More than 1 in 10 women will experience postnatal depression within the first year after giving birth. With a recent study showing that postnatal depression is 13% higher among black and ethnic minority women than it is among white women, it raises significant questions around whether these women are receiving the right treatment and support.
About the Author
In this interview Patient Safety Learning speaks to Sandra Igwe, Founder of the Motherhood Group, a support network to help black and ethnic minority women talk about parenting and mental health.
Questions & Answers
Hi Sandra, can you tell us about your own experience of early motherhood?
Sure. When I had my first baby I thought it was going to be the happiest time of my life but I just felt this huge pressure to be the perfect mum. I cried a lot and obsessed over keeping the house immaculate and cooking the best food. I didn’t rest and I became increasingly anxious. Although it took me a long time to realise it, I now know that I was experiencing something called postnatal anxiety.
Did you ask for help?
I’d had a terrible experience with my community midwife during my pregnancy, who wrote things that weren’t true about me and led me to fundamentally distrust the system. The way I was treated made me fearful to interact with the NHS after I gave birth which I know isn’t good thing. If I had been better supported, I would have asked for help much sooner.
How did the Motherhood Group begin?
We know that black women are more likely to have postnatal depression but are less likely to access care or to be referred for follow up treatment. I wanted to create a network for women of colour to connect and talk freely about mental health and motherhood. It started off as a small WhatsApp group. Now our network now has over 11,000 members.
We connect mums with other mums, stream live events to help generate conversation and work with experts to raise awareness around perinatal mental health and parenting challenges. Our members can get involved in facilitated and focused discussions as well as social meetups. The aim is to create a safe space for mothers to share challenges, triumphs, questions and advice on their personal motherhood journey.
Do you think that black women could be better supported in their maternity care?
Yes, absolutely. I don’t believe that black women are always offered the support or encouragement they need to be able to talk about mental health problems. Speaking from my own experience, I felt like the six-week postnatal check was a bit of a tick box exercise. There was no time to fully respond or get to the heart of my difficulties at that time, so I suffered alone. There is a cultural assumption sometimes that black women are very strong, but no one is immune to mental health problems. That kind of bias can cause real harm and black women can slip through the net, where white women may not.
How do the other women in the Motherhood Group feel?
Many of the women in the network feel they have been judged by the colour of skin while accessing healthcare services and consequently have received a second-class service. Although they are all too aware of the institutional racism that exists in the UK, these women are understandably shaken when they experience discrimination at such a vulnerable time as during pregnancy, labour or postnatally.
Many are concerned they will be treated unfairly, deemed a bad mother or have their babies taken from them. Some feel that staff were inappropriately unempathetic or unkind to them throughout their care. And there have been experiences of clinicians withholding epidurals for hours or being dismissive of a woman’s pain because her screams didn’t coincide with contractions. There is a fundamental, widespread distrust in what most see as a white system for white people.
What needs to happen to start addressing the racial disparities in postnatal mental health?
There needs to be better training for clinicians around unconscious bias. Unfortunately it exists in every industry and in healthcare it can have a dangerous impact on a patient’s safety. Maternal suicide is the leading cause of direct deaths occurring in the UK within a year after the end of a pregnancy, so racial disparities in postnatal mental healthcare have got to be addressed.
We need to see more diversity in the resources and support groups available too. I tried to attend mum and baby groups but found that I was often the only black woman in the room. On social media, most of the mum groups and bloggers and vloggers are white, middle class women too. The parenting industry as a whole is the same. It gives the message that we are not part of it, not included or in need of support.
There also needs to be proportionate repercussions when patients suffer unfair or negligent treatment.
What are your hopes for the group in the future?
The Motherhood Group has given women of colour a voice in maternal mental health. People are beginning to value our experience and ask for our input into research projects around maternal mental health. We need to continue to be loud and to be heard and to support each other as we face the challenges of motherhood. Raising awareness has been an important first step in the journey. Now we need to make sure that we are also part of the solution.
Find out more about the Motherhood Group
Facebook: The Motherhood Group
YouTube: The Motherhood Group