Beyond the Baby Blues: Post Partum Depression and Black Women

My girlfriend had a beautiful baby boy two weeks ago. Now she's having tearful meltdowns nearly every day.

I've tried to assure her that part of what she is experiencing is very normal. The hormonal freefall after birth can be so powerful. And the overwhelming nature of life with a newborn can break down even the strongest woman--even if it's your third child, as in my friend's case, or perhaps precisely because it is your third child! In fact, about 1 and 8 women experience some sort of postpartum depression within the first few months after childbirth.

But my Spidey senses are all in overdrive because I know black women have a special relationship with postpartum depression. For starters, we don't talk about it. In fact, depression in general, is a taboo topic in our community.

Yet, depression among black women is more common than most realize. Formal statistics on depression in African American women are either uncertain or non-existent because the research is scarce. But studies have indicated that we experience postpartum at a higher rate than white women.

After all, African-American women live with more depressing stressors. We are black and female and living in a society that frequently devalues our children and our culture and undermines the significant roles we play in our communities. And because we are so used to suiting up in our Strong Black Woman gear, we take it personally or as if we have somehow failed miserably when we just can't handle it or keep it together post baby. And we have rarely allowed ourselves to be damsels in distress, vulnerable or able to ask for help. But I'm here to tell you ladies that depression is a chemical imbalance in the brain, not a character defect or a moral failing.

With so many nuances as to how we process and respond to postpartum depression, I canvassed the Internet to find out exactly what researchers do actually know about black women and postpartum depression. It may not be groundbreaking stuff, but it is certainly eye-opening and worth sharing. So here goes:

1. Our postpartum depression may be a result of lack of social support and more child-related duties among other issues.



2. It is also associated with more physical issues (back pain, tiredness, headaches) in comparison to Caucasian women, according to one study.



3. Black women culturally view it as a sign of weakness and often have feelings of guilt that they can not live up to certain cultural ideas like the "Strong Black Woman."



4. We often treat it through the use of self-talk or by confiding in family and/or friends.



5. Is sometimes a secret, as African-American women may sometimes fear the cultural stigma attached to depression, as well as the negative consequences of confiding in the medical community. These negative consequences include past atrocities in the health care system, such as those illustrated by the film Miss Evers' Boys.



6. It is sometimes recognized in the African-American culture as not having faith in God, being possessed by demons or a form of punishment for wrongdoings.



7. In general, black women handle postpartum depression better in comparison to their white counterparts.

The problem may be nuanced and complex, but the solutions seem simple: more support.

In a study on race and postpartum emotions by the University of Iowa, the researchers found that "strong social support can serve as a buffer against postpartum depression, and that poor social support is a major predictor of postpartum depression.Past studies have also shown that Latina mothers tend to have more social support, while African-American women tend to have weaker support networks," the study said. The researchers speculate that these ethnic differences in social support might account for racial differences and the higher rate of depressed moods among black women during the postpartum period.

If you know a new mom, offer your support, beyond the, "hey girl, how are you?" phone call. I'm brushing up on my new baby skills, packing the hand sanitizer, my trademark good humor and some yummy take-out and heading to my girlfriend's house this week. Keep you posted!

Racist School Boards. Insensitive Teachers. Black Moms Have Their Hands Full

Lately, I've been very concerned about some disturbing new reports coming out of our nation's school systems.

In Alabama, a teacher uses a hypothetical assassination of President Barack Obama as an example in a geometry lesson. The teacher later apologizes for his "very serious error," gets a formal reprimand and is ordered to take diversity training.

A North Georgia teacher allowed four students to don mock Ku Klux Klan outfits (they used SpongeBob Squarepants party hats under the sheets for that oh-so necessary cone effect) for a final project in a high school social studies class.

On a state level, The Texas State Board of Education, a Republican-dominated group, recently voted to 'rewrite history" in its textbooks and adopted a social studies and history curriculum that amends or waters down the teaching of the civil rights movement, religious freedoms, America's relationship with the U.N. and hundreds of other items. The suggested revisions include calling the Atlantic slave trade the "Atlantic triangular trade" instead and describing the civil rights movement as creating "unrealistic expectations of equal outcomes" among black and white Americans.

These are the things that really frighten me as an African American parent. There seems to be a strong tide to make black history invisible and I worry black children aren't too far behind on the list.

Thankfully, as a black mom, I've always thought it was my responsibility, not the schools, to teach my children black history. They never really got it right in schools anyway and only seemed to focus on slavery and Martin Luther King. But black history, even an incomplete version of it, really isn't for black children. It is really to help all children learn how diverse peoples have contributed to America's greatness and even to her not-so-great moments.

