Treating postpartum depression in impoverished mothers of colour, it takes a community

Pregnancy and childbirth is a beautiful experience, but it leaves many women with postpartum depression. According to a recent study, treating postpartum depression (PPD) in low-income mothers of colour requires an understanding of each person's lived experience.

The study also suggested that practitioners should consider interventions that develop broadly from a community level in order to improve outcomes for their clients.

"Social workers need to do more than simply work with the mother. Focus on the mothers, but get into the communities where they live and draw on supports from neighbourhood organizations like churches, clinics, and other services a parent or child would access," said says Robert Keefe, an associate professor in the UB School of Social Work and the study's lead author.

Keefe's research, published in the journal Families in Society, contributes valuable knowledge to an understudied area and for the first time provides guidance for social workers that can better inform their practices with this particular population.

Nearly 20 per cent of the 4 million women who give birth in the U.S. each year will develop PPD.

Findings of the study were published in the journal of Families in Society.

"Most mothers when discussing their PPD describes a horrible process. They've gone through this wonderful experience of having a child then feel shame for what they coin as negative feelings. They often don't know where to turn or even if they should turn for help," said Keefe.

While many of these mothers do eventually get help and find the treatments effective, the mothers in Keefe's study talked about the professional care they've received as being largely ineffective, often worsening their depression.

According to Keefe, this leads to intense frustration with mothers taking ownership of the false belief that "this is what being a mother is all about," a claim echoed by many of the study's participants.

"The current therapies are not addressing what these low-income mothers have to face on a day-to-day basis. These therapies are individually focused, and sometimes family focused, which is a good start, but to stop with the individual or family is to ignore the community issues they're often facing," Keefe explained.

Keefe reports one mother told him "it doesn't matter how much antidepressant medication they give me, I still have to face living in poverty, not having enough food for my children to eat, or having any transportation to get a job."

Impoverished mothers of color are at greater risk of PPD than white middle-class women, but most of the research has focused on the latter group. Researchers in disciplines outside of social work has done some research on low-income mothers, but Keefe says this information, while beneficial in some contexts doesn't have immediate utility for social workers.

For the study, Keefe and his research team interviewed 19 African-American and 11 biracial or Hispanic low-income mothers between the ages of 18 and 44. Four themes emerged from the discussions including recognizing depression, isolation, community violence and living with depression.

"When we were conducting the interviews these themes kept coming up," said Keefe.

The mothers in the study all expressed financial pressures, but help was often out of reach, because of the limitation of their jobs, inconvenient appointment times and services that were often difficult to access.

Keefe says social workers need to advocate for agencies to expand hours of operation, and to provide childcare and transportation services.