Equal Footing will address the racial and socioeconomic inequities in mental health care. We will create opportunities to empower, educate and build community. We will work collaboratively with leaders and members in the communities from which our clients come. We will center the voices of the marginalized and we will provide services and access to individuals and families that are pregnant, parenting and/or have experienced loss.
To reduce disparities in mental health care through accessible, effective and holistic programming that serves individuals that are pregnant, parenting and/or experienced loss.
Why Equal Footing?
Equal Footing was started in an effort to address the disparities in maternal health care experienced by women of color. Birth outcomes for women of color are significantly worse then their white counterparts in many areas, including, maternal mortality and infant mortality. In addition to birth outcomes, women of color are suffering from perinatal mood disorders at far greater rates and it is going unnoticed. Something must be done.
Check out what the data tells us!
In the case of Maternal Mortality Black women in the United States are up to three times more likely to die in pregnancy and childbirth compared to white women. Maternal mortality rates persist regardless of class or education status. Deaths among mothers extend beyond the period of pregnancy or birth. Nine months of prenatal care cannot counter underlying social determinants of health inequities in housing, political participation, education, food, environmental conditions and economic security—all of which have racism as their root cause.
Did you know?
Pregnant women of color are under served by the mental health profession and relevant support services. When perinatal mood disorders are left undiagnosed or untreated, the results can be deadly. Suicide is a leading cause of maternal death for women with postpartum depression. Women of color are typically unaware that the mental health symptoms they experience are the result of pregnancy or childbirth, which also means that the symptoms often remain unaddressed both by the woman and her medical provider.
Perinatal Mood Disorders
Perinatal mood disorders (such as Postpartum Depression) have received more and more attention in the media, in health care and among new moms. However, the narrative is often centered from the experience of white women. This is misleading for many reasons, most notably because, studies have shown that women of color experience postpartum depression at a rate close to 38% compared with approximately 13-19% for all postpartum women (“Postpartum Depression and Race: What we all should know.” 2016). Racism is at the core of this significant difference. Black and Hispanic women who experience maternal depression have higher rates of adversities compared with their white counterparts. In a nationally representative study of the rates and risks of maternal depression in the United States, these adversities include poverty, employment issues, issues related to personal relationships, and marital problems.
Risk Factors for developing a Perinatal Mood Disorder:
- A traumatic pregnancy or birth: really sick during pregnancy, bed rest, complications, emergency c-section, NICU
- An experience with emotionally painful or stressful experiences around pregnancy, childbirth and/or early parenting: traumatic birth, breastfeeding issues, colicky baby
- A history of domestic violence, sexual or other abuse:
- A traumatic childhood: Abuse, neglect, attachment disorders
- Stress: Poverty, racism, sexism, homelessness, loss, or big changes.
- Lack of social support: Living far away from family, baby’s other parent is not around or helpful, no friends, military spouse.
From 2005 to 2012, the infant mortality rate for black infants decreased from 14.3 to 11.6 per 1,000 births, then plateaued before increasing from 11.4 to 11.7 per 1,000 births from 2014 to 2015. Comparatively, among white infants, the mortality rate decreased from 5.7 to 4.8 per 1,000 births from 2005 to 2015.
“The sustained progress in reducing infant mortality among black infants since 2005 has stalled in the past few years,” the researchers write. “This has led to increases in the absolute inequality in infant mortality between black and white infants during the past [three] years.”
The U.S. has some of the most sophisticated medical care, yet the country still lags far behind in the area of maternal and infant health care. According to 2015 data from the World Health Organization, each year approximately 60,000 women in the U.S. experience near-fatal complications during pregnancy or birth. Statistically, this puts the country in the same category of developing nations such as Afghanistan, Belize and South Sudan. In last year’s March of Dimes Premature Birth Report Card, the U.S. earned a “C” grade due to widening differences in prematurity rates across different races and ethnicities.
Access to Mental Health Care
Access to Mental health care is a huge issue for low income individuals and women of color. The National Healthcare Disparities Report 2012 reported that “health care quality and access are suboptimal, especially for minority and low-income groups [and while] overall quality is improving, access is getting worse, and disparities are not changing.” Similarly, disparities in mental health care across race and ethnicity, geographic regions, and socioeconomic domains continue. Due in part to a lack of awareness/lack of screening of these disorders, African American women are also less likely to recognize and report symptoms for mood disorders, which translates into lower rates of mental health care utilization. African American women are half as likely to receive mental health treatment and counseling as white women. They are one of the most under treated groups for depression in the United States.
So, what do we do?
The Center for American Progress in response to the overwhelming data on health care disparities in maternal health care and maternal mental health has offered these recommendations:
- Support comprehensive health care coverage under the Affordable Care Act (ACA), including mental health services and maternity care.
- Improve access to culturally competent and well-trained mental health care providers.
- Fully fund the MOTHERS Act. https://www.govtrack.us/congress/bills/111/hr20/text
- Support the integration of mental health screenings into other health care settings.
- Fund large-scale, culturally appropriate public education campaigns.
- Conduct additional research on perinatal mood disorders.
- Develop policies and education campaigns in a way that takes into account the lived experiences of pregnant and postpartum women of color.
- Educate health care providers, patients, and communities about the importance of mental health care access.
- Support culture shift efforts.
- Amplify and support women of color-led organizations.
- Support policies that improve work-family balance for women in the workplace.
These actions are critical to helping ensure that pregnant and postpartum women of color can stop suffering in silence and can gain access to the necessary supports and services in times when they are experiencing perinatal mood disorders.
Equal Footing will collaborate with elders and members of communities of color to identify the needs of the women, we will support women of color led organizations, we will offer accessible services, we will work to advance public policy, we will recruit therapists of color, and we will provide education on pregnancy, birth, parenting, and loss from a culturally competent lens.