Introduction
Postpartum depression, although a widely recognized disease, remains a medical phenomenon that suffers from stigma and dismissal among society and medical professionals. Essentially, postpartum depression is a severe mental health condition that is manifested through depressive episodes, anxiety, and suicidal thoughts in women after giving birth. According to the Centers for Disease Control and Prevention (CDC, 2020), one woman out of eight struggles with postpartum depression. The statistic, however, can be tampered with due to the fact that many women do not address medical professionals when having postpartum depression (PPD) because they are either unaware of the symptoms or they are unwilling to admit them (Mughal et al., 2021). The difference between a screening two weeks after birth and six weeks provides a window into the different experiences of PPD by mothers. The issue is especially significant among minority women, as, in addition to the stigma surrounding PPD, they are exposed to gender and ethnic discrimination by medical professionals and society. African American women, while more likely to be diagnosed with PPD, are not encouraged to undergo the early PPD screening. Hence, it is reasonable to assume that early PPD screening in African American women plays a crucial role in the timely detection and prevention of relapse.
Early Detection of Postpartum Depression
To begin with, it is necessary to define the overall impact of early PPD intervention. The hypothesis that early detection of PPD has a series of benefits for both young mothers and children has been proven in a recent study by Hahn et al. (2021). According to the researchers, currently, “there are no accurate screening tools for either disorder to identify at-risk mothers and enable them to benefit from early intervention” (p. 1). It means that both PPD and adjustment disorder in women are not perceived as health conditions that need to be identified in an orderly manner. Meanwhile, the scholars claim that “early diagnosis and treatment of PPD can substantially improve the outcome, prevent relapse, and minimize the associated emotional and financial burden.” (Hahn et al., 2021, p.1). The significance of early diagnosis and the neglect of this intervention creates cognitive dissonance, as it is unclear why professionals continue to abandon prompt PPD screening. One of the explanations presented by the researchers is the fact that behavioral changes are common among women in the postpartum period due to severe alterations in the hormonal balance (Hahn et al., 2021). As a result, many cases of early PPD remain undiagnosed and result in severe complications for the family.
The effect of undiagnosed PPD does not only impact the mother’s behavioral patterns but the mental state of children in the long term. In a systematic review conducted by Slomian et al. (2019), the data from empirical studies indicate that “postpartum depression creates an environment that is not conducive to the personal development of mothers or the optimal development of a child” (p. 1). In the majority of studies analyzed, the researchers found out that besides children’s physical characteristics such as weight and length, PPD was associated with poor cognitive development, speech apparatus, health status, behavioral patterns, and quality of sleep (Slomian et al., 2019). Hence, it becomes evident that it is “important to detect and treat depression during the postnatal period as early as possible to avoid harmful consequences” (Slomian et al., 2019, p. 1). When neglected, women become more likely to worsen their mental condition and negatively contribute to the children’s cognitive development at the early stages and later in life.
Postpartum Depression in African American Women
As far as African American women are concerned, the issue becomes even more complex due to several reasons: the stigma associated with the mental health of African American women and the mental health complications that pass with generations of discrimination. Thus, women from marginalized groups are more likely to be exposed to mental health issues, as the generations of trauma and psychological abuse take a toll on the women’s predisposition to mental health complications and instability. According to Maxwell et al. (2019), “they [women from marginalized groups] become stigmatized, are often at the receiving end of negative public attitudes and are more likely to experience PPD” (p. 33). The major risk factors for PPD include such factors as the previous history of anxiety and depression, history of sexual and psychological abuse, pregnancy complications, and lack of support system, including both psychological support and beneficial socio-economic postpartum environment (Mughal et al., 2021). PPD screening is not often accessible or provided for African American women and creates complications with mental health at both the two-week and six-week timeframe. Evidently, all these factors are dominating in minority groups, as the long history of marginalization and exclusion from society results in a higher risk of developing long-term mental health complications.
