FOUR: SHELLIE’S STORY

Episode Summary

After trying to conceive for 10 years, Shellie was finally having her dream baby, but the challenges of motherhood slowly evolved into a silent struggle with postpartum depression. Reproductive psychiatrist Dr. Sinmi Bamgbose shares how she's working to expand mental health resources for Black birthing parents.

Episode Notes

In this episode we mention:

• Mind Over Melanin Podcast

• Dr. Sinmi Bamgboshe of Cedars Sinai Medical Center

• Postpartum depression and reproductive psychiatry

Follow NATAL on social media: @natalstories

Join our Facebook Community to connect with other parents, birth workers, and advocates.

NATAL is produced by You Had Me at Black and The Woodshaw. Listen to You Had Me at Black wherever you get your podcasts.

EPISODE TRANSCRIPT

Dr. Sinmi Bamgbose: If it was me or my sister or somebody who is gonna, you know, have a baby, I've always imagined like, what would I want to see? You know? And I think there are some places, like a very integrated model is what I see. So a place where there is like a community center, kind of, where there's a lot of Black women who have experienced doulas or spiritual leaders or all that together in a place also where you have your OB GYN and you have a social worker and you have a psychiatrist and a therapist, you can go to one place.

There's groups, there's the fellowship with other people. You have your medical care. Everyone is kind of very much in the same place and on the same team and working towards a good outcome. And I just see this as like a very joyful place where people go and you almost kind of hang out, but also get to have your medical care and your mental health care and feel supported and feel like you're in a community.

And you have, like the village really that's helping to take care of you and guide you through this difficult period. 

[NATAL Jingle]

You're listening to NATAL, a podcast about having a baby while Black

Gabrielle Horton: I'm NATAL cohost, Gabrielle Horton. That voice at the top of the episode was Dr. Dr. Bamgbose. She practices reproductive psychiatry and consultation liaison psychiatry at Cedars Sinai hospital in Los Angeles, California. And that birth place she's describing with just about everything short of rainbows and glitter?

Well, that is the kind of vision of care Dr. Bamgbose wants, and is fighting for, for Black birthing parents here in my hometown. If you're like me, right about now, you're probably wondering what the heck reproductive psychiatry even is. In short, it refers to mental health care for individuals at every stage of childbearing, including preconception, pregnancy and postpartum.

But don't worry, we're going to hear more from Dr. Bamgbose later, By now, you've probably already guessed it. In this episode, we're diving into mental health for Black birthing parents. Mental health is something that even as a country, we haven't had the best language for, let alone, adequate and culturally specific resources. Between finding quality mental health providers, paying for treatment commuting to appointments, it can all feel like yet another task on the never-ending to do list. And for many Black folks, it's flat out taboo, certainly not an easy topic to bring up. So when you add all that together, plus being a new or expecting parent, navigating mental health is a lot to manage, especially if you don't know where to turn.

And that was certainly true for our next parent, Shellie Blackson. 

Shellie: I'm Shellie, I'm an educator. I'm an advocate for all children, especially those with disabilities. I am Mommy to Miles and Davis. I am an LA native, LA girl to the heart, and this is my NATAL story.

I always knew I wanted to be a mom, yes. Um, I never thought it would be the way that I ended up having Miles and Davis. So that's the interesting part of my life and my story. 

Gabrielle: Back in 2006 way before they became parents to their boys, Miles and Davis, 36 year old Shellie and her partner, JD were ready to start a family. In fact, they have been ready for over a decade. 

Shellie: We struggled for about 10 years to have kids. And we started with artificial insemination and that was just repeated fail after fail.

Then we finally said, you know what? Let's go to IVF.

