Abstract
Being a good mother is the highest calling for many women. However, the demands of being a “good mother” can be stressful, especially during pregnancy and the first 2 years postpartum. For many low-income mothers from marginalized groups facing multiple responsibilities with limited resources, the stress of new mothering can lead to postpartum depression (PPD). Although PPD affects roughly 12% of all white mothers, at least 3 times as many mothers of color (38%) have been found to experience PPD. In this study, 30 low-income mothers of color with histories of PPD were interviewed about how they viewed being a good mother while living with PPD. Their views of “good mother” emerged during the interviews, which uncovered four major themes: being strong mothers, juggling responsibilities, being self-sustaining, and taking care of self. Using these themes and drawing on research on mothering informed by feminist perspectives, this article examines how the mothers strive to be good mothers while coping with PPD. Social workers working with new mothers of color who have PPD can benefit from understanding these mothers’ experiences with PPD while striving to achieve well-being for themselves and for their children.
Keywords
Motherhood represents a highly respected aspect of womanhood, yet certain mothers are socially validated while others are not (Chavis, 2016). Motherhood demands women to be the primary caregivers of their children, provide them with ongoing nurturing, and attend to and meet all of their needs, while being financially able to do so (Mesman et al., 2016). A mother is expected to bestow abundant time and energy on her children, focus on their development, and put their needs above her own, all of which are to occur outside of paid employment (Hays, 1996).
Although most mothers strive to achieve these ideals, this narrow conceptualization does not take into account the experiences of mothers who are unmarried, adolescents (Bailey, Brown, Leterby, & Wilson, 2002), older, single, lesbian (Lewin, 1994), or women of color or of low income (Collins, 1994). Mothers who are not from privileged backgrounds, whose life circumstances require them to work outside of the home, and whose incomes make achieving middle-class standards unlikely risk failing to achieve these social expectations of “good mothering” (DiLapi, 1989).
To expand the lens on mothering, we explore a group of women whose strengths have been invisible because of their race, ethnicity, income, and struggles with maternal depression. Although the struggles for mothers from oppressed backgrounds have been well-documented in the literature, the difficulties of mothering are often worse for mothers with limited supports (Beck, 2001), which in turn can limit their ability to care for their children (Amankwaa, Picker, & Boonmee, 2007) and lead to postpartum depression (PPD; Terry, Mayocchi, & Hynes, 1996).
The Centers for Disease Control and Prevention (CDC, 2008) concludes that African American and Latina mothers have the highest rates of PPD in the United States. Despite this finding, they are frequently overlooked (Keefe, Brownstein-Evans, & Polmanteer, 2016a) and their strengths have gone largely unrecognized in the literature on PPD (Keefe, Brownstein-Evans, & Polmanteer, 2016b). This examination shifts the lens from mothers whose experiences resonate with dominant ideologies to the experiences of mothers from marginalized groups who aspire to the ideals of good mothering but are challenged by single parenting, low incomes, and racial and ethnic discrimination. We argue that these challenges, combined with the demands of trying to be good mothers, contribute to their depression.
Research concludes there is a marked disparity in the prevalence of PPD by education, race, and ethnicity. Di Florio and colleagues (2017) found significant differences in PPD symptoms among 8,209 new mothers whose results on various PPD screening instruments were documented in several data sets in the United States and in Europe. Although the differences were greater among less well-educated mothers, differences were also noted among mothers by race and ethnicity. Ertel, Rich-Edwards, and Koenen (2011) used the National Epidemologic Survey of Alcohol and Related Conditions to study a cross section of 8,916 mothers and concluded that mothers who experience a large number of adversities including poverty and marital conflict had worse depression, with African American and Hispanic mothers having greater numbers of adversities and less likelihood of receiving services than white mothers. Gaynes et al. (2005) reported that although approximately 12% of white mothers in the United States will develop PPD, nearly 38% of low-income mothers and mothers of color will develop PPD (CDC, 2008). Moreover, the majority of low-income mothers and mothers of color are neither formally diagnosed nor receive appropriate treatment (CDC, 2008; U.S. Department of Public Health, Office on Women’s Health, 2012). PPD researchers have largely neglected the needs of low-income mothers and mothers of color. In fact, the published research on PPD has centered largely on white mothers while very little has focused on mothers from traditionally oppressed backgrounds (Keefe, Brownstein-Evans, Lane, Carter, & Polmanteer, 2015), including African American and Latina mothers who have the highest fertility and PPD rates in the United States (CDC, 2008). Furthermore, little research has focused on the challenges marginalized mothers experience because of socioeconomic factors including limited jobs or unemployment, living in poor neighborhoods, and the lack of family support. Finally, although mothers from all racial and ethnic groups strive to be good mothers (Elliott, Powell, & Brenton, 2015), much of the research on good mothering, like the research on PPD, is based on white mothers (DeSouza, 2013).
