The Key to Safeguarding Maternal Mental and Physical Health

As the adverse health outcomes plaguing black mothers around pregnancy labor and delivery continue to rise there remains a primary focus on identification and research, in spite of known and understood factors rather than practical actions for resolution and address. There’s an inherent and obvious gap that remains around the provider-patient relationship and the historical lack of culturally responsive health care practices. Coupled with the continued impact of COVID and socioeconomic implications that can impede access to quality healthcare the need persists for a collective effort to address deficiencies in culturally responsive healthcare. We’ve all witnessed the highlight and rally around the inclusion of culturally responsive practices being added to the legal justice and education systems. However, the healthcare system continues to lag behind the curve of what culturally responsive maternal care looks like for black women specifically. 

There’s no question that understanding the diverse cultural backgrounds of mothers is crucial in providing effective, safe, and responsive maternal mental health care. Culturally responsive care naturally lends itself to giving the patient a stake in their care and fosters informed decision making and consent. When women from different ethnic groups, financial status, and societal roles experience pregnancy and motherhood differently, the intersection of how they exist in the world becomes synonymous with their mental health, and has a significant impact on how they receive and interpret their care.  A culturally responsive approach, much like in teaching, can be an essential tool in bridging these differences and ensuring the physical and mental well-being of mothers.

As a black woman, mom, educator and mental health coach applying cultural responsiveness is a part of who I am. As an educator it was a part I carried into every educational environment I exist in.  An inherent understanding I grew up knowing, that I in turn fostered. In order for any student to learn successfully they have to be given the opportunity to take ownership of the information and see themselves within the context of what they’re being given. This creates a space for them to feel safe to ask questions, make connections and dig deeper to determine how they relate to what they’re learning. 

In the same way, culturally responsive care requires healthcare providers to truly see and value each patient, and to recognize that the transition into motherhood is a delicate one, often overwhelming the mind and body at once and requiring of the mother the kind of self awareness that can be as frightening as it is beautiful. While it does take a more intentional approach, the benefits well outweigh the risks, because under no circumstance should choosing motherhood ever be a death sentence. 

Activating a mother's prior knowledge is the first step in cultural responsiveness. Educating mothers on the mental health changes they may experience during pregnancy, using their cultural context, will create a foundation of understanding and comfort. Every mother’s existing beliefs and understandings about pregnancy and childbirth can be leveraged to make the learning process more relatable. This is especially true because every pregnancy is different, healthcare providers should be asking the mother about her existing knowledge or beliefs around pregnancy and using that as a starting point for discussions. This doesn’t have to prolong visits it can be done through surveys, pre or post visit communications electronically or over the phone. 

Learning about the physical and mental health changes during pregnancy should be contextual. Explaining the why and how of every area from medications (risks and benefits), sleep hygiene, impact of diet on prior conditions and even comorbidity matters. Providers can do this by partnering with nontraditional wellness professionals including maternal/child dietitians, massage therapists, chiropractors, and mental health coaches. Referring patients to organizations like Love Worth Work, or other community based initiatives, that create communities for moms to share in their experiences and understand how the hormonal and life changes they are experiencing can impact and improve their mental health. By connecting new information to women's lived experiences and cultural backgrounds, we can make learning more meaningful and impactful .

Encouraging mothers to leverage their cultural capital by finding a doula or midwife who understands their cultural nuances can create a supportive environment that caters to their unique needs. Having someone who shares your culture or understands your frame of reference is important to connection. This type of support can significantly reduce anxiety and depression and maternal mortality rates among pregnant women, especially those from low-income minority groups.

Most importantly, the environmental impact where a mother lives should be considered. Not only her geographic location but her home life which is impacted by socioeconomic factors, access to healthcare, and community support, which can greatly influence her mental health. Healthcare providers should strive to understand these environmental factors and help mothers navigate them. This can be done through referrals to outside organizations or resource equipping through a network built just to support moms. 

Building relationships in the provider patient setting is crucial to positive maternal health outcomes. Strong relationships can foster trust, encourage open communication, and provide much-needed support. The story of maternal mortality in Texas, particularly among Black women, underscores the importance of a culturally responsive approach. It's time to acknowledge the unique challenges pregnant women and mothers face, and ensure that our healthcare systems are equipped to provide culturally responsive care. The physical and mental health of our mothers is at stake, and we cannot afford to ignore it.