Gabrielle: they wanted to give IVF, or in vitro fertilization, a real try. They also knew that it wouldn't be a simple process. IVF is a fertility treatment where a person's eggs are mixed with sperm outside the body, in the laboratory. And once fertilized, the eggs are transferred back into the birthing parent's uterus.And if all goes well, the embryo grows into a fetus and eventually a baby. But the process, it ain't cheap 

Shellie: IVF at the time was about $15,000 a cycle. The first cycle failed and I didn't get pregnant. I remember I remember feeling really sad and down. I felt like, why wasn't I good enough to have a child?

Was I not worthy? Maybe God didn't think that I deserved it because I was having it within the context of a lesbian relationship, and maybe he wasn't pleased with that. Morals played a lot, a big part of this. Um, and then finally, we tried it a second time. We said, let's just give it one last shot and that moment was a hard one to swallow because I was like, well, what if it doesn't happen again? So I was already jumping the gun into the negative and like, if it doesn't happen, then what? 

Gabrielle: By this point, Shellie and JD had exhausted all possible resources. They had tried artificial insemination and different sperm donors. They had weathered through the disappointment, the doctor's visits, the fertility shots.  At times, they were long distance JD's job taking her to different cities throughout the year. And they even mortgaged their home to finance their second IVF cycle. 

Shellie: This is our second cycle. So by now, we know the workers and the nurses and all the lab techs in there.

So I find this Ethiopian lab tech guy, and he was just really nice to us. And I remember the day that I knew that I would find out if I was pregnant and I was on my way to visit my partner JD up in Nor Cal and I got the call from him on the plane. The plane hadn't taken off yet. And so he's like, Shellie, "I just want you to know the test came back positive and you're pregnant."

And I remember being on the plane and like silently screameing, cause you can't scream too loud, cause then people think you're crazy and the security come take you on the plane. And then I called my mom and then the plane took off. And it was, it was a happy moment. So between here and San Francisco for about an hour, I just was, I remember being elated and I just remember like, starting to dream, what is it going to be like, what is this kid?

This is the kind of mom I'm going to be, and this is, this is the kind of birth that I'm going to have. So I began to think about what kind of birth experience I wanted. I wanted a water birth, I love water. And so in my mind, I had created this birth plan. And I visualized it, I saw it. I was in a pool, and there was water and I'm giving birth and my baby comes out and in the water, and I scoop up the baby and put the baby on my chest. And I said I was going to have Miles Davis playing in the background.

I remember my first trimester was awful. I was sick every day, throwing up nausea, couldn't eat, lost weight, which was an advantage. Once that passed, I then began to relish in the fact that I was pregnant and really enjoy it. Enjoy my body. Enjoy the baby bump. I actually enjoyed shopping for maternity clothes.

And I had this vision that I wanted to be the most stylish pregnant woman on earth. It may seem shallow, but that's what I saw for myself, and that's what I wanted. Um, it pretty much happened that way. It, it did. As my stomach grew, I began to love the feeling of being pregnant. I loved the tossing and turning of baby Miles in my belly.

I loved when I would be lying down, or seated, or just when I'm still. And I remember his little feet poking through my stomach and I'm looking down at my belly and I'm like, whoa, this is fascinating shit right here. And then you'd see an elbow and it just, it would just poke out. In this, otherwise from this otherwise round and perfect stomach and it was like, Oh my dad's like an alien inside of you.

And then it will just be moving and your stomach is moving. You're like, this is witnessing God's grace and His glory. 

Gabrielle: Shellie recalls her early prenatal care being just, okay, nothing memorable. And although her and baby Miles were safe and healthy, Shellie just couldn't shake the trauma of trying to conceive for 10 years.

Shellie: I remember being paranoid. I forget the number of kicks per minute a baby is supposed to do at a certain period in gestation, and I remember if baby Miles didn't kick, I was going to the hospital. Like something's not right. He's not kicking. And I remember I probably went to a visit like that, to an urgent care type of setting, no lie about three times because I didn't feel him. And I was scared. It scared me. So I thought he was dead. And so I would go and I'd make this excuse. I'm like, okay. He hasn't moved in, in, in, in about a couple hours. And so they would do the ultrasound, they were like, he's sleep. And I'm going, okay. Okay. I'm fine, now I feel better. And then when it may happen again, a couple of weeks later and I go right on back, something's not right. I was paranoid. I was so afraid of losing the pregnancy that, that was my way of making sure in between my prenatal visits, that he was still there and he was still thriving. 