This article addresses the lack of research on the intersection of these topics by focusing on how one group of low-income mothers of color characterize “good mothering” and address the challenges they face. We apply a feminist, contextualized view of mothering to the problem of PPD and challenge the dominant ideologies of each. Consonant with the values of black feminist thought (Collins, 2000), we focus on the effects of race, class, and gender on the access to supportive social structures and resources.
Feminist Perspectives
Feminist perspectives consider the influence of oppression and social structure on self-identity and relationships (Allen & Jaramillo-Sierra, 2015). While critiquing the structure of the idealized family, feminist scholars have also considered the effects of societal oppression on diverse families (Allen & Jaramillo-Sierra, 2015). Exploring the diversity of women’s experiences shifts the focus from a singular view of mothering to a more contextualized view on how social structures such as poor urban neighborhoods, low-income housing, inadequate employment, limited transportation, and the lack of access to other social and economic resources constrain mothers’ lives (Collins, 2000), thereby contributing to maternal depression (Liu, Gallo, Dona, Seidman, & Tronicki, 2015).
Feminist views of mothering and child well-being argue that family preservation is achieved through adequate material well-being (Roberts, 2002). Growing out of the response to feminist perspectives that focused too heavily on oppression resulting solely from sex and gender, black feminist thought argues that oppression results from the intersection of multiple factors that negatively affect all people (Lindsay-Dennis, 2015). Black feminist thought emphasizes that oppression makes adequate caregiving impossible (Collins, 2000) and that the oppression of all women must be viewed through the intersection of race, class, and gender (Coontz, 2011; Hamilton-Mason, Hall, & Everett, 2009). Black and Latina women are frequently only recognized as good mothers when demonstrating extraordinary strength (Hamilton-Mason et al., 2009), while the inadequacy of resources challenging their mothering efforts is ignored.
Good Mothering
The transition to motherhood is an individual process influenced by a combination of social, economic, political, psychological, and environmental factors (Chapman, Coleman, & Ganong, 2016; DeSouza, 2013) and guided by social norms about what is best for the child, how the child should be raised, and who should be accountable for the child’s development (Thurer, 1994). These expectations persist in various social policies affecting motherhood, employment, and child rearing (Freeman, 2016), which are often achievable only by mothers from the middle and upper classes who have adequate resources (Ladd-Taylor & Umansky, 1998). Yet, lower income mothers and mothers of color are frequently judged by these same standards (The Center for the Study of Social Policy, 2009), scrutinized by others for their mothering practices (DeSouza, 2013), and viewed as bad mothers (Ladd-Taylor & Umansky, 1998; O’Reilly, 2004) if they turn to social programs, multiple partners, or substance abuse, or experience domestic violence or divorce (McDermott & Graham, 2005). As a result, much of the research on mothers of color concludes these mothers believe they have to be independent, stalwart, and above reproach (Collins, 2000; Elliott et al., 2015), work to defy the negative views many people have of one-parent families (Zartler, 2014), and overcome stigma that labels them as risks to social stability (McDermott & Graham, 2005).
PPD
Unlike the symptoms of major depressive disorder, which appear within 2 weeks of the psychosocial stressor (American Psychiatric Association, 2013), the symptoms of PPD can take up to several months to manifest (O’Hara & McCabe, 2013). Like major depression, the symptoms include disrupted sleep, poor concentration and appetite, decreased self-esteem, feelings of failure, and lack of energy (American Psychiatric Association, 2013). Many mothers with PPD report experiencing hopelessness, suicidality, anxiety, insecure attachments, and social withdrawal (Lucero, Beckstrand, Callister, & Sanchez-Birkhead, 2012).
