact a woman’s risk of developing a postpartum mood concern, such as depression or anxiety.

As health care practitioners, when we care for racially diverse women, there are several unique cultural variables that may affect a woman’s emotional well-being after her baby is born. These cultural variables are especially important to tune into, because as health care professionals we serve at the forefront of maternal care. When a mother suffers from a perinatal mood concern, it’s often obstetricians, pediatricians and midwives that are the first to notice something is awry. Educating oneself about common cultural beliefs and patterns helps build and maintain trust with new mothers and their families. This trust helps ensure that providers have the repertoire that is necessary to recommend additional psychological support when it is needed most.

There are unique nuances and a diverse array of birthing rituals and practices; here are a few examples that are common within Asian cultures:

Gender of the baby: For some families, the root of male preference is deeply imbedded in cultural beliefs. The belief is that a male child will extend the bloodline, and that sons will care for their aging parents. In certain cultures, having a female child adds pressure financially and emotionally,  because it is believed that the daughter will marry and contribute to another family. Depending upon familial cultural beliefs and practices, a woman may feel a range of emotions if she is not having the son her family desires. It’s important to note that in some Asian cultures, gender of the child may be correlated with perinatal depression.

Hot-Cold Beliefs: In certain Asian cultures, it is believed that a new mother should be in a state of “hot and cold” balance during the postpartum period. If a woman is too cold it is believed that this may slow down lactation and interfere with maternal bonding. Hot and cold practices are represented not only in temperature but also in how certain foods increase or reduce heat in our bodies. In the Western cold, women are often offered cold beverages during labor and following childbirth. However, these offerings may not be aligned with the cultural need to maintain the balance of warmth. Health care professionals can sensitively attune to these beliefs by asking women to specify their preferences for hot/cold beverages/food in their hospital birth plans. Adding these small details helps build and maintain trust during the very sensitive postpartum period.

Maternal Confinement: The belief system behind keeping a mom “confined” for up to 40 days is to aid in the recovery of childbirth. This is an opportunity for maternal bonding and for family members to provide support and security for the mothers as way to alleviate outside stress. Mehndi (also known as henna, aids in cooling, and is an herb that is applied on the hands and feet in an intricate design) helps remind the mother that she should rest until the design fades. The importance of the maternal bond is reflected in this practice. Here, the mother devotes her attention to the bond with her baby without the outside distractions and other demands in life. It’s important to note that in the Western world following childbirth, the focus shifts towards the baby. However, in many Asian cultures, the mother remains a focal point after her baby’s arrival. These practices may impact how quickly a new mother ventures out into the world and which recommendations she’s apt to find supportive during the new days and weeks of motherhood.

As healthcare providers, the more we educate ourselves about various cultural practices and the meaning of these practices, the more we can advocate for our diverse patient populations. As providers, we become strong advocates when we ask sensitive questions related to our patient’s cultural beliefs and how these beliefs impact motherhood. Supporting a woman in a way that culturally aligns with her view of motherhood can be a universal practice.

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Dr. Bindu Garapaty is a leader in the Maternal Child Health arena. She is also the co-founder of The Happy Leader, a firm focused on executive leadership development. You can connect with her on Twitter @BinduGarapaty

Dr. Juli Fraga is a perinatal psychologist in San Francisco. She also co-developed and co-faciliates a postpartum depression support group, “The Afterglow” for the UCSF hospital. You can connect with her on Twitter @dr_fraga

photo credit to fotolia

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The Alcoholic Mother: on self-medicating PPD and anxiety

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mommyAsher

I was never a normal drinker, I just didn’t know that until I knew that. Before I had kids, whenever I drank, I drank a lot. Having just one or two never made sense to me. It wasn’t enough, because the one or two brought on the ease–a “click” that released me–and I wanted more, more, more.

I see now that my drinking increased after my first son was born. Of course, this wasn’t about him but rather, it was about the way I handled motherhood. I did not handle it well, and for years, I blamed myself for that. In reality, depression and anxiety coupled with a healthy dose of alcoholic genes muddied my coping skills. And I now know there were hormonal and biochemical reasons that were invisible and mysterious but proved themselves to me on a daily basis.

