The joys and stresses of having a child: What Asian families need to know

By Dr. Cindy H. Liu, psychologist, Beth Israel Deaconess Medical Center, Harvard Medical School

 

For most, having a baby is one of life’s greatest joys. Friends and family members often celebrate with the parents on the birth of their child.

Hand in hand with that excitement, of course, is adjusting to a new member of the household, which may include difficulties with feeding, sleepless nights and juggling a new schedule.

However, some parents experience challenges beyond these concerns, and show signs of depression, anxiety or even psychosis. This distress can occur among both mothers and fathers, although the majority of the research on these experiences concerns mothers. These problems arise due to a combination of psychosocial stress and hormonal changes.

Postpartum disorders — psychiatric conditions that take place during the postpartum period (the first 12 months following the birth of a baby) and that last longer than two weeks — can go undetected by friends, family members and treatment providers. Because having a child is considered a joyous occasion, people do not understand how parents might feel such extreme distress. Furthermore, there is shame and embarrassment associated with having a mental health problem. The stigma of having a postpartum mental disorder may be reasons why many of those who are afflicted do not seek help or support. This is unfortunate, given that these parents’ experiences have adverse effects on their children’s development, which are detectable even in infancy.

My research on Asian American women from New York City and Massachusetts reveals some startling results. Compared to Caucasian, Latino and African American women, Asian American women who recently gave birth are at least three times more likely to receive a diagnosis of postpartum depression, and are more than two times more likely to lose interest in things they normally enjoyed — a clear symptom of major depression. Even more, Asian Americans who give birth to a baby girl, regardless of whether they were born in the United States or not, are slightly more likely to be depressed compared to those who give birth to a boy.

Among mothers from New York City, 39.8 percent are Asian American women, and are less likely to have a conversation with their treatment provider about their mood during pregnancy, although those that do are nine times more likely to get a diagnosis of postpartum depression. Possible barriers to Asian American women speaking with their providers include not being able to communicate in English with their doctor or the doctors’ expectation that Asians do not have mood problems. However, having a conversation with a provider may be worth it. When this conversation occurs, more women are screened positively and treated for postpartum depression.

There are major initiatives in various U.S. states to screen for depression, but community efforts are needed to identify both mothers and fathers who are struggling with these psychiatric conditions. Given the potential for problematic outcomes for the family, it is not something that parents can easily “shake off.” Mothers and fathers must recognize these symptoms as a medical condition and should explicitly share their experience of distress with their treatment provider. If you are a parent of a newborn, remember to do this not just for yourself, but also for your child and your family.

 

Dr. Cindy Liu is a clinical and developmental psychologist at Beth Israel Deaconess Medical Center and the director of multicultural research at the Commonwealth Research Center. Her work focuses on culture and stress on children and families. She may be reached at cliu@bidmc.harvard.edu.

 

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