When one of our experiences is downplayed, rewritten or trivialized by teachers in a classroom or administrators on a school board, it is a sad day for all parents. Not just the African American ones. When educators make bone-headed decisions without thinking through the impact on all of the students, they have to be held accountable.

Meanwhile, every day I send my brown little boy and brown little girl to school, I hope they return without having their sense of self scarred or their history insulted. I hope their teachers are aware of their own biases (hey, we all have them) so that they can work past them for the sake of all the students. But lately, I've been losing faith.

And I give thanks that I don't live in Texas, where foolish men and women think rewriting history changes our present and future. Rewriting history books won't change the limitless future I'm creating for my children, but only shows me how in one more way, black parents have to really bring their A-game to our parenting journey. It also shows me, once again, the unique stressors that black women face in childrearing.

These are the subtleties that eat away at us and affect our birth outcomes and our overall health, despite prenatal care. These are the things that we have to recognize as relevant to our overall health and not just something we shrug off as part of the black experience. These are the things that make me recommit to a healthy lifestyle for myself and my children, so I can be here, strong, healthy and whole, to teach them at home, advocate for them at school and build their futures.

And no one will be able to rewrite that.

Breastfeeding Moms Found to Have Vitamin D Deficiency, Study Finds

African American Moms at Higher Risk

We all know breastfeeding is best for mom and baby. But moms have to continue to practice excellent self care, by eating well while breastfeeding. A recent study found as many as two of three mothers in Cincinnati, Ohio, who breastfeed had insufficient blood levels of Vitamin D. In addition, three of four one-month-old infants whose mother breastfeed had Vitamin D insufficiency, according to the study by the Cincinnati Children's Hospital Medical Center.

"Mothers who are Vitamin D deficient produce little or no Vitamin D in her milk and are unable to give a baby all of the Vitamin D that he needs," says Adekunle Dawodu, M.D., a physician in the Center for Global Child Health at Cincinnati Children's and lead author of the study. "Mothers and babies who breastfeed need Vitamin D supplements to ensure optimum health."

Dr. Dawodu presented his study recently at the annual meeting of the Pediatric Academic Societies in Vancouver, Canada.

The study focused on 120 mother-infant pairs who were enrolled in a global human milk research collaborative. The prevalence of Vitamin D insufficiency in mothers was 66.4 percent at four weeks postpartum and the prevalence of deficiency was 16.8 percent at four weeks. The prevalence of insufficiency in infants was 76 percent at four weeks and the prevalence of deficiency was 18 percent.

Major results of Vitamin D deficiency include brittle bones, rickets and increased risk of respiratory infections. Vitamin D deficiency is particularly high among African Americans, so black women have to extra vigilant.

"In addition to taking Vitamin D supplements, people can also make sure they are getting modest sunlight exposure," Dr. Dawodu says.

Your commitment to having a healthy baby and a healthy you doesn't stop at delivery. Breastfeeding moms have to continue to eat well, drink plenty of fluids and take vitamin supplements, if necessary, to maintain their own optimal health.

The Black Maternal Health Project is all about embracing the mother, and just as important, asking more mothers, breastfeeding or not, to do a better job of embracing themselves.

What's in Your Womb? Pre-programming for the rest of your life, that's what.

Do you have heart disease, high blood pressure, diabetes or high cholesterol? Like many people, you're probably thinking that your diet, exercise (or lack of it), or weight play a significant contributing factor. And they likely do. But there's something else to consider. Are you ready? Here's the 64 million dollar question: Were you a low-birth weight baby?

Did you know that being a low birth weight baby could make you more susceptible to having heart disease or high blood pressure 40 or 50 years later?

This amazing nugget relates to a new discovery in epigenetics, called fetal programming. Fetal programming refers to the process whereby a stimulus or insult at a critical point in fetal development creates permanent changes in the structure and function of the baby's vital organs, leaving lasting or even lifelong consequences for health.

The idea of fetal programming was first introduced by Dr. David Barker and his colleagues at the University of Southampton in England. Barker and his team made a connection to poor fetal growth inside the womb (which resulted in low-birth weight) and coronary heart disease, diabetes, high blood pressure, diabetes, high cholesterol and a many more chronic adult illnesses later in life.

Barker hypothesized that similar to programming a computer, a baby's heart and other vital organs are actually "programmed" inside the womb. If something negative happens during pregnancy then those organs may not get the proper programming and never fully function at their best over a lifetime.

It's an amazing way of thinking about the long term effects of pregnancy beyond just what happens at delivery. It was one of the many Aha! moments I had last week, as Dr. Michael Lu, from UCLA, presented on the Life Course Perspective as part of the Women's eNews Black Maternal Health Conference (click here to watch the webcast)

Lu discussed the "Barker hypothesis" and showed that although it was initially met with some skepticism in the scientific community, over the past decade more and more scientific evidence is building to support this idea.

