Black mothers are 'falling through the net' for postnatal mental healthcare

Sandra Igwe thought having a child would be the happiest moment of her life, so she couldn’t understand why looking at her beautiful little girl filled her with anxiety and sadness.

‘She was literally perfect, beautiful, and she hardly cried,’ Sandra tells

‘When I got home after giving birth, I realised that I wouldn’t be able to quickly run to the shops spontaneously, book a flight, or go for a meal with friends.

‘I found myself not wanting to turn the TV on anymore, I would randomly burst out crying for silly mishaps, like not defrosting the chicken on time. I started ignoring phone calls and messages from family and friends, and I lost interest in all the normal things that used to bring me joy.’

Sandra was experiencing postnatal anxiety, a mental illness that many new mothers go through. But she felt completely isolated and alone with her fears. On top of the stigma associated with mental illness in new mothers, Sandra had the added burden of coping with it as a black woman.

Postnatal depression or anxiety in BAME mothers is 13% higher than in white mothers. A 2011 study found that black women are the group least likely to initiate treatment for postnatal mental illness, and the least likely to receive follow-up treatment.

And this racial disparity is putting the lives of black mothers at risk. Research in 2018 found that 23% of women who died in the postnatal period suffered from mental health disorders, and suicide is now the second leading cause of maternal death in the UK.

A study in 2010 found that healthcare professionals in the UK lacked the training and the confidence for identifying the specific needs of black women – causing black mothers to ‘fall through the net’.

This is where Sandra found herself in 2016 after the birth of her first daughter.

‘I quickly realised that it was something that I shouldn’t be speaking out about,’ explains Sandra. ‘I was showed very early on that I had to put on this happy face and smile, because, after all, I was a new mother, I had reached the pinnacle of womanhood, the best moment of my life, my life was nothing until I became a mother, right?’

Sandra spent a long time struggling alone, battling her symptoms without any professional medical care, all while trying to get to grips with new motherhood.

She puts this lack of support down to an inherent distrust in the maternal health services in the black community.

‘I would be reluctant to speak to a healthcare professional mainly because we have learnt not to trust them,’ says Sandra. ‘There is a notion of “them” vs “us” in our community. We feel we are constantly being judged by the colour of our skin, so why would we open up about a subject matter that they could potentially use against us?’

Sandra says she had an awful experience with her community nurse when she was pregnant, that she broke her trust in a really fundamental way and told people things that weren’t true.

‘She made me feel as if my words didn’t matter, that I was inadequate and voiceless. What was supposed to be a monumental and precious moment for me, was tainted in inequality and institutionalised racism.’

Frustrated and upset, Sandra started a Whatsapp group for other BAME mothers that quickly grew from seven to 70 new mums, and now has more than 7,000 BAME mothers across their social media channels – The Motherhood Group.

Talking to other women across this network, Sandra quickly found out that she wasn’t alone in her lack of trust and unfair treatment at the hands of postnatal healthcare.

‘One mother told me she was a nurse and has witnessed discrimination against ethnic minority patients who are not listened to,’ recalls Sandra. ‘Another mother said that the microaggressions she received during her pregnancy and after birth has put her off from having any more children.’

The lack of trust doesn’t come from nowhere. As well as the individual negative experiences, studies have found, again and again, that black women are at the highest risk of dying during childbirth. The latest study found that black women in the UK are five times more likely to die than white women.

Dr Giuseppe Aragona, GP and medical advisor at Prescription Doctor, says social, economic and stereotypical factors all play a part.

‘One theory, and something that many people overlook, is the racial differences in maternal mortality,’ says Dr Aragona. ‘These statistics are likely to promote mental illness in women of colour due to anxiety, OCD and worry over these findings, this could, in turn, promote postnatal depression.’

Dr Aragona adds that the evidence shows that black women are not getting sufficient support from clinicians, health support workers, the media or social groups.

‘The lack of diversity when it comes to advice, support groups, social media as well as treatment types is stark,’ he continues. ‘Instagram is a prime example of this disparity; the amount of white “yummy mummy” bloggers outweighs black bloggers by miles.

‘The parenting industry as a whole is not showing enough diversity and is not catering to women of colour or women of different social status and economic background. This leaves black women feeling as though they are not included, they shouldn’t ask for help, they are not worthy of help or that their background and upbringing means they do not deserve help or treatment.’

Sandra says another cause of the neglect of black mothers is down to misconceptions and archaic, racist stereotypes. She conducted a survey of 500 mothers in her network and it was a theme that came up again and again.

‘Many mothers expressed the same notion that it is not believed that mental illness is something that affects us. There is the need to appear strong, all the time – the “strong, independent black woman” myth needs to die. We have emotions, we struggle, we face challenges, and that’s ok.’

Dr Aragona agrees. He says these stereotypes can be incredibly damaging and can project the image of a superwoman who never needs to ask for help.

‘This may leave women feeling helpless and alone, like they can’t or shouldn’t ask for help, medication or seek any sort of advice from any healthcare professional whether that be a GP or a counsellor,’ he says.

‘I would suggest always reaching out, whether that’s to a family member, a friend, a support worker, a doctor or local GP. If you are feeling isolated it may be a good idea to join support groups, especially ones that cater to you and your needs as these will make you realise that it’s not just you, and the advice and stories from other women should put you more at ease.’

This is where Sandra’s support network fits in. She hopes that The Motherhood Network will provide a community for BAME women who are lacking the support they need in other areas of their life. Over the last three years, Sandra has facilitated workshops and events involving more than 1,600 mothers – and she wants to take it even further.

‘We need participation in more workshops and events that give BAME mothers essential tools to thrive,’ says Sandra. ‘We need to learn how to spot the signs of postnatal depression in ourselves and others, and how to vocalise unfair treatment.

‘We all need to improve how we speak to and engage directly with the communities that have not had their voices heard on something as intimate as maternity mental health.’

Sandra is passionate about speaking more widely, more openly and louder about maternal mental health in the black community. She says it is an elephant in the room, and the only way to dispel it is to first acknowledge it.

‘We need to keep the conversation going to normalise that it is OK not to be OK – even if you’re a black mother.’

The State of Racism

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