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A Tragic Imbalance: Black Maternal Perinatal Mental Health

At StoriBoard, we have the amazing opportunity to discuss a wide array of subjects with our various ‘Expert Voices’, who offer insights into subjects we would all like to know more about. One of those experts is Dr Orinayo Onabanjo, a counselling psychologist specialising in perinatal mental health, who recently spoke to us about maternal mental health within the Black community and shared some difficult but revealing insights. Hard to reach? Or not reaching in the right ways? When it comes to birth experiences, it’s fair to note that each person will go through their own unique story, but when it comes to perinatal mental health within the Black maternal community, Dr Onabanjo points out some alarming statistics which demonstrate that some negative outcomes are sadly more prevalent than one might think. Onabanjo points out that ‘the research shows that there are significantly higher rates of perinatal depression amongst Black mothers than their white counterparts. It also shows that they’re less able to access treatment and that when they do, there’s a sense of not feeling that compassionate care, or feeling that their race sometimes negatively impacts the way that they’re cared for.’ Onabanjo mentions various reasons for this, but one stands out: A ‘lack of cultural understanding about the community and how they do things.’ As a result, the care that Black maternal patients receive may not be up to par. She goes on to explain that diversity within the Black maternal community itself must be appropriately considered as ‘there are a lot of cultural nuances, and particular traditions that are practiced during the pregnancy or postpartum period that also need to be taken into consideration’. A critical factor when it comes to this targeted approach is appreciating that within this community there may be ‘a lack of resonance with this Eurocentric concept of perinatal depression as a diagnostic label – because for some people that’s not how they would interpret their experience’. Onabanjo goes on to explain that even if one’s symptoms resemble a Western idea of depression, that may not be how many would define what they’re going through. She therefore recommends using more general, normalising language, like ‘emotional wellbeing’, or ‘struggling’, to grant all mothers an opportunity to feel seen in their experience. One of the major issues faced by Black mothers, Onabanjo points out, is a lack of knowledge of the support systems in place. ‘The communication around perinatal organisations that offer support around mental health isn’t being circulated properly or well enough to this community’. But interestingly enough, she also goes on to explain that ‘there’s research that shows that for Black mothers who experience depression, when they are able to access services, even though there may be difficulty in gaining access to it, that Black mothers do engage really well.’ She therefore sees it as critical to dispel the myth about Black mothers being hard to reach; ‘they’re not hard to reach, it’s just more about what is being done to reach this particular demographic/community of people? Is it attuned to their particular needs? If it’s not, then you can’t expect them to engage in a system of offering support that does not adequately understand or represent them. Birth trauma within the Black maternal community Tragically, it’s not just perinatal depression that is statistically more likely to impact Black mothers. Dr Onabanjo revealed the alarming fact that it’s currently almost 4 times more likely for Black mothers to die during childbirth or soon after the birth of their child than white women. Black women are also over 80% more likely to have a near miss, ie. to potentially have a brush with death or have something go seriously wrong. It’s no surprise therefore, that adverse experiences such as these make it more likely that birth trauma is going to be particularly prevalent within this community. What can be done? Dr. Onabanjo has several suggestions for handling the emotional impact of negative neonatal outcomes. Firstly, she encourages those who are struggling to focus on creating a sense of safety and stability. ‘This may involve surrounding yourself with safe people who care for you and make you feel loved, or simply thinking about stability in terms of routine.’ She acknowledges that motherhood can make it difficult to establish a routine, but suggests trying something new every day to create a sense of consistency and normalcy. This can help ground individuals after a traumatic birth experience. She also recommends taking the time to reacquaint yourself with personal values and priorities. ‘Sometimes, after experiencing something distressing, we may lose touch with what matters to us in life. Reconnecting with those values can help in the healing and recovery process.’ Onabanjo also highly advocates for cultivating self-compassionate practices. ‘Self-compassion is responding to your needs, and sometimes that means doing things that are hard. It isn’t necessarily about doing things that are easy; in fact, it can be difficult to act with self-compassion. However, it’s about being in tune with and responding to your needs. By doing so, you can build up your resources again and re-engage with life, including the process of being a parent.’ In terms of seeking help, if you do feel that you are struggling with birth trauma or depression, Dr Onabanjo notes that the first thing you could do is talk to your GP, who can refer you on to primary care services, such as talking therapy, but if it’s something that’s more severe or more debilitating, there are also perinatal community mental health teams out there who specifically deal with these sorts of cases. Another factor that was identified in the research literature that might contribute to depression, was a perceived lack of familial and interpersonal support – ‘this really isn’t surprising in the sense that we know that not having a good support system is a huge factor and a massive protective factor actually for your mental health.’ An app like StoriBoard provides a network of support for people who have gone through similar life experiences. Communities on the app offer guidance and the opportunity to learn from others while developing meaningful connections. According to Dr. Onabanjo, ‘research shows that a good quality support system for Black mothers is key, and that peer support is something that’s really effective in helping to enhance emotional wellbeing.’ Connection is a crucial part of healing, and StoriBoard brings people together to do just that. It empowers them to tell their story and change others’ lives for the better in the process. For more information, and to watch StoriBoard’s ‘Expert Voice’ videos, download the StoriBoard app today, and find your community.

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