Psychiatric and other medical factors help predict PPD including low self-esteem, an inability to cope, feelings of incompetence, loneliness (Fitelson, Kim, Baker, & Leight, 2011; Hirst & Moutier, 2010; Logsdon, Eckert, Tomasulo, Beck & Dennis, 2012), and a history of depression prior to (or during) pregnancy (CDC, 2008; Hay, Pawlby, Waters, & Sharp, 2008; Patel et al., 2012). Additional predictors such as sexual dissatisfaction (Morof, Barrett, Peacock, Victor, & Manyonda, 2003), suicidality (Beck, 2002; Lucero et al., 2012), obsessive thoughts (Beck, 2002; Lucero et al., 2012; Ray & Hodnett, 2001), hopelessness (Ray & Hodnett, 2001; Sealy, Fraser, Simpson, Evans, & Hartford, 2009), and fear of harming the baby (Sealy et al., 2009) have also been reported on in the literature.
Moreover, hormonal and endocrine issues can play a role including low progesterone and estrogen levels (Dennis & Ross, 2005), premenstrual tension (Boyce & Hickey, 2005), diabetes (Anderson, Freedland, Clouse, & Lustman, 2001)—including gestational diabetes—mellitus (Crowther et al., 2005), and obesity (Andersson, Sundstrom-Poromaa, Wulff, Astrom, & Bixo, 2006).
Psychosocial Risk Factors
Psychosocial issues such as living in poverty, having lower levels of education and higher rates of unemployment (Fellenzer & Cibula, 2014), job-related stress (Grote & Bledsoe, 2007), and living in unsafe neighborhoods (Schultz et al., 2006) serve as risk factors for PPD. Likewise, experiencing an unplanned pregnancy (Fellenzer & Cibula, 2014), having a poor or disrupted relationship with the baby’s father (Grote & Bledsoe, 2007; Luke et al., 2009), and being in poor health (Luke et al., 2009) are also risk factors. These issues are the primary factors that form the context of the lives of the women in this study.
Service Barriers and Use
Mothers in these circumstances often turn to health, social service, and community resources for help and support. Yet, some mothers who access formal services report their health-care providers contribute to their PPD by minimizing their distress in efforts to be reassuring (Dennis & Chung-Lee, 2006). Other barriers include having too few health providers of color (Ley, Copeland, Flint, White, & Wexler, 2009), inconvenient clinic locations and business hours (Phillippi, 2009), and limited transportation (Dennis & Chung-Lee, 2006).
Life situations complicated by social location, which includes a mother’s race, socioeconomic class, gender, age, ability, religion, sexual orientation, and geographic location have been largely overlooked in the literature on PPD. In response to the limited research on the intersection of PPD and mothering, this study provides qualitative data on how low-income mothers of color with histories of PPD conceptualize what it means to be good mothers in spite of multiple challenges they face in their daily lives.
Method
Prior to beginning this study, the researchers canvassed local health and mental health providers who serve new mothers from various low-income racial and ethnic groups seeking input for survey questions on PPD. Examples from the interview guide of questions from these categories are (1) the mothers’ demographics (her age, number of children, and their ages; number of pregnancies, race/ethnicity; and marital status), (2) their experiences with PPD (How do they describe what they were going through?), (3) how they coped with depression and mothering (What sources of help they received from formal and informal resources?), and (4) their recommendations to service providers for helping other new mothers with PPD (What did they want physicians, nurses, social workers to know and do to be helpful to mothers experiencing these feelings?). Practice interviews were then conducted with 12 racially and ethnically diverse research assistants who provided additional feedback on the interview questions and process.
The researchers partnered with a large, multisite, and urban-based health center serving low-income residents. Flyers were posted in the centers’ waiting rooms inviting mothers to participate who were least 18 years old, self-identify as black/African American or Hispanic, were pregnant or had a child under age of 2, have at least one child living with them, and had experienced feelings of sadness, anxiety, depression, or difficulty concentrating or sleeping. Thirty low-income mothers of color who met the inclusion criteria agreed to be interviewed at the health center. The semistructured interviews were digitally recorded and transcribed immediately afterward. The mothers received a US$20.00 grocery store gift card at the end of the interview.
