Did you ever wonder if you were suffering from postpartum depression because a friend talked to you about their experience? Did you read a book that reflected your experiences? If you found a narrative that fit with your experience, did you have access to health care because you had a treatment team that believed you?
Often times women dealing with postpartum depression or anxiety will report their difficulties finding a diagnosis and/or helpful treatment and support. Everyone is still working hard to understand PPD and other perinatal mood and anxiety disorders.
As part of this conversation, though, there are two key words that are often overlooked: Exposure and access. These two words are important factors that impact the well-being of protected classes of people. Protected classes of people often have double the difficulty when dealing with maternal mental illness, because in order to obtain help, you have to be exposed to stories and information that reflect your experience, and then you need access to the processes that allow you to obtain help.
Postpartum depression is a serious, debilitating illness that affects approximately 10-20% of women. This statistic, though, is a measure of women who were able to identify what they were going through. Imagine the women—for instance, women of color—who aren’t added to this statistic because they don’t have exposure and access to understand what they are suffering with?
A psychiatric study by Katy Backes Kozhimannil and her colleagues yielded results that concluded that:
“… there were significant racial-ethnic differences in depression-related mental health care after delivery.”
These results outline a stark reality for women of color: They are less likely to be screened for PPD and less likely to get treatment and receive follow-up care. The results also showed that it was more likely for treatment teams to attribute symptoms of Black and Latin women to other ailments and not PPD.
To make it plain, while many women are never screened, women of color are bypassed in the screening process even more so, and when they do display symptoms of PPD, other factors are often blamed. So these moms won’t get the help they really need. This reality means it is vital for women who are at risk for perinatal mood disorders to be strong self-advocates.
How, the question becomes, can one advocate for something that you haven’t been made aware of? If you have been exposed, how then does one self-create access in a system that either doesn’t offer access to people who look like you or offers less-effective help or many fewer options?
Awareness for postpartum depression is increasing, yet there are still women who are falling through the cracks due to systemic oppression and racism. We must care for the most vulnerable among us. The postpartum depression conversation should involve early intervention, treatment, and awareness for ALL women.
The study I mentioned above also cited:
“The differences in initiation and continuation of care uncovered in this study imply that a disproportionate number of black women and Latinas who suffer from postpartum depression do not receive needed services. These differences represent stark racial-ethnic disparities potentially related to outreach, detection, service provision, quality, and processes of postpartum mental health care. Although suboptimal detection and treatment rates are not uncommon for this condition or in this population (7,42,43), these results emphasize that postpartum depression remains an underrecognized [sic] and undertreated [sic] condition for all low-income women, especially for those from racial and ethnic minority groups.”
During July, which is Minority Mental Health Month, I’ll be having leading a conversation here at Postpartum Progress about ways to improve the conversation as it relates to women of color and postpartum depression. We will talk about stigma, social constraints, patient-provider communication, and involving more women of color in the change agency efforts.
Postpartum Progress means progress for ALL women, which means some difficult and important conversations. I hope you’ll join me.
[Founder’s Note: One of the goals at Postpartum Progress is to expand our reach and support so that all women are getting the information and help they need. As you all know, in general most women with perinatal mood and anxiety disorders are not getting the right help. It is also true, though, that women of color get even less access and have even fewer options than the general population. I’ve been an advocate for more than a decade now and I know this to be true because I have seen it with my own eyes. I’m thrilled that Jasmine is joining us to share her experience and knowledge so that we can open our eyes to what all types of women are experiencing and figure out what we can do better. -Katherine]