In a way, becoming a mother pushed all the buttons that would bring me to my knees, and hindsight tells me that despite the pain, I needed to be there.

I was bonding with my firstborn, but I was constantly terrified. There was a heavy weight behind my eyes and in my chest, at the pit of my stomach, down to my toes. I felt incapable and alone. I feared every horrible fear. I was sleep-deprived, martyring, begging to be seen, exhausted and empty.

I did not drink through my pregnancies, but I picked it up as soon as I possibly could postpartum. I pumped and dumped a lot. I fantasized about the days when I wouldn’t have to even consider it, and when the last day of breastfeeding arrived, I celebrated it with a lot of wine, and then slowly, carefully, and sneakily, my drinking grew and grew like my children. Fast and slow all at once. By this time, I had two beautiful boys and I loved them deeply. I spent my days with them and continued to feel depressed and anxious. I didn’t talk about it, I just moved through the hours that felt like quicksand, and I drank too much every night, to escape.

Had I known that my mind and body were experiencing something that has a name, that it had started with PPD and severe anxiety, perhaps my drinking would not have spiraled. I can’t say for sure, but I know now that getting help would have certainly been a better course of action than the road I chose, or that chose me. Or both. I have always held the propensity for alcoholism and it lived itself out, triggered by a condition, or conditions.

I got help over five years ago, between my second and third babies. I am sober, and was sober throughout the postpartum period after my third baby, a girl, was born. Unfortunately, I had the most severe depression and anxiety during this time. But what I did not do was drink. What I knew then was that drinking only exacerbated my symptoms, made them so much worse. This time, I got help. I went to more meetings for support. I called on my sponsor. I saw my doctor and started medications. I kept talking. I had learned that talking about the darkness of my mind stole the power from The Big Scary Things.

I was not perfectly fine, but I was free of the gripping snare of addiction. I was free of that shame and guilt. I was no longer a drinking mother, I was simply a struggling mother, as so many of us are, together.

Motherhood brings with it incredible joys and sorrows. Our children are certainly worth every good and bad thing that arises within us as we learn to handle the stress and fears that come with parenting. There is grace in letting go of the fear of help. Speaking our truths takes the power from even the grasp of addiction. If you are struggling with addiction, please know you are not alone. Talk to someone you trust. Get help. There is freedom and peace on the other side.

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Heather King writes at The Extraordinary Ordinary.

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Finding Help: Pediatricians Can Defend Against Postpartum Depression

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by Lindsay Maloan
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(photo via Boss Fight)

Most moms wouldn’t ask their pediatricians to check them out if they thought something was wrong. After all, they specialize in children, not women.

But in the early months of motherhood, moms spend more time at the pediatrician’s office than they do with their own doctors, so wouldn’t it make sense for pediatricians to know the signs and symptoms of a suffering mama?

People are starting to think so.

Thanks to social media, an article by Dr. Linda Chaudron, describing how pediatricians can be an important line of defense against PPD, is making the rounds. Even though it was published in 2003, people are beginning to pay attention to it now. You can find it here.

My pediatrician was the one that got me the help I needed after my own doctor insisted I was fine. By the time my son’s six-month appointment came around, she had seen us enough times to know that I wasn’t myself. She asked ME how I was feeling in a way that I felt like she just knew, and that’s when I asked her if she knew of someone who would actually listen to me and help me get better.

She took literally two minutes of her time and it changed our lives. She used the knowledge she already had, mixed it with compassion, and sent me on my way with the names and phone numbers of two doctors-a therapist and a general practitioner-who could take the reins. That’s it. No diagnosis, no prescriptions, just information on how I could get help.

That’s exactly what Dr. Chaudron’s paper suggests pediatricians do: take a very small amount of time, utilize knowledge and resources they already have, and pass the information on in a small way that can make a major difference.

So if you’re a mama that’s struggling or know of one, don’t overlook a pediatrician as a line of defense against the darkness. They help your babies, and they just might be able to help you. All you have to do is ask—but hopefully, they’ll ask first.