Gabrielle: As she entered her last trimester, Shellie also had to get ready for another big change: relocating from Los Angeles to Danbury, Connecticut, where JD was now based for work. While JD's hometown was 30 minutes away from Danbury, Shellie didn't know anyone there. Her mom, her family and friends, her support system, they were all in Los Angeles, 2,835 Miles away.

Shellie: I probably along with JD were, we were probably like one of very few Blacks there. So I really felt like a fish out of water because I am all about living in  a metropolitan city. Seeing people that look like me, being able to go and enjoy art experiences, the theater, and Danbury had none of that.

It was absolutely nothing. It was very white. It was very sterile and it was very unfriendly, but I knew nobody. I had nobody. I had no friends. I only had JD and she worked from sunup to sundown. She traveled probably about twice while I was there. And that was not a good feeling. I felt lonely. I felt isolated.

Um, I felt cut off from the world. I didn't have anyone to talk to. Nobody came to visit because it was such a remote place. So it was, it was lonely. I spent, my days, Target was like the highlight of my day, and it still is, unfortunately. But you wake up, you clean, you maybe run to the grocery store to buy things that you probably really don't need, but you're trying to find things to do and to fill your time.

I ran errands for JD. I took her clothes to the cleaners and that was it. I found a Michael's and so I began to craft, which is something that I liked, but that got old after a while. And I was just bored. I was bored and I was lonely.

Gabrielle: While Shellie still didn't feel at home in Danbury, she was surprised by how welcomed she felt a Danbury Hospital. Shellie's new doctors and nurses were so kind and eagerly attended to her needs and questions. And check this out, Shellie's prenatal care was so good, she still considers it the best hospital experience she's ever had in her entire life. But it still wasn't enough to mask the loneliness of her pregnancy and life away from home.

Shellie didn't have time to deal with all her feelings just yet. She was just a couple of weeks out from her May 30th due date, and she still had a few more things to cross off her to-do list. 

Shellie: Okay. So I knew, I knew my delivery date and I begin to have pains and I didn't know what they were, but I began to have back pains like two weeks before baby Miles came. But I have a hair appointment and my hair appointment was in New York. And I had a plan. See, I told you I had this birth plan. Part of that plan, I had to have my hair done because I felt like I cannot go into labor looking a mess. I can't! I have to go in and I have to be together. And my hoo hoo has to be waxed, the legs have to be waxed. Cause you can not have your legs open to someone and then it's not right down there.

That's just. I felt I had to be fabulous. So anyway, I wake up that morning. From Danbury, Connecticut, Westchester, New York was probably about a little over an hour. So I have this appointment. I drive down there, and I get there a little early and the stylist, the salon wasn't open. So I was like okay, I'm a little early. I'm just gonna just kind of drive around. I remember I went to Target. I said, I'm gonna run to Target, find something I don't need, and I'll come back and she'll be there. I come back and she's still not there. I was like, oh shit. Okay. Well, let me run over here to Fortunoffs, which is comparable to like a Saks Fifth Avenue.

I pull into the parking lot, I get out of the car, and as soon as my feet hit the ground, I feel water come down my legs. And I'm like, ah, shit, no, not right now. It's not, you know, I got, I got shit to do. I've got to get my nails done, my hair done. I got things to do so. I ignore it. I, but I do go use the restroom and Fortunoff.