Two key areas that Dr. Lu highlights:

• Maternal stress linked to ADHD in children. When a woman is stressed out during pregnancy, her baby is immersed in a stress hormone called cortisol. Studies indicate that over exposure to cortisol in the womb results in permanent changes in the structure and function of the fetal brain. There are more and more studies linking maternal anxiety and stress during pregnancy to neurological disorders in children, including ADHD.
  
   


• Maternal nutrition linked to childhood obesity.  Poor fetal nutrition cause permanent alterations in key organs such as the pancreas, kidneys and blood vessels which can lead to diabetes, hypertension and heart disease later in life. In addition, poor fetal nutrition affects the genes the help the body use and store energy more efficiently. They are called the "thrifty genes." In our food-crazy society, those turned on "thrifty genes" mean that body will hang onto to every calorie possible, predisposing a child to a lifelong struggle with obesity.

The point is, so much is happening in the womb that affects your baby not just at their birth but for the rest of  life. And if we really want to prevent obesity and heart disease in children and adults, then we have to go back to the womb and make sure those organs are properly optimized from the start.

Learn more about what you can do to prepare your womb for optimal fetal programming by reading Dr. Lu's book.

 

Black women are dying! Enough scaremongering, it's time for solutions!

Lately, I've been extremely frustrated by all the news reporting about maternal mortality. Yes, it is a terribly frightening and frighteningly embarrassing issue. Women are dying during childbirth for preventable reasons, and African American women at even more shocking rates and something must be done. Like now.

A recent study by Amnesty International, entitled "Deadly Delivery", reports that deaths from pregnancy and childbirth in the United States have doubled in the past 20 years--from 6.6 per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006. Pregnant women and new mothers are dying because of "systemic failures" in the current health system, the Amnesty report said.

The alarming data on maternal mortality is even more shocking for African- American women. We are three to four times more likely to die during childbirth than white American women. And even wealthy black American women have a higher rate of mortality during childbirth than wealthy white women.

Yeah. It's serious.

Now I understand the power of fear as a coercive tool in the media world and in political circles, but my personal fear is that all the negative reports and doom and gloom coverage makes the situation seem hopeless. It makes women, particularly Black women, feel powerless to a force that no one can succinctly explain or otherwise tell them how to prevent.

People don't get behind hopeless. Research money doesn't come to hopeless. And the right kind of awareness that actually empowers women to have healthy childbirths and live healthier lives overall doesn't come from hopeless. It comes from hope.

That's why I'm so excited about the work of Dr. Michael Lu, an associate professor in both the UCLA School of Public Health and the David Geffen School of Medicine at UCLA, and one of the influential thought leaders who's talking about new solutions to the maternal health problem. It's pretty clear the old ones aren't working.

Dr. Lu's work focuses on the "life course perspective," a simple yet groundbreaking premise that rests on one simple truth: you cannot correct the outcomes of childbirth simply by looking at the 40 week gestational period. Saying that black women need better prenatal care is a start but not the complete answer. We need a longer term "life course perspective" to address the issue, which includes rethinking how healthcare is delivered, how we look at life stressors and how we get back to focusing on mothers and communities.

I've been a fan of Dr. Lu for some time. In fact, his work was one of the research inspirations for writing my first book, The Mocha Manual to a Fabulous Pregnancy (Amistad/HarperCollins). At the time, it was the first-of-its-kind book for African American women that looked beyond the nine months of pregnancy to offer advice on all areas of life that could affect a woman's pregnancy outcome from her finances, relationships, life stressors, cultural taboos and her medical history. It was the "all you" approach to pregnancy for black women, and I'm grateful to Dr. Lu's work for inspiring me to develop that concept.

I'm also very grateful and excited that Dr. Lu will be speaking this week at our Black Maternal Health conference and sharing his insights and answering your questions on what we need to do now to close the gap in maternal and infant health disparities for African American women.

Please join us on April 28th at our NYC offices at 12:30 p.m.(simply rsvp with your name and affiliation to rosemary@womensenews.org) or click here http://www.ustream.tv/channel/wenews to watch live via our webcast.

We've read the depressing headlines. It's time we start talking about solutions. Please be a part of the conversation.

Hatred After Health Care Reform. Racism Rears Its Head

I'm sorry, where exactly are all the people who vehemently declared after President Obama's election that we were living in a post-racial America? Please stand up.

Seriously.

Let's recap a recent scene: The president of the United States passes a historic bill to reform health care in this country and actually save lives and protestors resort to allegedly hurling racial slurs at black lawmakers? I won't even mention the choice words being thrown at our nation's commander in chief? Protesters, what about the million things that are supposedly wrong with the bill? Why not use those as your sticking points?

