Commentary On & a Link to The Paradox of Postpartum Depression, an article in Colorlines by Rebecca Blustain

Day 24 in 30 posts after Oprah’s 60 Minutes show.

Cissy’s note: Parents are not all treated the same, not during pregnancy, birth, or in the post-partum period nor in the adoption process for that matter. Parents with ACEs (adverse childhood experiences and adverse community experiences) aren’t all treated the same either, not when in crisis or seeking help and support. 

Context always matters.

The article below shows how and why addressing racial bias must be central to trauma-informed care and change and why a one-size-fits-all approach is actually least helpful to those most impacted by the pair of ACEs. It’s articles like this that demonstrate why I don’t support universal screening of parents or patients and why I caution people about being selective when, where and with who we share ACEs related information about ourselves or our children. 

In an ideal world, a trauma-informed change would require just and equitable systems for all. While asking, “What happened to you?” instead of “What’s wrong with you?” is an improvement it’s not enough. There are other questions that must be asked and which we must ask ourselves such as, “What have we and our systems done to hurt people based on our ignorance or bias?” “What can we do to correct that and earn back trust from those hurt and harmed?” And also, we must ask, “Who and what have we not listened to or heard til now?” 

It’s not only new questions we need but new conversations among peers talking and listening to one another. So far, those most vulnerable in the system, who have the Pair of ACEs, are rarely even acknowledged, and even as we finally are understanding why and how ACEs have a lifelong impact. Too often, we’re still refusing to acknowledge that those impacts disproportionately impact people of color.

This article does a great job of showing and telling how and why the system has worked to date and why, without healing and accountability, it’s foolish to expect all people to trust that using, confiding in and relying on the medical system, in general, or medical professionals, in particular, will be healthful or helpful for parents, patients, and families. Research, experiences, and past and present realities have often proved otherwise.

However, we can still keep using the research and share it with one another to support healing in ourselves, families, and when creating new solutions.) 

Excerpt from an article in Colorlines by Rachel Blustain.

Like Granberry, Kay Matthews founded The Shades of Blue Project after she lost an infant at birth. Matthews uses the offer of free diapers and formula to draw mothers into her organization, then connects them to a support group where women talk, exercise and cook together. “We’re like a family,” said Matthews, especially for women whose own families offer more judgement than support.

Matthews knows it’s risky when women need professional help and don’t get it. So when women say it’s too hard to speak to their doctors—because they’re scared, ashamed, or because they’re going to a clinic where the doctor has no time for them anyway—Matthews asks them to write down their feelings on a postcard to give it to the doctor.

At the same time, Matthews is transparent that talking to a doctor about postpartum depression is not risk free. Whenever possible, she refers them to doctors and therapists within her circle. In addition, Matthews’ postcards have her organization’s name, her name, and her telephone number on them. Asking for help can put a mother in danger of involvement with child protective services, but showing that she has a support system behind her, Matthews said, can mitigate that danger.

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Who Postpartum Depression Hits the Hardest

Since the 1950s, there has been a sea change in public understanding that postpartum depression and anxiety, though at times severe, are, by and large, time-limited illnesses when properly diagnosed and treated. A 2017 study by the Royal Australian and New Zealand College of Psychiatrists even found that postpartum psychosis, though potentially lethal for mother and child, can resolve itself within weeks if treated. So much has changed in our attitudes that when Ivanka Trump joined the list of celebrities to share her story of postpartum depression, critics suggested that she’d made a cynical and safe confession only to distract from her father’s efforts to undermine insurance coverage for mental health and maternity services.

Despite all that, mothers are still afraid to acknowledge their suffering, making suicide a leading maternal killer in the year after birth. Depressed moms living on low incomes get help less often than more affluent mothers; mothers of color less often than White mothers; and low-income mothers of color least of all, according to research by The Urban Institute.

Between 2004 and 2007, after New Jersey mandated doctors to screen all new mothers for postpartum depression, 9 percent of White mothers on Medicaid in the state sought treatment for it, while 5 percent of Latina and 4 percent of Black mothers did. Black and Latina mothers were also less likely to receive follow-up treatment.

Disparities in treatment are particularly troubling given imbalance in rates of postpartum mental illness. Roughly half of poor mothers report some level of postpartum depression, compared to an estimated 10 to 20 percent of all new mothers.

Read more of this article by Rachel Blustain in Colorlines.