And after I finished using the restroom, more water comes down. I'm like, shit, this, this can't be. So I finished shopping and something said, you know, Shellie, maybe you should just leave now. So I go back to the salon, she's still not there. I said, you know what? This there's a reason for this. I'm not supposed to get my hair done cause I'm, I'm actually going into labor. My water has broken. Shellie, you need to get your ass back on that freeway and head back to the doctor in Connecticut. So I look at the gas tank. I have no gas. I called my best friend at the time. And we're on the phone, I remember pumping gas and I'm just laughing. I was like, girl, my water broke, water's running down my leg. And she's like screaming, she's like, "you need to get back to Connecticut!" And I'm like, oh, it's okay. It'll be okay. So I drive back up to Connecticut. By then I called JD and I'm like, listen, my water broke, it's time. 

Gabrielle: As Shellie headed back to Connecticut to meet JD and head to the hospital, she made another call, this time, it was to her mom. Oh, and Shellie's hair? Well...

Shellie: Needless to say, I didn't have my hair done. I looked a fucking mess in labor. It was terrible. It was terrible. So I said, well, since my hair's not done, let me just put a scarf on. So I put on a cute little silk scarf to try to jazz it up a little bit. It wasn't working. Those contractions really hit. I was like, fuck this scarf, you don't even care. At that point, you don't care about vanity. You don't care about being cute. You are in pain and all you want, is this, for this experience to be over. You will never know pain until you know some contractions.

And at that moment I said, okay, I can do this. And I remember feeling like my ancestors did this. I swear to God, this is the truth. I said, my ancestors did this. Shellie, you can have this baby without an epidural. You don't need it. The slaves in the field didn't have epidurals. You can do this. And I remember this was the conversation with myself and I was like, come on, you can do it.

But the pain was so bad and I wasn't dilating. And I finally got to the point, I said, you know what? I cannot do it. I can't, it's too painful. So I got the epidural and that was a whole emotional roller coaster because I felt like I had failed. I'm like, you mean to tell me you can't have a baby without drugs? And then you're your ancestors before you have been doing this kind of a weird conversation, probably to have yourself, but I had it.

Gabrielle: Epidural anesthesia is the most popular method of pain management for birthing parents. But these thoughts that she was somehow a failure for having a medicated birth really started to consume Shellie's mind. To make matters worse, Shellie still wasn't dilating. The doctors wanted to perform a C-section. 

Shellie: And by then I had already been at the hospital probably for about seven hours. And so we knew that it would be a planned C-section the next morning. When I was told that I had to have a C-section, that was really a let down. Because I feel like I have defied true womanhood and true motherhood, because I feel like in my mind, giving birth to a child means the child comes through the vaginal canal. And it didn't happen like that. And I feel like I cheated having a C-section.

Gabrielle: Shellie was having her dream baby after years and years of waiting, and not a single thing was going according to plan. What Shellie didn't know was that even in 2007, C-section deliveries were pretty common. Even today, nearly a third of all US births are cesarean. March of Dimes is a national maternal health research and advocacy organization. And according to them, Black birthing parents have C-section deliveries at higher rates than any other racial group. Why? Well, there's a number of reasons, including preexisting conditions, financial incentives for hospitals, shorter delivery times, and the pressure Black parents feel to go under the knife.

The one good thing though, about Shellie's labor, was that she was never alone. 

Shellie: I felt supported. My mother flew in, um, in time for the birth. JD was there trying to sooth the pain of the contractions. And I remember JD trying to like, rub my back, but after a while it became irritating and I just felt like, okay, nobody touch me.

You kind of feel like, I just need to do this and I just need to be in my own space. And then it's time. They're like, okay, it's time for this planned C-section. 1:00 PM. And I remember being wheeled into the operation room. I remember, vaguely remember because I was heavily medicated, the delivering doctor was also training another doctor.

And I remember they were having some conversation about another patient who had died in delivery. And I remember JD saying, "Uh, excuse me, like, no, we're not having this conversation at this time." Um, I remember the pulling and the tugging of my, of my belly. It didn't hurt, but it's just the pressure of pulling baby Miles out.

