'I was lying to you'
Smith had her first child at age 14. Down the hall from her hospital room, another young black woman had twins.
, ”Smith recalled. “I saw her screaming.”
Smith never confirmed what happened, but she was born to another family. The memory created a sense of dread that would stick with here for years.
For many women of color, the fear of child-welfare services comes from seeing and hearing of incidents in their community. , ”Said Alfiee Breland-Noble, an associate professor of psychiatry at Georgetown University Medical Center, who specializes in depression in minority populations.
Studies in several states and at the national level a higher rate than white mothers, even when controlling factors like education and poverty.
The result is a disproportionate number of black youth in the foster-care system ̵
At a recent Philadelphia City Council hearing, parents and child-welfare advocates raised concerns abo child-abuse reporting rules and unnecessary removals. The hearing was called by Councilman David, who said he felt racially discriminated against by social workers within the Department of Human Services, who were investigating him for child abuse following a collateral injury to his son. Oh said he was teaching his son martial arts, and the inquiry found no wrongdoing.
But the experience revealed nothing new.
Women sometimes try to hide their real feelings to protect their kids, said Ayesha Uqdah, a community health worker who does home visits for pregnant and postpartum women through the nonprofit Maternity Care Coalition.
During a home visit two months ago, Uqdah asked her 10 questions on the Edinburgh Postnatal Depression Scale survey, one of the most commonly used tools to identify women at risk.
It Ask women to rate how often they've experienced certain situations in the past seven days, like "I have been able to laugh" or "I have been so unhappy I have difficulty sleeping." , and anyone who scores above 10 is supposed to be referred to a formal clinical assessment.
The first time Uqdah conducted the survey with one pregnant client, the woman scored a 22. The woman refused to go for the mental health services Uqdah found for her
A week after having her baby, the woman's answers were just a score of zero: perfect mental health.
"I knew there was something going on," Uqdah said. “But our job is not to push our clients to something they are not comfortable doing.”
So she waited. About Uqdah, "The woman was lying to you. I really did need services, but you didn't want to admit it to you or myself. ”
The woman's first child was taken to the Department of Human Services and ended up with her grandfather, Uqdah said. She didn 't want that happening again.
Experts agree postpartum depression is highly underreported. Many women are not given screening surveys, and even those who are – like Uqdah's client – may feel too fearful to answer truthfully, said Aasta Mehta, a gynecologist and women's health adviser for the Philadelphia Office of Maternal, Child and Family Health.
While the city does not track rates of postpartum depression, Mehta said it could be more prevalent in Philadelphia due to high levels of poverty, a risk factor for postpartum mental illness. Lactation consultant Jabina Coleman (left) introduces herself to new mom Christine Smith and her fourth month old, Henry, ” width=”2100″ height=”1400″/>
Screening tools are not one-size-fits-all
As a lactation consultant, Jabina Coleman shares some or all clients' most intimate moments as new VAT. So she shares part of her clients, too.
"It was the darkest place," she said. "I probably cried every day for a year."
That might be why women often open up to Coleman about their own challenges, count her things like they're "snapping out."
The term doesn't appear on any screening tool, but as soon as she hears it, Coleman knows to ask more.
"Tell me what snapping out looks like for you," she'll say. “Are you sleeping? Are you eating? ”