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Moments

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         “Enjoy every moment, won’t you?”

I offer a watery smile and nod but inside my blood freezes and my heart pounds with the anxiety that has come to constantly plague me like an unwelcome guest. Because how can I? How can I enjoy every moment of what is hailed such a precious time when I’m so frightened I can’t even hold a conversation or cook a meal? When I’m so sad I sob my heart out several times a day? When I’m so anxious that just being in the same room as my baby causes me to sweat and shake?

“It goes by so quickly, doesn’t it?”

Every minute feels like an hour, and every hour may as well be a week. The hours before my husband arrives home stretch on like years and I wonder if I’ll make it to the end without hurting myself, or worse.

“Isn’t your heart just bursting with love and pride?”

If I could locate my heart I’d tell you but I haven’t felt it for weeks. I can’t feel anything beyond the crippling terror and sadness. I can’t see past the horrifying, persistent images in my head of blood and pills and death.

“These are the best days of your life.”

Then why do I crave my old life, the old me, with a staggering ferocity? Why do I long for a time machine to the past when everything felt normal and right, or to the future where I pray this nightmare will be over?

“You’re just tired. Sleep when the baby sleeps and you’ll feel better.”

I can’t sleep when the baby sleeps. I can’t sleep when my husband sleeps. I can’t sleep when it’s 3am and the whole country is sleeping. If I could just switch off my brain…if I could just switch off everything.

“You need to eat something.”

Why would I put food in my mouth when I can’t breathe, can’t think, can barely speak? When I feel sick all the time. Why would I sustain my body just so my mind can keep going like this? Where is the girl who loved her food, where is she?

“You aren’t well, but you’re not alone. And you will be okay.”

I wish I could tell you that sentence alone was enough to make it all better, but it wasn’t. In fact, merely being diagnosed with Postpartum Depression and Anxiety brought a wave of panic so strong I had to call my mother in law to take my son for the afternoon. But it was a turning point. It was the end of that horrible chapter and the beginning of the next challenge. It was someone pulling me from the blizzard, strapping much-needed supplies on my back and standing me steady at the bottom of a mountain, ready to climb.

Enjoying every moment is impossible when you’re suffering from PPD/A. In truth, it takes lots of therapy and hard work just to enjoy a single moment. But when you do, and you will, just grab onto that flash of relief and hold it tight. Memorize it. For when the darkness slips back, that memory will make it harder for the illness to take that moment of light from you. Soon another moment will come, and another. You’ll have a rush of relief every week, then every day, then several times a day.

It will be frustrating. The mountain is high and steep and horribly intimidating. Some days you’ll be too exhausted to climb and you’ll simply collapse on the ground and cry with exhaustion and that’s okay. Because when you’re ready to get up and carry on you won’t be back at the bottom, nothing will be undone, and you can continue on your way.

Eventually, and how I wish I could tell you how long it takes, you’ll be enjoying many moments. You’ll feel again. You’ll think straight again. You’ll love again. And maybe it won’t be one glittering, wonderful moment of realisation when you think “I’m cured.” But, more likely, it will be a series of moments that creep up on you, a collection of evidence that shows you’re recovering. A few hopeful glimpses of the summit.

I have many days when I feel truly well, and I have other days when I wonder if I’m still climbing. But in the meantime, I’m living life, I’m enjoying lots of moments and not enjoying others and learning to be fine with that. Because when well-meaning people tell you to “enjoy every moment” they are setting an unrealistic goal for any parent. Many aspects of parenthood are simply not enjoyable. Instead, I focus on feeling every moment, good and bad. If I feel afraid, that’s okay, I just sit with it and let it pass. If I feel sad, I allow myself to cry. And if I feel happy I clutch that joy to my chest and absorb it into my soul, and try to keep it safe forever.

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Laura is a thirty-something wife and mum from Essex, England. Following the birth of her son in 2013 she unexpectedly found herself battling Postnatal Depression and Anxiety. Reading blogs became her obsession and she’s now decided to flex her own writing muscles. You can find more of her words at https://thebutterflymother.wordpress.com and Laura can also be found on Twitter – @butterflymum83

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