Issue No. 4: Black Maternal Health
Words - Malika Ali Harding
Illustration - Leia Kaprov

“You do pregnancy like a white woman.”

She was twenty and I was twenty-two when my cousin spoke these words. Our maternal lives had mirrored one another. We were both teen moms—she in high school and I in college. She had been my Lamaze coach during my first pregnancy, a postpartum critic after my second, and the voice on the other end of the line encouraging me to accept the propofol the hospital staff wanted to inject after my third pregnancy when I was caught racing down the emergency room halls in hysterics. Like me, she is mom to three, but unlike me she’s never had the luxury of falling apart.

“Pain travels through families until someone is ready to feel it.”
- Stephi Wagner, Children’s Rights Activist & Mother Wound Healer

“Depression in Black women can manifest itself as anger or irritation in the absence of time and support for acknowledging sadness.”
- Dr. Thema Bryant-Davis, Licensed Psychologist & Trauma Recovery Specialist

Two decades ago, I was hella irritated when my cousin bleached my blues white. Understanding the cultural context from which her words sprang, she was actually right; I did do pregnancy white-girl-style, and I have the mental health facility receipts to show for it.

I would never suggest that mental illness, maternal or otherwise, is a “Whites Only” thing. It is not. However, family survival in America has often relied on Black women keeping our shit together. After that last pregnancy, my genealogical intestines exploded and several generations worth of shit, previously held in, went flying everywhere. When I awoke from my propofol induced sleep, I was informed I’d been placed on a 72-hour hold and diagnosed with postpartum psychosis (PPP), schizophrenia, and bipolar disorder.

Some terminology.

Above, I’ve used the words depression, sadness, and blues interchangeably, but from a maternal mental health perspective, there are distinctions. Experiencing the “baby blues” after birth is considered par for the course. These blues tend to go on about their business after a few days or so. Advocacy organizations like Postpartum Support International explain the different types of illnesses women may experience during and after a pregnancy. Most are treatable, though some are medical emergencies and require immediate help.

My Postpartum Psychosis recovery team incorporated family and friends, my psychologist, obstetrician, doula, a host of psychiatric doctors and nurses, medication, as well as the liturgical dance troupe at my local church who permitted me to move my body to healing choreography, without judging all the steps I missed. I knew I was well again when, after a laughing spell on a call with my cousin, she whispered, “Oh Malika, you’re back!”

Some terminology

Postpartum Depression:
Postpartum depression is a mood disorder that can occur after childbirth. It's characterized by levels of sadness, anxiety, and exhaustion that can make everyday tasks challenging.

Postpartum Anxiety:
Experiences of postpartum anxiety can vary, but may consist of constant worrying, fear of something bad happening, difficulty sleeping, nausea, and loss of appetite.

Postpartum Post-Traumatic Stress Disorder:
Postpartum PTSD is most often caused by trauma experienced during delivery or postpartum. It can involve anxiety, panic attacks, flashbacks, irritability, and difficulty sleeping.

Postpartum Psychosis:
Postpartum psychosis usually happens in the first two weeks postpartum and should be treated as an emergency. Symptoms include delusions, hallucinations, mood swings, paranoia, and hyperactivity. Postpartum psychosis is temporary and treatable with proper medical care.

Bipolar Mood Disorders:
Bipolar mood disorders are characterized by lows and highs; the lows refer to depression and the highs refer to mania. In Bipolar II disorder, the highs and lows are less extreme, and therefore sometimes less noticeable. Pregnancy and delivery do not necessarily trigger bipolar disorders, but sometimes women are diagnosed postpartum because this is the first time they are receiving increased health care attention.

Postpartum Obsessive Compulsive Disorder:
Postpartum OCD may involve obsessions or intrusive thoughts that are persistent and repetitive, as well as compulsions. Both obsessions and compulsions can be scary for a new parent who has never experienced either before.