Participants
The 30 mothers who participated in the study (19 African American and 11 Latina) were between the ages of 18 and 44 (x = 28.60), had histories of PPD, and had between 1 and 7 children living with them (x = 3.06); 11 were currently pregnant. Nineteen were unemployed, 4 did not provide information regarding their employment status, and 7 women were employed at various low-wage jobs. All but one of the 30 mothers received Medicaid; one mother had health insurance through her employment at a low-income job. Each mother completed the 10-item, self-administered Edinburgh Postnatal Depression Scale (EPDS; Cox, Holden, & Sagovsky, 1987), which has been normed on mothers from various racial and ethnic groups including African American (King, 2012) and Latina (Hartley, Barraso, Rey, Pettit, & Bagner, 2014), prior to being interviewed. Cox, Holden, and Sagovsky (1987) conclude sensitivity to be 68–95% and specificity to be 78–96%. Scores range from 0 to 30, with a score of 12 or above indicating PPD (Cox et al., 1987). The average EPDS score in this study was 18.75.
Data Analysis
Data analysis followed a constant comparative method where the responses were broken down into fragments, compared, and then coded into categories (Walker & Myrick, 2006). This process was followed by comparison to responses and coding in subsequent interviews and to the identification and exploration of emerging themes (Corbin & Struass, 1990; Glaser, 1965). Constant comparative analysis is used to explore phenomena through analyzing individual responses between the interviews and between fragments of interviews (Corbin & Strauss, 1990; Walker & Myrick, 2006). The data were initially coded independently by each author using line-by-line coding, then organized into categories and compared to subsequent interviews to refine categories by looking for commonalities in experiences, actions, attitudes, perspectives, and explanations of behavior (Walker & Myrick, 2006). Interviews were coded chronologically, making comparisons between older and newer data to refine categories and themes. This process was followed by comparison among the authors during meetings to analyze and further refine the thematic coding within the categories. Given the purpose of this study, this analytic approach was considered the most appropriate method.
While analyzing what living with PPD was like for each mother, as well as how mothers coped with depression and mothering, descriptions about “being a good mother” began to emerge. The authors therefore explored this content in subsequent interviews by asking mothers to describe good mothering and to explain how they try to meet mothering responsibilities, comparing the descriptions and perspectives the mothers provided. Using the above process, four main descriptive and explanatory themes emerged regarding the mothers’ beliefs on what makes a good mother: being strong mothers, juggling responsibilities, being self-sustaining, and taking care of self. Consistent with comparative analysis, the authors continuously reread the data to identify subcategories within each mothering theme. This process allowed the researchers to understand each of the emerging categories and its relationship to themes and subcategories, finalizing the analysis with the themes discussed in this article.
The Intersection of Good Mothering and PPD
In discussing their efforts to be good mothers, the participants inevitably referenced the context of their lives and the barriers they encountered to being the mothers they wanted to be. First, we discuss how mothers described what being a strong mother meant to them and then examine the contexts of their lives that made mothering difficult for them. We explore the connection between their efforts to be good mothers, the present barriers to their social contexts, and the subsequent PPD they experienced. The women in the study acknowledged that good mothering begins with recognizing the responsibility one has for one’s children. Rochelle, a 29-year-old African American mother of six children, summarized: I have no choice. I brought my kids into this world so now I have to take care of them. And sometimes you can’t provide all the time for them…but you try your best. I stuck it out, and I did what I was supposed to do.…And I know it’s gonna be a lot more on top of what I already have.
Despite failure of resources, opportunities, relationships, in her life with six children, Rochelle went on to describe the need to persist as a mother to …Keep pushing, and do what I have to do, so…when everything else fails, Mom’s gonna be there. So, that’s how I look at it. Cause if we don’t do it, who’s gonna do it? You know, these are our responsibility, these are our children, so, this is our job.
Anjelica, a 25-year-old Puerto Rican mother with four children, responded similarly saying: “Moms take care of responsibilities, financially…me I take care of my kids, we don’t have everything…but they have clothes, they’re fed, they have a roof over they head.” She goes on to state, “…as a good mother, yeah you’re doing what you have to do because it’s your child but as a real good mother you’re gonna wanna do everything, like your kids come first.” To give a context to her role as a single mother, she shares, There’s nobody really to help us…my sisters are in New York City, my father was a drunk, my mother was a crackhead so you can add it up and yeah.…I keep my distance from them.