And then I heard his cry. And then they showed me him over the curtain and it was the strangest moment because I was like, is he mine? Like, can I take him home? The doctor kind of laughed. She was like, yeah, this is, this is your baby. And it was like, it was like amazing that finally, this life that had been growing inside of me is now here.

And I see him and I meet him for the first time. And I'm in awe. Like I can't believe it. Like he's mine. This is my baby. I grew him. And I remember JD gave him a bath with the nurse. And I remember holding him and nursing him for the first time and I just cried. I just looked at him. He was lashed onto my breasts and I just cried because it was a happy moment.

And it was the moment that I had been waiting for, for so long. And it was here.

Gabrielle: On May 16th, Shellie and JD welcome to a healthy 7 pound 11 ounce baby boy, named Miles. As the new trio prepared to head home, the physical and mental exhaustion of childbirth really started to catch up with Shellie 

Shellie: Miles and I spent a couple of days in the hospital and what I could appreciate about Danbury hospital, I vividly remember how supportive they were, in terms of once Miles was born, that was a time where they still had the nursery and the baby was taken from you and put in the nursery to give the mom a rest. And you could, of course, whenever you wanted to feed or just whenever you wanted to bond with your baby, all you had to do is ask. And I remember being exhausted, also crying, because I couldn't get him to latch on after, after the first time.

And when you've got a screaming baby and you are exhausted, your baby can't latch on, you know, you have to feed your baby, then all these thoughts go through your head. Like, Oh my God, is my baby going to die of hunger because he can't latch on? Then a couple of days go by. We go home. JD is there. My mom is there.

I've got all this support. I'm able to rest and have other people, uh, help take care of Miles. And then a couple of weeks later, JD had to go back to work. My mom had to return back to LA and then here I am, I'm alone. I'm alone with the newborn. There's no rule book. I'm still exhausted. Some days I don't shower because sometimes you'd rather sleep when the baby is sleeping, then use that time to shower and get yourself together. And the loneliness set in. Sometimes boredom set in. And I didn't, I didn't have anybody to call and say, hey, I need help. And then I just remember, I got really sad and I never told JD, I never told her. And she'll find out now, but I suffered from postpartum depression for a long time. Honestly, three years.

Gabrielle: Postpartum depression, or PPD is a serious mood disorder that can appear days or even months after delivering a baby. And it can make you feel really, really low about yourself and about being a parent. 

Shellie: I questioned everything that I did. Am I being a good mom? Am I doing this right? Does my baby like me? My baby's crying. So my baby doesn't like me. So then you go through this, this whole mental trip in your mind about who you are as, as a new mom.

And sometimes I remember feeling like I'm just tired. I just don't want to nurse right now. I don't want to, my nipples are bleeding. They're chapped, this baby's got this vice grip and it feels like your nipple is about to be chewed off. And so I'm crying. I'm putting on, it's like a, kind of like a Vaseline to help with the chafing of the nipple, but that didn't work. And so I eventually moved to formula, a then that's a whole 'nother guilt trip in and of itself, because I'm like, look at you, you can't even nurse your own kid.

And so there's more sadness. You can't nurse your kid and you gotta go buy formula for your kid. You know formula's not good. It's not healthy for the baby, breast milk is best. So it's this mental trip. That I'm going through alone.

That was something I struggled with even up until he was a toddler. Am I nurturing enough for this baby? How does my child see me? Does my child find comfort in me? Do I soothe him? Does he long for me when we're apart? All these things I remember played in my mind. Just wondering does my baby like me? And even sometimes now I still wonder if I'm doing a good job and how my kids rate me as a mom.

I suffered in silence. I didn't ask for help because I was ashamed. I didn't share with JD because fear that, fear of her, her judgment, what will she think of me? So nobody knew until now.

