RACHEL MARTIN, HOST:
At least 1 in 7 mothers suffer from postpartum depression. Left untreated, this can have serious consequences for both moms and babies. The burden on women of color is especially heavy. They are three times more likely to experience postpartum depression and are also less likely to get treatment for it. Nina Feldman at member station WHYY in Philadelphia has our story.
NINA FELDMAN, BYLINE: Santeno Adams is a talkative and precocious 2-year-old.
SANTENO ADAMS: Umbrella.
STEPHANIE LEE: Umbrella, right.
SANTENO: The rain.
LEE: Yes, the rain.
SANTENO: Rain and clouds.
FELDMAN: He's at home playing with his mom, Stephanie, Lee on their living room floor in Philadelphia. Santeno is Lee's second son - and he was a surprise. At 37, she thought she was done raising kids.
LEE: Like, I was busy. I was out. It's like - almost like I felt like, Stella (ph) got her groove back. I got my groove back.
FELDMAN: But even when she found out she was pregnant, Lee thought she could keep her momentum going.
LEE: I thought I was going to be able to work out until my ninth month and work up until my ninth month. Like, I was like, I'm going to be in labor at work.
FELDMAN: But about five months into her pregnancy, Lee had a procedure to prevent her from going into an unsafe, early labor. It forced her to stay on bedrest.
LEE: It was so rough. Like, I was a mess. Like, I was crying.
FELDMAN: Lee was stressed. She was worried about money and didn't feel like her friends or family understood what she was going through. The depression continued after Santeno was born, too, but Lee felt embarrassed to ask for help.
LEE: The black community don't know postpartum. It's like they look at it like, you need to be strong, girl. Like, my aunts and all them went through and had 5, 6, 7 babies and they are about 2, 3 years apart. Like, you only got one. And there's this expectation on us as women of color that, like, we have to be, like, these superhero - strong, that we're not allowed to be vulnerable. I'm not allowed to have postpartum because I'm black?
FELDMAN: Underreporting of postpartum depression and the fear of being judged is pretty common for lots of women.
But 27-year-old Auriel Dickey says that as a black woman, she had another concern when she thought about asking for help.
AURIEL DICKEY: What color is it?
UNIDENTIFIED CHILD: Green.
FELDMAN: She also struggled with postpartum depression and was afraid her newborn daughter would be taken from her.
DICKEY: She's, like, so sweet and nurturing. Like, we'll - like, if she sees me a little sad, she'll say, what's wrong? And she'll grab my face and kiss it.
FELDMAN: After her maternity leave, Dickey went back to work. The separation felt overwhelming.
DICKEY: Sometimes I would be with my - talking to my boss and things and I would have, like, this impulse of, like, I quit, you know, just because to me, in that moment, it's like, my time here isn't worth me being away from her.
FELDMAN: That feeling lasted months. Dickey knew it was more than separation anxiety, but didn't dare utter the words postpartum depression.
DICKEY: I was scared 'cause just, like, what if they think I'm like a danger to us? Oh, wait, postpartum depression, doesn't that mean, like, you want to harm yourself and the baby? You know, like, that whole thing.
FELDMAN: Dickey says she worried that admitting she had depression would trigger a call to child welfare.
DICKEY: It's something that I've seen happen, like seen growing up, hearing stories of moms that, you know, like, they had their kid in, like, the most loving home and, like, for the slightest thing, now you're under investigation, you know. It just didn't seem like a risk I was willing to take.
FELDMAN: Her fears are warranted - research shows child welfare workers judge black mothers as unfit at a higher rate than white mothers, even when they have the same education and income level. It can also be harder to detect postpartum depression in women of color because they were mostly excluded when the screening tools were being created.
ALFIEE BRELAND-NOBLE: And so what we're stuck with is tools that weren't necessarily developed with these cultural nuances in mind.
FELDMAN: That's psychiatrist Alfiee Breland-Noble. She says screeners often ask questions using keywords like depression or anxiety. But different communities use different language.
BRELAND-NOBLE: So they'll say, I have the blues, I'm in my feelings, I don't feel right, something feels off. We have this old saying in - amongst southern African Americans where people will say, nothing ain't wrong, but something ain't right. You know what I mean? So it's just this uneasiness. So those are the kinds of things I've encountered with people where they will sort of talk around depression, but nobody really wants to say that what they have is a mental illness, like depression.
FELDMAN: Even if women of color show signs of depression, getting treatment means even more challenges.
Stacey Kallem is a pediatrician at the Children's Hospital of Philadelphia. During the baby's first year, she screens new mothers for postpartum depression at each visit. If signs point to a problem, Kallem offers them to mental health services. But once she had her own kid, she wondered, are the moms really going?
STACEY KALLEM: Literally just bundling up your child and leaving the house is an accomplishment in that immediate postpartum phase.
FELDMAN: Kallem did some research and found that in the six months after being diagnosed, only 1 in 10 mothers got any kind of treatment.
KALLEM: So first, you have to get yourself to the appointment. You have to arrange for childcare. And then on top of all that, you might have depression. I mean, of course, it's hard. Of course so many mothers aren't receiving services. The system isn't set up to be easy for them.
FELDMAN: Eventually, both the Philadelphia moms, Stephanie Lee and Auriel Dickey, were able to get treatment. Lee's counselor actually came to her house, so it felt private and easy.
LEE: I don't know if words can, like, really describe how much it really did help me. And I think there needs to be like a campaign of, like, a bunch of faces of women of color that look like us so they know, like, I went through it, too.
FELDMAN: Treatment for postpartum depression is effective. Talk therapy and antidepressants usually work. The hardest part for most new moms is getting the help. For NPR News, I'm Nina Feldman in Philadelphia.
MARTIN: This story was reported in partnership with Aneri Pattani of the Philadelphia Inquirer.
(SOUNDBITE OF DISTANT.LO'S "FEELINGS")
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