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Foundations of Maternal Mental Health

We’re taking a look at the importance of mental health and how mothers can support their mental wellness before, during and after giving birth.


As black mothers and birthing persons, it is important to be aware of our mental health while pregnant and postpartum. Mental health can be affected by a situation of birth inequity or a birth experience that didn’t go as hoped or planned.


In pregnancy and motherhood, we experience changes to our bodies, minds, families and lives. It’s normal to feel different emotions — even conflicting ones — all at once.


To learn more about mental health support and how mothers can prioritize their mental wellness, we spoke with Michelle Brown, a licensed clinical social worker with Willis Counseling and Consulting. Michelle is also a birth and postpartum doula who has been with Chicago Birthworks since 2018, consistently putting black maternal health and mental wellness at the forefront of her work with black women and families.


Identify Your Thoughts and Feelings

Michelle began our discussion with a prompt: Share one word to describe how you’re feeling right now. She explains that identifying and acknowledging how we are feeling is an essential first step to becoming empowered and letting go of negative emotions.


When our mental health takes a hit, it can be hard to pinpoint exactly what is happening or recognize that we are hitting a wall and approaching an unhealthy space. We might have mental fog or feel disconnected. So often, we use the word “tired” as an umbrella term because we’re simply too tired to figure out what we’re actually feeling.


So pause and ask yourself, “What is this feeling beyond being tired?” Sometimes, there isn’t anything you can do at that moment. Maybe you just have to sit with the feeling and accept it. Or perhaps there is something you can do to change your situation, shift your thoughts and improve those feelings.


Michelle recommends that expecting mothers take time before labor and delivery to think about the changes that have occurred during pregnancy and what lies ahead. Consider what you’re looking forward to, what’s changing and what you miss (or will miss). If you need to, take time to grieve what you’re leaving behind or feel nervous excitement for what’s to come. Give yourself permission to just feel how you feel.


Time for reflection can also be helpful after giving birth, especially in processing an unexpected or difficult pregnancy, traumatic birthing experience or negative interactions in which you didn’t feel cared for or heard. Your feelings are valid.


Let Your Feelings Out

Once you’ve identified how you feel, you need to let it out so it’s not just bottled up inside you. Talk about it with a trusted person or write it down in a journal. Give yourself time to process your feelings.


We are often hesitant to share our feelings with others. We might fear judgment, having unmet needs, being a burden or worry we won’t be able to change the situation. But think of the people who have supported you and built you up and allow them to help you.


People are willing to help. They can listen and hold space for you to work through your thoughts and feelings. If you worry that they’ll try to fix it, ask them to just listen or choose to write it down instead.


An important but challenging part of this process is having compassion for yourself, just as you do for others. You aren’t a burden. The people in your circle care about you. Have confidence that you can share openly — doing so will help you move through this and beyond.


Signs of Postpartum Depression and Anxiety

As an expecting or new mom, you may wonder if your struggle with mental health is within the realm of normal (like new mom anxiety) or if it’s crossed over into something more serious. During the first two to three weeks after birth, as many as 50 to 85% of new mothers experience “baby blues.”


In this initial period, your hormones are readjusting, you are adjusting to caring for a new baby and your body is changing. You might not want to breastfeed, may feel disconnected from your baby or have a lack of interest in engaging with people. Perhaps you’re grieving your past life and pregnancy or trying to accept a new normal. That takes time. While you might feel more irritable or have frequent crying spells with the baby blues, you’re still able to function, and the symptoms typically resolve within a couple of weeks.


If you’re feeling symptoms of depression and anxiety anywhere from one month to one year after birth, you may be experiencing postpartum depression or anxiety. It’s critical that you bring this up with your doctor, midwife or a trusted person who can advocate for you.


Signs of postpartum depression include:

● Overwhelming feelings of sadness and frequent crying spells.

● Feeling overwhelmed to the point of hitting a wall on a consistent basis.

● Irritability, agitation or anger.

● Sleep disturbances (can’t rest or sleep, constantly checking on baby).

● Mood swings.

● Appetite changes.

● Overall apathy.

Signs of postpartum anxiety include:

● Panic attacks, including rapid physical symptoms, shortness of breath, tightness in the chest and racing thoughts.

● Insomnia.

● Low appetite.

● Fear of losing control, becoming ill or that you or others will harm baby.

● Intrusive thoughts.

● Physical symptoms such as shakiness, dizziness and shortness of breath.


These symptoms can also come up during pregnancy as signs of perinatal depression. During pregnancy, Michelle suggests sharing this list and asking someone in your life to check you for these symptoms in the postpartum period, especially if you’re predisposed to depression or anxiety. If you know your typical signs, communicate those to someone you trust so they can be on the lookout.


Steps to Support Your Mental Health

You have the power to be proactive about your mental health. Start by creating a self-care plan for yourself so you’re ready if you need it. Think of it as your emotional first aid kit or toolbox for when you encounter difficult times.


First, make a list of your support people. Who will be there to listen and talk to you? Who can you ask for help? This is where community comes in — your partner, friends, family and experts. Identify a therapist and other resources ahead of time so you have them on hand.


Then, make a list of your needs and what you need help with. Other people can make or deliver food on certain days, run errands, do household chores and give you time to take care of yourself. Maybe your list includes a comfortable breastfeeding area, a stock of snacks, a full water bottle and other specific self-care items.


Your mental wellness practice is a collection of things you do regularly to feel your best. No matter what, you need rest, personal hygiene, food, water and time to relax and be who you are. Don’t be afraid to ask for help to make this happen.


Regular Mental Health Check-Ins

At any stage of pregnancy or postpartum, give yourself permission to feel how you feel and name what you need. Be present in your mental wellness by asking yourself, “What do I feel, and what do I need?” Move through it moment by moment, and let your emotions come out.



Also, check on what’s going on around you. Ask yourself, “What is working for me and what isn’t?” Based on those answers, stick to what works, add what you need and get rid of what is not serving you.


When we get a free moment, we’re sometimes too tired to figure out what to do. Avoid that by making a “menu” of things you can do to support your mental health with the time you have. Break it down into 30-second, one-minute and five-minute ways to give yourself a boost. And, as Michelle says, never underestimate the power of a deep breath.


Mental health affects everyone. It affects us as mothers and human beings and impacts our partners, families and communities. We have to be well within ourselves. When we name our feelings, share them, ask for help and prioritize our needs, we take care of our mental wellness and, in turn, the people around us.


For additional support during your pregnancy and birth, learn about Chicago Birthworks Collective’s services and the benefits for your mental health of incorporating a doula into your birth plan.

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