[Mind Over Melanin Promotion]

Throughout the season, we're highlighting different podcasts that explore various facets of the Black breathing experience. Mind Over Melanin dives into the psychological impacts of being Black. Hosts, and mental health therapist, Bailey Jeremie, examines the state of our mental health and provides vital tools for self care. Listen to Mind Over Melanin wherever you get your podcasts.

Gabrielle: Even though Shellie felt incredibly isolated from everything and everyone, we know that unfortunately, she wasn't alone then, and she's not alone now. According to the American Psychological Association, up to one in seven women battle with postpartum depression, and it doesn't just go away on its own. It can develop and last for weeks, months, and even years. Let's circle back to Dr. Bamgbose for some medical insight on PPD. She's the reproductive psychiatrist I introduced you to at the beginning of the episode. 

Dr. Bamgbose: One of the things that's so hard is when women are pregnant and when they're postpartum, they get this idea from culture and from media that they should, this is just a happy time and they should be so excited and everything's hunky dory.

And it doesn't often feel that way. So if there's a way that a woman who was pregnant or postpartum can have someone to talk to and say, you know, "I'm feeling really sad all the time." And, and not feel like they're being judged for that. Or I feel like I don't connect with my baby, or I feel like, even my baby might be better off with a different mother.

So the kinds of feelings of inadequacy that, um, really would be worth opening up and talking about more with somebody. So those are those hearing. Those kinds of things would be red flags, especially the, just not feeling connected to the baby, feeling like very tired and all the time, not eating, or not having any energy.

Um, and then of course the more significant ones that we definitely want to make sure we address is if a woman is having kind of, um, concerning thoughts, like thoughts that they might want to hurt themselves, thoughts that they might want to hurt their baby. And on, on the flip side, women can have those thoughts. They're not uncommon actually, especially in the postpartum period. And there are someone who have thoughts that are not, that they have those thoughts, but it's, they're not wanting to do that, so it's very disturbing to them cause they're like, what's happening? Am I accidentally going to hurt my baby?

So then it creates this anxiety of, um, worrying too much. You know, needing everything to be extra, extra clean, or extra, extra orderly. So those kinds of things too, we see a lot. Um, and the anxiety, increase in anxiety symptoms. 

Gabrielle: These feelings can escalate and if left untreated, postpartum depression can be deadly for both the birthing parent and the child. Several maternal mortality review committees have even identified mental health problems as a contributing factor in pregnancy-related deaths. 

Dr. Bamgbose: So I'd say that kind of spectrum of something is not right, and it's this anxiety that's related to, um, taking care of the baby or this fear that you can't do it yourself, you're going to cause harm to the baby, would be very good reasons to seek, to seek some help,  professional help.

Shellie: I don't ever remember being asked how I was doing. Everything was baby focused, baby centered. Looking at making sure that Miles was meeting his benchmarks.

It was never about how are you doing how's your mental health? Are you okay? It was never that it was never that. So I just learned to cope. I just learned to deal. I learned to survive in my own feelings. So you just cope by throwing yourself into a routine, doing the same thing every day. Um, you cook breakfast or you make the bottles. If you need to, you get the baby dressed, you get yourself dressed. You go to the store, you get what you need. You come home and you cook dinner. You're changing diapers, have dinner, maybe sit around and talk, get the baby ready for bed. Baby to sleep. And then you go to sleep and then you wake up the next day and it's the same thing over and over again.

I learned to hide it, I think, through just acting like it just didn't exist. Somehow I compartmentalized being a mother, being a partner and just being myself, like taking care of myself, I was just able to kind of move through each of those areas without realizing that something was suffering, that something was missing from the other area.

Gabrielle: That missing something was her. Shellie had all of these feelings bottled up. These new experiences that she was having difficulty processing, and a newborn who needed her to show up, be present, be happy and healthy.