It really goes to show how far we have not come in this country. Whenever there is passionate disagreement, which, by the way is a good thing and what makes this country great, someone somewhere is going to resort to race. It's as if racial bias consistently sits just under the skin of the culture of this country, and if anything slightly irritates or pricks that delicate skin, the ugly truth just comes oozing out.

Then you wonder why I fear for my black children. The reason: I'm in fear of many white parents, who are acting out their racial biases for everyone to see on CNN, YouTube, at Tea Party conventions and on the local news for crying out loud. What kind of messages are these children getting at home and then bringing to the playground?

In fact, the whole health care reform process has been an embarrassing stain on our reputation. As I watched the drama play out in total "SMH" mode, I desperately tried to extract a few lessons:

The ridiculous myths about death panels and the alleged slippery slide into socialism reminded me how important it is for me to teach my children to be independent thinkers willing to research the facts on their own, rather than have that dangerous herd mentality where people foolishly rally behind buzz words that speak to their issues and biases.

The fact that not one Republican took a stand for better healthcare said to me that partisan politics was more important than saving lives. I hope my children never lose their humanity in their quest to get ahead. I will remember to remind them of that.

And watching the racial slurs and Obama assassination threats on Twitter (even allegedly by two conservative blacks, no less) reminded me of something my Daddy taught me long ago: people who resort to mud-slinging and in-the-gutter tactics, are desperate and pathetic because they really have nothing of substance to say.

Our so-called post-racial America has a lot of road ahead of it. In the meantime, the impact of racism is still seen everywhere from our political circles to our health disparities to our educational system.

Memo to Michelle Obama: Big Food Makers Don't Give a Fructose About Our Kids

I love Michelle Obama. Her strength, professionalism, sass and savvy are enviable. And as a mom, I can only applaud her efforts to reduce the embarrassingly high obesity rates in this country. Earlier this month she spoke at the Grocery Manufacturers Association meeting and asked big food companies like General Mills, Kraft Foods and Coca-Cola to produce more healthful food. What chutzpah! Then she went one step further by asking the food companies to then market the healthy food to children, instead of the red-dye, high sodium, high calories crap they usually market to our children.

Now I can certainly understand that the First Lady has to ask everybody to join in the fight against obesity. It is certainly an all-hands-on-deck type of goal. But if she really thinks big food companies will actually do something , then I'm a little concerned. I'm hoping she figured, "well, the event is in D.C. and I won't have to miss school pick up so what the heck."

The truth is, big food makers are not going to kill their cash cow by actually making healthier food, especially when making the unhealthy stuff is so cheap and rakes in serious money. I mean, hey, if it ain't broke, why fix it? That was like asking the healthcare companies to support health care reform with a public option. It was never going to happen. These corporations are big businesses looking for a profitable business model that works. Remember the multi-billion dollar kick in the bottom line it took for the tobacco industry to actually clean up their act? Big business, no matter what public relations spin they try to put on it, only acts in their own self interest. That interest is to keep shareholders happy and CEOs happier with fat paychecks and even fatter bonuses. My child's health is the last thing on the mind.

Thankfully it is the first thing on my mind. That's why it is really my responsibility and that of every other parent to make sure their child has a healthy diet and an active lifestyle. This is particularly true in our community where studies show that almost 36 percent of black children between the ages of six and eleven are overweight, and more than 19 percent are considered obese. Among twelve- to nineteen-year-olds, 40 percent are overweight and nearly 24 percent are obese.

More importantly, we as black mothers have to set a good example by modeling healthy living and healthy eating ourselves. Our own health impacts our children from pregnancy through adulthood.

I appreciate that the First Lady has to make all the appropriate rounds (and like I said, no out of town trip required) but no parent or reasonable adult should ever expect big business (or government, for that matter) to do what we need to do for ourselves and our children. That is, take back our power as parents and as the CNO (chief nutrition officer) in our homes. When your child begs for unhealthy crap, try this novel approach and simply utter, "No!" and actually mean it. Or better say, yes, but only once in a while.

Attention world, here's how to get the food makers on board: Stop buying the unhealthy stuff. When they lose the financial incentive for making unhealthy food options then they will stop. Period. When we educate ourselves as parents so that, as Mrs. Obama noted, we don't fall for gimmicks such as a food maker marketing one healthy aspect (such as adding one gram of fiber) while doubling the calories, then they will be forced to clean up their act. Until then it's just photo opps, PR spin and back to the sodium-laden processed foods with ingredients you can't even pronounce (Someone please ask the good folks at Hooked on Phonics to produce a special edition to help us get through our food labels).

That's fine for them. But we, as moms, have plenty of work to do. Let's get down to our big business.