She expresses the responsibility she feels to prioritize her children’s needs while having no family members helping her. Perhaps most poignantly, she also describes her neighborhood, which represents the context of her housing options, “I mean there’s shoot outs here, but that’s everywhere you go.”
Latoya, a 25-year-old African American mother of three children, reports how various contextual challenges, including job insecurity and community violence, created challenges for her. She reports, “when I was still working, one of the managers, she was really nice to me, but it didn’t work, I still lost my job and everything.” She goes on to report her neighborhood poses another challenge, “It’s not safe and I’d rather keep my kids in the house than to have them in that environment.” Likewise, Gloria, a 27-year-old Latina mother of three describes her community, “I live in the ghetto. Since I’ve lived there for two years I’ve probably heard at least 80 gunshots.” She goes on to report being victim of domestic violence, …He don’t like me to have friends. He don’t like me to talk to nobody…go nowhere. He wants me to stay in the house all the time, cook, clean, laundry.…We got into a big fight…him hitting me.
Being Strong Mothers
Many of the mothers spoke about doing whatever they needed to be strong, powerful, and unwavering while taking care of their children. Tammy, a 38-year-old African American mother of five, discussed how she encourages herself to be strong and confident: I try to keep the positive impact and confidence, and not be looking down on myself. I say my name, and then I say ‘Well…you gotta…think about it, and go on with the flow. You got little ones. They’re looking up to you, and…depending on you. So you have to do what you gotta do.
According to Tammy, the responsibility for bringing children into the world means she is responsible for doing everything necessary to care for them. Arissa, a 31-year-old Jamaican mother of three, states …You have to go with it as it is. Every parents gets depressed and stressed out. Kids can be a handful…It’s a lot of things that comes with them a lot of things that they need…but you try your best. …your role is to be strong at the end of the day. I mean as a mother, that’s our role. You know, you can’t let your kids see you crying, “cause it shows all type of weak areas. So, you try not to do that around your children.”
For many interviewees, being a strong mother is centered on leadership and responsibility. One more interviewee, Tamara, a 30-year-old African American mother of seven children, said, You’ve gotta set an example and, you know, lead by example. That’s what I’m doing…I don’t want them to walk in my footsteps or make the mistakes that I made in my life. I can’t let…being depressed…be a barrier in my life, because that’s always gonna hold me back from the things that I need to do.
She explains that she has to overcome her depression to be a role model for her children and do what is demanded of her. She holds herself to a high standard of mothering despite the challenges contributing to her depression. Yet, she sees it as her responsibility to overcome her depression, which we believe emerges, at least in part, from her day-to-day struggles with unequal societal structures.
Juggling Responsibilities
Many mothers acknowledged that they had to juggle responsibilities and handle numerous tasks simultaneously simply to take care of their families. Tammy described, “My kids say, ‘Mom, you work too much.’ And I said, ‘Well I have to…I’m a single mom.’” She explained that she tries to manage multiple responsibilities of single parenthood, by caring for her children, and working at various jobs. Jezel, a single 27-year-old African American mother of three, responded similarly, “Motherhood is hard. It’s hard on us especially when you don’t have too much help and sometimes there can be an absent father.” Like other mothers in this study, she had little family help and an absent father.
The mothers described at length the multiple tasks they engaged in daily in the work of mothering. Tammy provided further explanation: I get up and do my routine…get the kids ready for school, send them off…make sure the baby all right…once it’s time for the kids to come home, now I have to cook and clean and do other stuff…after that…I get them all settled, homework.…And…by the time.…[I] slow down it’s like seven o’clock, eight o’clock, time to go to bed…get ready for bath, bed, dinner…see them off to bed, make sure they eat, and then…my day is ended.
These multiple tasks necessitate constant juggling of time, energy, and priorities, which require both mental and physical adaptability. Yet mothers like Tammy are judged for having several children rather than credited for their hard work (Ladd-Taylor & Urmansky, 1998; O’Reilly, 2004).
Being Self-Sustaining
To address responsibilities and promote good mothering, several mothers described the importance of being self-sustaining, or remaining productive despite living with depression. For Latoya, being self-sustaining meant being independent. She reports, “I just carry on as a parent every day.…I’m really strong for them (her children), I have to be you know.…I gotta carry the burden by myself.” Tabitha, a 34-year-old African American mother of five, echoes this point by saying Nine times out of ten…the father’s not there or around. She has to be a mom, and then she has to be that father figure. I see a lot of African American, Latina women, they hold that role, and really carry it well.