But she didn't have the language to ask for help. She didn't know what resources were even available to her or what they could look like. And everyone around her also seemed to be at a loss for what this new mom could be feeling, 

But if we're keeping it all the way 100. Mental health is a really touchy subject for Black communities. I myself have grappled with depression and anxiety over the years, and I still do. So I know firsthand that on top of trying to find language to describe your own feelings, it's even harder to talk about it out loud with family and friends. Folks don't always know what to say or how to support you. And we oftentimes see mental health as this quote, unquote, white people thing. Hell we don't even call depression, depression. How many times have you heard? "Oh, I'm not feeling too well," or, "I'm having the blues," or, "I feel off lately." In many cases, we're just searching for the words to describe the physical signs of depression. Like the headaches, anxiety, slower speech, or even digestive issues.

And according to the Center for American Progress, Black women are half as likely to receive mental health treatment and counseling as white women. Medical providers are much more likely to overlook these symptoms in mothers of color, especially those who are low income or identify as queer. And this gap between Black folks and mental health care is something that Dr. Bamgbose is constantly thinking about and trying to improve at Cedar Sinai. 

Dr. Bamgbose: Black of people do face a lot of risk factors for developing depression and anxiety, just based on a host of socioeconomic cultural issues. And so I think being able to recognize that and then be able to offer support in a way that's not stigmatizing, can be a really difficult line, especially if you're dealing with non-Black providers. Even if they're, I think if everyone is doing their best, there often as a mistrust of, um, uh, providers when they are not Black, from Black patients and Black families.

So I think one of the things that I try to do, especially in an acute setting and even in an outpatient setting is, how can I normalize this process and say, oh, you know, always start by saying, this is a very common experience. I'm going to talk about some things that I've experienced, a lot of moms have dealt with.

Then I hear a lot of moms who say, and I'll just say, for example, moms tell me, they sometimes feel like they don't have a connection with their baby. And people are surprised like, "Oh my God, really? Do other people say that?" Yeah. And then I think being able to help train all the people who are going to come into contact with Black moms and Black families, and just in terms of. How to be aware of this stigma that might, that might exist, and aware of the ways in which some, um, interventions which may be presented as trying to be helpful, can be seen as kind of, um, prejudice or a little bit discriminatory or offensive even. 

Gabrielle: And when it comes to reproductive psychiatry, medication is not the only choice. There's actually a wide range of treatment options available to parents 

Dr. Bamgbose: Within a reproductive psychiatry role, if I'm focusing primarily on making sure that medications are optimized, it's always going to be an evaluation of whether a medication would be appropriate. And sometimes it's not, for various reasons, you know. And at that case either, maybe the psychiatrist themselves, or they might refer out to another therapist who could provide therapy, individual psychotherapy to help you address what's going on.

So whether it's, for example, cognitive behavioral therapy to help you modulate your thoughts and your behaviors, or more of a supportive psychotherapy to just give you extra support. I think another thing that is really important for somebody who's under the care of reproductive psychiatrists would be to be able to have access to resources that could address other social stressors that could be addressing your condition, like loneliness and isolation, is very significant.

And when addressed, can help with, um, Improved outcomes. So things like referrals to support group or even referrals to social work, to help with practical things like, is there a way to get childcare so that you have time to do your support group meetings or even go to work? Or is there a way that you can make sure that you have the resources to take care of your family financially?

And I think even addressing some of those barriers is going to be huge for a lot of women because an antidepressant isn't going to help if you're the only person taking care of four kids and you're working two jobs. 

Gabrielle: And as hard as Dr. Bamgbose is fighting to both change the perception of mental health and normalized treatment for birthing parents, she acknowledges that there are some barriers to getting hospitals fully on board.

