Rolling Out

Shaenor Ishmael lists issues that affect Black maternal mental health

The trusted psychotherapist is helping mothers navigate the challenges of maternal mental health

Maternal mental health is a big topic among new mothers, and Shaenor Ishmael, Ph.D, is an expert in the field, finding different approaches to help those women. A psychotherapist, Ishmael has committed to providing her expertise to help mothers navigate the challenges of anxiety, depression, and other perinatal mental health conditions.

Ishmael spoke with rolling out about maternal mental health and issues that are being ignored that affect Black women.

What should we know about maternal mental health?

Maternal mental health is just the overall emotional, social, and mental well-being of women during pregnancy and in the postpartum period. Oftentimes, when we talk about mental health or even postpartum depression, it’s often after the baby is born. The unique thing is that you can often develop mental health concerns during pregnancy and even in that preconception planning period. I am a true advocate for women to have a mental health professional on board during their pregnancy, just so we can monitor for the potential of any mental health disorders that may arise. We talk about postpartum depression and postpartum anxiety, but you can also have what’s called perinatal depression, perinatal anxiety, and perinatal OCD. Though you have those disorders during pregnancy and then in the postpartum period, it doesn’t always show up after childbirth.

What are some issues that affect Black women’s maternal health that are being ignored?

There’s a survey, I believe, posted by the CDC that 30% of Black women feel unheard in their maternal journey, so I’m talking about maternal health overall. They do not feel heard, and they do not feel as though their concerns are being adequately addressed. It’s interesting enough because maternal mental health complications are the number one reason for maternal mortality in this day and age, according to the CDC. Fifty-two percent of maternal mortality rates occur seven days postpartum to that one-year period, so there’s something happening in that timeframe. We talk about not being heard, being easily dismissed, and not fully engaging in concerns that Black women have, so when a Black woman goes to her provider and says, “I’m really struggling this postpartum period,” the hope is that the provider will truly listen…

Another concern that I noticed is there are supposed to be screenings that are done in the postpartum period, so when you go to your pediatrician, the pediatrician gives you a postpartum depression scale, in the sense of gauging how you are feeling overall after having the baby. There is a conversation that I saw occurring in the sense that a lot of times, a Black woman will lie on the screening because of the fear of intervention from Child Protective Services. They do not want to indicate that they’re having any trouble with taking care of their baby. This goes back to the fact of those disparities and not being heard. We have to do a better job of having cultural humility. It’s not necessarily cultural competence. I don’t need people to know everything about every culture, but I need you to be humble enough to sit down and say, “Okay, let me hear you. Let me hear what’s going on. Let me try to see your point of view. Let me reach across the table and empathize with what you’re going through.” For a Black woman, that is the piece that we’re missing.

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