Giving birth and bringing new life to this world would, ideally, be a joyous event. For many, it is more complicated and the experience can be shrouded in depression and anxiety. This can make the journey to motherhood, and the days and months following birth, extremely hard. For racialized mothers, because of many pressures and barriers, this journey can be all that much harder.
As a result of my positive experience receiving support, I encouraged other mothers I saw struggling with their mental health to seek help. It never occurred to me there wouldn’t be safety in reaching out for help.
My name is Pat Baxter. I am a white cis-gender mom of white children of settler descent. I live, work and play on the unceded territories of the of the lək̓ʷəŋən People, in the area known today as the Esquimalt and Songhees Nations. I am a member of the MAR Healthcare Advocacy Team and professionally, I am a medical physicist. For our discussions this month on Restorative Justice, I wanted to write a post about maternal mental health.
I have struggled with this post for the last month. I know I needed to complete it, but I have felt paralyzed by my experiences. I felt inadequate to comment on PPA/PPD in the terms of restorative justice as I was so unaware of the vastly different experience of racialized mothers when they reached out for help; if they reached out for help.
I had postpartum depression and anxiety. Twice. And pregnancy depression and anxiety were diagnosed once, but likely I had them twice as well. I reached out for help with the expectation I would get help and not judgment.
The public health nurse was concerned when she came for my home visit after my first son was born. We had just moved into the apartment the month before. During our home visit, she could see the unpacked boxes and the disordered way the home was set up. I was struggling. Her intervention? Referral to the post partum depression support group and encouragement to talk to my physician about my mental health. I was referred to the post partum depression psychologist/therapist and was funded for 6 sessions. I never feared other interventions could occur. I trusted the system, because I could. I had no experience otherwise.
As a result of my positive experience receiving support, I encouraged other mothers I saw struggling with their mental health to seek help. It never occurred to me there wouldn’t be safety in reaching out for help. I sent links to different organizations and websites. I told them about the PPD support group. I know I helped some people, but I was so naive to the struggles my friends who are people of color, Indigenous, or Black, have with the healthcare system. And so, sharing my story for maternal mental health felt inadequate. I felt stuck.
So I researched.
Some facts about PPD/PPA
Baby blues should not last beyond 2 weeks after birth.
8-12% of mothers develop PPA/PPD
10-16% of women who develop PPA/PPD experienced symptoms in pregnancy.
Women can develop PPA/PPD in subsequent pregnancies even if they did not experience it with earlier pregnancies.
Partners can experience a type of PPA/PPD
History of mood or anxiety problems
Family history of mood or anxiety problems
Recent stressful life events (e.g. death of someone close, moving)
Unreasonable expectations (your own or your partner’s)
Lack of a village (support from friends and family)
Experience of abuse or violence
Social determinants of health (e.g. unstable housing, inadequate income)
Medical complications for yourself or your baby
Other factors (ahem, systemic racism, ahem)
Recovery from PPA/PPD can look differently for each person. Often women are encouraged to reach out to their primary care provider for medical intervention. In Canada, we are encouraged to reach out to our public health nurses for publicly available support. This can be an option, and it was the option that I took during both bouts of my PPA/PPD, but as we have heard from racialized moms it is not always the path that feels safest. And when a person doesn’t feel safe to reach out for help, the consequences can be deadly.
I am not qualified to speak to the racialized mother’s experience but thankfully this is currently being researched. Discussions about how to improve screening for PPD for racialized mothers, how to improve access, and how to start conversations are occurring. Here are a few examples:
Similar to other health inequities, barriers to reaching out for help for racialized mothers are multifaceted:
Income uncertainty, lack of medical coverage/insurance
Housing uncertainty, criminalization of poverty
Distrust in healthcare system, social work system
Lack of discussion around PPA/PPD and how to help mothers through it.
Dissolution of cultural supports through immigration, reservation systems, Indian Act
Stigma related to mental health issues in different cultures
Weaponization of mental health against racialized people
Postpartum depression and anxiety crosses cultural and racial boundaries. The risk factors are similar, the symptoms are similar, and the consequences without help are similar. We need to find ways to ensure that the help is similar - is equitable - and accessible. This is an ongoing task and one that cannot be solved by any single person. But together, we are powerful in our anti-racism actions, and we will find the way.
In my personal anti-racism journey, I will continue to be open about my journey through PPA and PPD. I will continue to advocate for better support services for racialized mothers. I will continue to encourage women to talk to their primary care provider for medical intervention, if it is the right thing to do for them. I will also be their support system, if they don’t have one. I will also be cognizant that what was safe for me, may not be safe for them, and hold space for that.
Much Love, Mom of two amazing boys,