Dr. Bamgbose: The cost and the billing. And you know, the question that any, whenever you take an idea to any meetings, you have some administrator who's going to say, okay, where's the money coming from? Where are we funding this? And so, um, mental health treatment doesn't bring in a lot of money. So it makes it hard to fund these programs. So a lot of times institutions, organizations have to look for private funding, grants, that kind of thing. And so I think that is one huge barrier. And another one is the added burden on the provider. So when they say all, all providers have to be trained to offer these screenings and what to do next, it does add on the, on the demands we already ask of our nurses, and our social workers, and our physicians. It adds to, you know, the paperwork, they have to do the amount of hours they're working on every patient. And of course, everyone has signed up to help people and they want to do that. When there's another thing added to your plate, it makes it difficult. And so I think the time is, is a big one, but less important, than the than the financial barriers.

Gabrielle: But through it all, Dr. Bamgbose, she is committed to creating a community model of care where Black birthing parents can have everything they need in one centralized place, including mental health resources, because that vibrant community center Dr. Bamgbose painted for us at the top of the show, that warm, joyful space full of doulas, OB GYNs, spiritual leaders, social workers, and mental health professionals? You know, everyone working in sync with one another to support Black birthing parents and their families? It doesn't have to be something that lives in our imaginations. We can collectively work towards bringing that model of care to life. And for this Nigerian-American doctor, that work is personal. 

Dr. Bamgbose: I think that I first came to it just in terms of all women. I wanted to work with all women at this intersection of psychiatry and reproduction. But then as I got further into my training and started to learn more and really understand more about the disparities between Black women and white women, I thought, okay, I really would love to be more involved in this and be like a, somebody who knows a lot about this and this community, because I think it's really important. There are not a lot of psychiatrists that look like me, and there's definitely not a lot of reproductive psychiatrists that look like me. And I know that every time I see a woman who's Black and she sees me, she's so relieved.

So I really feel like as I'm going through my career, I want to be able to say I'm helping all women, but I really want to focus on Black women and other women in my community so that I can make sure that we're having the best outcomes possible. 

Shellie: I would say, when you go to your postpartum appointments, that you speak up and you let your doctor know, I feel off, I feel like things are imbalanced. Because quite possibly, you may require support from someone other than your friends and your family. And it's okay to seek professional support and intervention to make sense of it all, because it is your hormones out of balance and just shit at the time. Just everything just doesn't make sense. And it's okay. Go get the help because it's out there, but you just have to ask, but I didn't know to ask

Gabrielle: It took two years, but Shellie finally asked; she's been in therapy ever since. Her story reminds me of a quote from one of my favorite books, Toni Morrison's timeless novel, Song of Solomon. She writes, you want to fly? You've got to give up the shit that weighs you down.

For parents grappling with depression and anxiety, that shit represents all the ideas they're told and tell themselves that they are in some way invalid or less than because of how they choose to give birth, if they do it all. Including myself, it represents all the times we've told ourselves that we aren't worthy or deserving of support to navigate new life chapters. It represents all the times we've been too afraid to say, I can't handle this on my own. I need help.

Today at 50 years old, Shellie is preparing to fly she's back in her beloved Los Angeles, the mother of two now, and she's finally ready to live her truth. 

Shellie: I think if there's one takeaway from this that I would want to share with other women is that you don't have to suffer in silence.

And you have to find somebody that you trust. You have to find someone who is going to listen without judgment, someone who is going to hold you with benevolent hands through it all. Sharing my story in terms of the postpartum depression, again, this is the first time that I've ever told anyone about it because I've held it in.

Miles is 12. That's a long time to hold onto that, and to carry that around. And I just felt like you caught me at a good time in my life where I was ready to share, and it no longer mattered how other people thought of me, because I feel like there's something bigger than me in my story. There's something that someone else can gain from this experience that I have to share.

And what good is knowledge, if you only hold onto it? I'm here. And I'm happy that you found this story and my story interesting and worthy to be shared with the world. 

Gabrielle: We know that it can be hard to ask, but if you or someone, you know, is struggling with depression, anxiety, or another mental health concern, contact the National Alliance on Mental Illness at +1 800-950-6264.

[This article was originally published by NATAL.]