Maternal Mental Health

The Plight of Black and Brown Birthing Individuals

By Kay Matthews, Founder of The Shades of Blue Project, and Kimberly A. Baker, Ph.D., Assistant Professor, Health Promotion & Behavioral Science

After seeing how policies were directly impacting the lives of the people we served, my collaborative partner Kim, my team, and I made the decision to focus on public policy. To plant ourselves at tables where the well-being and livelihood of the families we serve were being decided.

Since making that decision, we’ve had the opportunity to work on the Momnibus, particularly the Moms Matter Act. That piece of legislation was in Biden’s Build Back Better Plan and would have expanded access to treatment for maternal health conditions.

The passage of that bill would have provided funds to diversify the workforce and hire more therapists of color, and expand access to culturally competent care. The bill would have also allowed for investment in community-based programs to support those who are expecting and in the postpartum period.

Now we’re working with Representative Lauren Underwood of Illinois on the Black Maternal Health Momnibus Act of 2021. We’re extracting key pieces from the first bill and we’re hopeful the legislation will pass and get funded. What we’re excited to see in this bill is the inclusion of maternal health issues related to COVID-19.

Two more pieces of legislation we’re carefully watching are the Into the Light for Maternal Mental Health and Substance Use Disorders Act of 2022 and the TRIUMPH for New Moms Act of 2021.

Into the Light would reauthorize through FY2028 a program that addresses maternal depression and expands its scope to include mental health and substance use disorders. It would also require the Department of Health and Human Services to maintain a national hotline to provide mental health and substance use disorder resources to pregnant and postpartum women and their families.

TRIUMPH would amend the Public Health Service Act and allow the establishment of a Task Force on Maternal Mental Health.

I don’t know if there’s ever been a time when three different bills centered around maternal mental health have been part of the legislative consciousness. Especially since we’re seeing an about-face on women’s reproductive rights.

We’re trying to implement acts to ensure that women have affordable access to healthcare and childcare. We see this gap in the families we serve and with the possible repeal of Roe v. Wade, that gap will widen. Black and brown women and poor rural communities will certainly be negatively impacted.

And for us being in the middle of this crisis, we’re going to have to find new ways to respond. Find new solutions and ask, “what do we need to do now that we weren’t doing before?”

Here again, we find ourselves bridging things together that no one is correlating. Like, abortion care or the lack thereof, and the maternal mental health impact that will likely worsen once these new laws go into effect.

We’re seeing it firsthand but others in our communities are slow to see and respond. Why do we have to wait another five years for experts and legislators to see how abortion care impacts maternal mental health? We’re telling you now because we see it and SB8 isn’t even a year old.

There’s even research that supports this correlation called, The Turnaway Study. This study followed women who were seeking an abortion. They followed women who were able to receive those services and the ones who were turned away—thus the name, The Turnaway Study, Researchers wanted to know what social impacts, what social determinant impacts, what happened to those women who were turned away, including what happened to their mental health.

The tenfold increase in long-term mental health effects of the women who were turned away from having an abortion is apparent. It is in the research. And mind you, this study only included White women. Imagine if the study had included Black and Brown birthing individuals.

Extend Postpartum Care to Mothers of Stillborn Babies

By Kay Matthews, Founder of Shades of Blue Project and Black Maternal Mental Health Week


I delivered Troya Simone stillborn on May 29, 2014.

And it is in the late night hours when I think about my daughter the most. 

Even though I delivered her naturally I have no recollection of doing so.

My body does.

My heart does. 

When my husband then boyfriend asked me if I held her, my knee-jerk answer to him was, “Why would I want to hold a dead baby?”

By the time I fully understood what happened, Troya had already been taken to the Harris County Medical Examiner’s Office. 

So there would be no photographs.

No footprints on parchment paper that I could frame and hold on to. 

I never even saw her.

I didn’t get to mourn her at that moment.

