Black Perinatal Mental Health
Pregnancy, birth, and the postpartum period are some of the most profound passages a life can hold. For Black folks who become parents, they are also passages that the medical system, the wider culture, and many mental health frameworks have failed to support with anything close to what they require.
If you are reading this, you may already know some of this from the inside. You may be pregnant, postpartum, parenting an infant or young child, in the long aftermath of birth loss, navigating fertility work, or considering what becoming a parent might look like for you. You may be a partner, a co-parent, a family member, or a chosen-family member of someone moving through these passages.
Black perinatal mental health describes the specific landscape of mental health work with Black folks during pregnancy, birth, postpartum, and the early years of parenting. Some of what shows up in this work:
- The cumulative weight of moving through a medical system that has not historically taken Black pain seriously, including in obstetric care. The vigilance required during prenatal appointments, labor, and postpartum follow-up. The cost of advocating for yourself or your child inside a system that may not believe you.
- Grief and rage at the maternal mortality crisis, which falls disproportionately on Black birthing folks, regardless of income, education, or insurance status. Carrying the knowledge of what has happened to others in your community while moving through your own pregnancy or postpartum.
- Birth trauma. The particular kind of trauma that comes from feeling unsafe, unheard, or harmed during birth, which is not uncommon and which is not adequately addressed by standard postpartum check-ins.
- Pregnancy and infant loss, including miscarriage, stillbirth, neonatal death, and the deaths of older children. The under-acknowledged grief of losses.
- Postpartum depression, anxiety, OCD, psychosis, and rage. Common, treatable, and often missed in screening tools that were validated on populations very different from yours.
- The work of being a Black parent of a Black child. The ongoing negotiation of how to protect, prepare, and honor a child whose existence will be treated as political.
- The specific exhaustion of mothering or parenting in a culture that has projected onto Black motherhood for centuries, in ways that have rarely lined up with the reality of any actual Black mother or parent
- Intergenerational material. The ways your own caregivers were shaped by their own conditions, the patterns you are interrupting, the patterns you are passing forward intentionally and the ones you are working not to pass forward
- The work of finding postpartum support in a culture that has largely dismantled the village structures that earlier generations relied on
- Reconnection with ancestral and lineage practices around birth, postpartum, and the care of new mothers and infants. Practices that long predate any clinical model and that hold wisdom worth recovering.
- Joy, pleasure, and the irreducible fact of bringing children into the world inside a lineage that has continued, against everything, to do so
Black perinatal mental health cannot be separated from the conditions Black birthing folks are navigating. The maternal mortality crisis is a structural problem with a long history. The medical system’s failure to take Black pain seriously is documented and ongoing. The economic precarity that disproportionately falls on Black families compounds what is already a vulnerable period. The political moment, including ongoing racial violence and the dismantling of reproductive rights, is the background of every pregnancy and postpartum experience right now.
What this work can look like at MLC:
- Supporting you through the specific vigilance of medical encounters during pregnancy, birth, and postpartum, including processing what has already happened in those settings and preparing for what is ahead
- Building your capacity to advocate for yourself inside medical systems, where Black patients’ pain is too often under-treated and Black patients’ concerns too often waved away. We can rehearse how to name what you are feeling and insist on being heard, think through who you want in the room with you, and practice the questions, second-opinion requests, and refusals you have every right to make, while also holding how exhausting it is to have to fight for your own safety at one of the most vulnerable times in your life.
- Helping you build the team you deserve around the birth, including doulas, midwives, lactation and feeding support, and providers who will actually see you, with particular attention to Black and culturally attuned care when that is what you are looking for
- Working with birth trauma honestly. We will not minimize what happened to you. We will help you process it at the pace your nervous system can hold.
- Holding perinatal grief, including miscarriage, infant loss, fertility losses, and the disenfranchised forms of grief that often go unwitnessed
- Treating postpartum depression, anxiety, OCD, intrusive thoughts, and rage with care and without judgment
- Loosening the grip of the “strong Black woman” script, the expectation to be unshakable, to downplay your pain, and to carry everyone while asking for nothing. We work toward permission to need, to rest, and to be cared for, not only to be the one doing the caring.
- Working with the body, which has been through enormous changes and which often carries postpartum and trauma material more directly than the mind does
- Supporting reconnection with cultural, ancestral, and lineage practices around birth and postpartum, when this is part of what you are reaching for
- Working with partners, co-parents, and chosen family when that is useful
- Making room for the particular fear that can begin long before the baby arrives: what it means to bring a Black child into this world, and the protective vigilance that can switch on in pregnancy and never fully switch off. We hold that fear with you rather than trying to talk you out of it.
- Honoring the joy, the love, and the profound creative force of bringing a child into the world, alongside everything else
The therapists at MLC understand that Black perinatal mental health has been historically under-resourced, under-believed, and over-pathologized. The work asks for clinicians who can hold the full weight of what is being navigated. We bring this work with care, with ongoing learning, and with deep respect for the lineages of Black birthing folks and the children they are bringing forward.