She underscores the concern many mothers recognized that there would be times when they needed help, including using community resources and relying on family members. Roberta, a 32-year-old African American mother of four, described interacting with formal providers to receive information on community resources: If I’m walking around I look around, I look on doors. If I see something going on in the community and if it’s free.…I’m in it.…You…have to look for yourself; you can’t rely on everybody to help you out. You have to be your own resource.
Mothers like Roberta realized there can be many varied community resources to support the work of caring for their families even though it is tiring to constantly seek community resources for oneself and one’s children in addition to the caregiving work of mothering.
Outside of knowledge of community resources, mothers emphasized how close friends and family members helped them to be self-sustaining. Raquel, a 27-year-old African American mother of two children, said, “Just so you know, it’s everybody. I think all women at one point need help. Even if it’s a strong mother that has it all planned out.” Raquel shared the importance and benefit of receiving help from family and friends and how all women, benefit by receiving help. Other mothers identified specific individuals that they would seek out for help. Yvonne, a 20-year-old African American mother of one child, described, “If I feel like I need more advice in anything, I’ll call my mom, and she’ll talk to me about everything that I need to know.” Marta, a 27-year-old Puerto Rican mother of two, shared, “Anytime I’m depressed or anything, or I’m overwhelmed, I can talk to [my aunt] about my problems.”
Where possible, these women did access social supports, but self-sustaining practices also included deciding who is and is not a positive source of support. As Shameeka, a 24-year-old African American mother of one child, explained, "I can’t…be friends with somebody that doesn’t wanna do anything. They’re slowing me down. Only thing I need to do is work, and that’s it…I’m trying to get on my feet for my daughter."
She goes on by saying: I gotta move on…this is why…I don’t have any friends. They slow me down…I don’t got time for nobody. I’m trying to work, I’m taking care of her [daughter]. She’s in daycare most of the day…gets picked up at 6:30 in the morning…gone till five.
To care for themselves and their children, some mothers explained they must focus solely on their roles of mothering and working and leave behind relationships or activities that distracted them. These mothers faced the challenge and sacrifice of accepting the fact they no longer had the freedom to pursue social relationships and leisure activities and build a social support system.
Being self-sustaining also included being future oriented and taking steps to achieve one’s education and employment goals. Shameeka, who was focused on pursuing employment, said, “I want a job. I’m not getting anywhere.…My goal is to get a job that’s going to take care of me and my daughter.” Roberta, who has focused on pursuing her education, shared, “On the inside I still wanna cry because I am not where I wanna be at right now. Once I get that GED no one can tell me nothing.”
These mothers explained that being future oriented and focused on their goals will help them to be better mothers and can counteract their depression through their positive action. Although these mothers are clearly focused on their futures, education and work programs rarely provide childcare, which is another obstacle for mothers to overcome to achieve their goals (Freeman, 2016).
Taking Care of Self
Despite the many challenges these mothers faced, they recognized the negative impact of self-neglect. They discussed the importance of taking care of themselves by using strategies and techniques to promote health and well-being. Some mothers such as Raquel provided a clear idea of how mothers do not take care of themselves: As a mom, sometimes you neglect yourself. And you don’t give yourself time, because you’re trying to give to your children and your husband and the household.…You forget about yourself a lot. You put yourself on the back burner all the time.
Fatima, a 25-year-old African American mother of two children, reported, “I feel like a good mom doesn’t just neglect herself just to take care of her children. I feel like she takes care of herself mentally, physically, spiritually, and her children.” Several of these mothers reported engaging in physical, mental, and spiritual self-care as a way to both promote being a good mother and cope with PPD. Tanisha, a 26-year-old African American mother of four children, said, I love music, I love dancing.…I will dance. I’ll try to do any dance move if you let me…and I will try to get out every once in a while, go to the beach, take a walk down the pier with me and my other half.
Although Muzik et al. (2015) found mothers who engage in self-care have better mental health outcomes compared to other mothers, some mothers found self-care challenging. Rochelle stated, “I even tried to do yoga and Pilates yesterday to relax my mind and my body and stuff.” She needed “a room in the house to lock out all the noise and stuff and actual relax and…be able to think.” D’Alonzo (2012) reports that although the mothers she studied were aware of self-help strategies, they are still challenged by childcare responsibilities.