Socio-Economic Environment
Moreover, overwhelmed with the future of a child, including socio-economic security overall well-being, African American women are more likely to be affected by stress and perinatal complications when bearing a child (Maxwell et al., 2019). Hence, instead of paying more attention to the women from diverse groups, medical professionals tend to overlook PPD screening whatsoever. Another contribution to this issue is the overall African American women’s perception of their mental health and women’s image in society. For example, in the aforementioned study by Maxwell et al. (2019), the researchers indicate the power of self-guilt and shame about accepting the disease prevailing among women from diverse groups. Indeed, women who have always been portrayed as strong individuals feel extremely ashamed of accepting weakness and resorting to psychological help, so they keep the pain and depression to themselves (Maxwell et al., 2019). Thus, early intervention and PPD screening are essential to African American women in order for them to feel more comfortable sharing their concerns.
Moreover, the socio-economic status of African American women is another contributing factor to their predisposition to PPD. In the research by Liu et al. (2018), the authors indicate that employed women are more likely to struggle with PPD because they suffer from both perinatal stress and the inability to connect fully to a child. In the context of African American women, employment is a necessity rather than a balanced decision. Indeed, the vast majority of women from diverse groups have no economic security, so they have no other choice but to work both during and shortly after pregnancy in order to support their child financially (Liu et al., 2018). As a result, considering the fact that Black women work during pregnancy and are more likely to develop PPD, early intervention should be mandatory.
Women’s Perception
Considering the aforementioned facts about African American women, it is natural to ask why data on PPD in minority groups remain underrepresented. The reason for it is that despite the undeniable evidence of women of color requiring counseling, some studies demonstrate women’s unwillingness to raise their voices and battle the existing stigma. According to the journalists, such fear is extremely reasonable. Indeed, Feldman and Pattani (2019) claim that “child welfare workers deem black mothers unfit at a higher rate than they do white mothers, even when controlling for factors like education and poverty” (para. 13). Hence, terrified by the possibility of being separated from their child, Black mothers do their best to create the image of model mothers, even if it means lying about one’s mental state.
It is impossible to expect African American women to change their perception of motherhood and PPD immediately. For as long as society continues to stigmatize and marginalize African American women, they will continue to stay quiet about their mental health. According to the researchers, the symptoms of PPD manifest themselves as early as during the first four weeks after birth (Hahn et al., 2021). For this reason, drawing African American women’s attention to the issue is critical when they are the most likely to struggle with depressive episodes. This responsibility should primarily concern doctors and counselors because, during the vulnerable context of motherhood, mothers are more likely to listen to professionals.
Conclusion
Considering the facts presented above, it can be concluded that early intervention in the PPD treatment is of paramount importance for young African American women. Pre-birth and two-week screening provided the most positive results, as clinical screening is often sufficient in treating certain symptoms while the six-week window often carried a number of adverse mental health implications. The evidence demonstrates that early intervention for women prevents a variety of complications for both mothers and their children. Thus, the PPD screening should take place during the first four weeks in order to yield positive results. Any intervention that would take place later will have to address more complications and have a weaker effect on the patient.
References
Centers for Disease Control and Prevention. (2020). Depression among women.
Feldman, N., & Pattani, A. (2019). Black mothers get less treatment for their postpartum depression. NPR.
Hahn, L., Eickhoff, S. B., Habel, U., Stickeler, E., Schnakenberg, P., Goecke, T. W., Stickel, S., Franz, M., Dukart, E., & Chechko, N. (2021). Early identification of postpartum depression using demographic, clinical, and digital phenotyping. Translational Psychiatry, 11(1), 1-10.
Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health, 15, 1-55.
Liu, C. H., Phan, J., Yasui, M., & Doan, S. (2018). Prenatal life events, maternal employment, and postpartum depression across a diverse population in New York City.Community Mental Health Journal, 54(4), 410-419.
Maxwell, D., Robinson, S. R., & Rogers, K. (2019). “I keep it to myself”: A qualitative meta‐interpretive synthesis of experiences of postpartum depression among marginalised women. Health & Social Care in the Community, 27(3), 23-36.
Mughal, S., Azhar, Y., & Siddiqui, W. (2021). Postpartum depression. In StatPearls [E-book]. StatPearls Publishing.