Instead, I was handed a pamphlet on grief and sent on my way with only the clothes I wore to the hospital that day.

I trashed them.

I was a new mother, who had just delivered a nearly full-term baby—stillborn. 

But since I had no baby to show for my labor, the hospital staff didn’t treat me as a new mother whose body would undergo the same changes any new mother would undergo.

The next few years were a blur.

I was angry.

I was depressed.

There were bouts of rage and extreme sadness and family and friends didn’t know how to help me. 

And if I’m truthful, I didn’t know how to ask for help and wasn’t sure what I needed. It would have been nice to be asked. It would have made things easier if people acknowledged my pain and suffering—my mental decline. To friends and family my name was no longer, “Kay” but “Kay You Know She Lost Her Baby.”

Somehow, I was able to piece together resources that would help me manage day-to-day life. Because you don’t ever get over the loss of a child. You learn how to manage your grief. Some days are easier than others and then there are the other days. The days where all the emotion and grief grip your heart and the tears fall uncontrollably.  

And even though my birthing experience didn’t produce the outcome I desired, I started to piece back the fragments of my life. 

Black Woman and Postpartum Care

Unlike Denise Williams, a 29-year-old mother of two who went to the hospital for the postpartum depression she was experiencing. Within 48 hours of her hospital stay, she died. How does a mother experiencing postpartum symptoms die just two days into a hospital stay?

It’s a question maternal healthcare professionals should be asking themselves. 

Denise took the appropriate response to the pain she was experiencing. And that’s not always easy for Black women. Seeking help for stress and other mental health issues has always been taboo for we Black folks. Admitting that we need help goes against the strong Black woman standard we ourselves, our families, our communities, our churches, and even our nation holds us to. We are the saviors of so many but who will save us?

Especially when biases and systemic racism plague our healthcare system. And not only health care but the very support systems designed to assist mothers and families can do great harm. 

Researchers at the Icahn School of Medicine at Mount Sinai in New York found that African American women were more than twice as likely to experience postpartum depressive symptoms as white women. 

And recent studies also show that Black women are 57% less likely to start treatment for postpartum depression. Why? Fear. Fear that they will not be heard. 

Sigh…The Biases Continue

If world tennis champion, Serena Williams was dismissed by her medical care team after giving birth to her daughter, what hope do the rest of us have?

Serena knew her body. She had suffered from blood clots before. She knew the symptoms and the remedy. When she reached out to her nurse, her complaint was brushed off as simply the pain of childbirth. Advocating for herself, she finally got the CT scan of her lungs and she was right—right down to the medication needed.

But this callousness towards Black birthing individuals is woven into the very fabric of the system. This dismissive behavior by those who are supposed to care and the internal and external pressure to shoulder so many burdens is adding to the rising number of Black morbidity.

Another reason why Black women shy away from postpartum depression treatment? We fear that our children will be taken away from us by state agencies. And this fear is not unfounded. A national study and news reports found that child welfare workers deem black mothers unfit at a higher rate than they do white mothers.

The maternal mental health of Black birthing individuals cannot be ignored. 

Reproductive Rights Under Attack

Especially now with women’s reproductive rights under fire. 

The Supreme Court’s possible reversal of Roe v. Wade will immediately impact poor women of color. The mental health of birthing individuals forced to give birth will have dire consequences and we’ll see these Black morbidity rates continue to rise. 

We’re already seeing the impact of SB8 on the families and communities we serve.

The Black maternal health conversation must include mental health. The two are linked and to try and separate them is a disservice to the Black mothers who find themselves struggling. 

I created the Shades of Blue Project and Black Maternal Mental Health Week for these women. Women like me who had less than favorable outcomes from their birthing experiences. Women who struggle to connect with their babies because they’re stressed about their domestic situations or abusive relationships.

Sometimes I don’t have the words to express how I feel about losing my daughter but what I will never hesitate to do is speak my truth in hopes that it helps the next woman or family push through their experience.