Many mothers described turning to spiritual resources when experiencing compounding challenges. Rochelle, recognizing she was “going through so much,” described: “All I do is pray, and I believe in God.…I’ll just be like, ‘Oh, God,’…I’ll talk to him out loud. You know, just to not feel so sad and stressed all the time.” Praying took away some of this mother’s sadness and stress when she was overwhelmed. Yolanda explained that not only talking, but listening to God helps: “He lets you know that…you gotta stop stressing, because you’re not alone.”
Finally, Dena, a 28-year-old mother of two from El Salvador, said of both praying and attending church that, “It helps. It makes me feel calm, and accept things, not worry so much. Helps me realize I need to let it out, let it go, and things will get better.” These mothers recognized the need to take care of themselves by turning to spiritual resources to relieve stress and find the strength to go on, which some researchers have found can relieve depression and provide much-needed social support (Keefe, Brownstein-Evans, & Polmanteer, 2016b).
Discussion and Conclusion
The purpose of this study was to provide qualitative data on how low-income mothers of color with histories of PPD conceptualize what it means to be good mothers in hopes of providing a more contextualized view on PPD that has to date been understudied. This study, however, is not without limitations. It should be understood that the authors are white, non-Hispanic, middle-class, and professors, one of whom is male. These standpoints undoubtedly affected the questions asked of the interviewees, the kinds of experiences the mothers were willing to share and the analysis of the qualitative data, thereby limiting the generalizability of the findings to research and practice settings. With these points in mind, the mothers’ discussions might have been quite different if the interviewers were African American or Latina women.
Another limitation is the level of knowledge the researchers had about the role of mothers and the strain of mothering in communities of color. To address this issue, we consulted with African American and Latino social workers in various settings and within various professional organizations of which we are members including area agencies that belong to perinatal networks. These consultations provided much-needed information on how to approach the research including some of the pertinent issues mothers of color face in our greater metropolitan area. Additionally, as researchers we differed regarding our experiences conducting qualitative research. Although two of the three authors had more than 10 years of social work practice experience working with mothers of color, only the second author had extensive training in qualitative methodology. This issue was mitigated in part by the ongoing communication among the authors, frequent consultation with researchers who study minority health, and ongoing training in qualitative methods provided by professional organizations at various conferences. Finally, because we used a qualitative methodology, the study’s results are not generalizable.
The mothers in this study show us that they strive to be good mothers despite the possibility that many will not earn sufficient incomes, live in neighborhoods with ample resources, or have social networks that enhance their self-assessments as good mothers. Their ongoing efforts are thwarted by limitations of time, employment, and living in unsafe areas. Their efforts reflect the struggles in carrying out mothering roles under adverse conditions. They demonstrate their wish to succeed through their continuing efforts to be self-sustaining, manage multiple tasks, and engage in self-care.
Skilled and compassionate social workers must call attention to the mothers’ demonstrated strengths and learn about the challenges faced in mothering. The attempts to be good mothers must be acknowledged and serve as the foundation for the client–worker relationship. Social workers must also consider how their privileged status as professionals affects their work with new mothers. Likewise, social workers must be attuned to the interlocking layers of oppression, as mothers talk about their experiences interfacing with various bureaucratic organizations including social service agencies. Helping mothers to recognize their strengths can help empower mothers to identify opportunities for choice and individual agency and support their ongoing efforts to be good mothers. Social workers must then advocate for access to sufficient resources for marginalized mothers to carry out their caregiving roles.
By applying a feminist lens to the problem of PPD among low-income mothers of color, social workers can help facilitate mothers’ self-evaluation of “good mothers” and challenge medical and mental health perspectives on PPD, which have focused heavily on diagnosis and symptom management and help remove barriers to the mothers’ efforts at autonomy as the mothers carry out their responsibilities for themselves and their children.
Footnotes
Authors’ Note
Rebecca S. Rouland Polmanteer is now assistant professor, Department of Social Work, Keuka Collage, Keuka Park, NY 14478.
An earlier version of this article was presented at the 145th annual meeting of the American Public Health Association, Atlanta, GA.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this project was made available by a grant from the Fahs-Beck Fund for Research and Experimentation, Grant Number 1111698-1-65217.