Perinatal mental health concerns affect as many as 20% of US women. Among Asian-American moms, ingrained cultural values can be an impediment to both diagnosis and treatment.
In this episode of the Mind Dive podcast, Nausheen Noor, PhD, and Rose Yang, PsyD, of The Menninger Clinic join cohosts Robert Boland, MD, and Kerry Horrell, PhD, to discuss the mental health needs of perinatal women in the Asian American Pacific Islander (AAPI) community.
Dr. Noor became passionate about women’s mental health as a community provider in Karachi, Pakistan working with women struggling with domestic violence, depression and traumatic stress. She is an advocate for mental health and wellness in the AAPI community, working to address lingering stigmas.
Dr. Yang, faculty leader for Diversity, Equity and Inclusion at The Menninger Clinic, became invested in AAPI mental health in her early career, but her own subsequent experiences as a mom led her to explore maternal mental health challenges and attendant cultural issues in the Asian-American community. She is a certified perinatal mental health provider.
Drs. Noor and Yang emphasize that it is critical to recognize that the AAPI community is not a monolith and is comprised of people from diverse backgrounds and cultures. Dr. Yang notes that the “model minority” stereotype — a 1960’s era term coined in a news article about Japanese American success — has been problematic, as it minimizes the struggles of many AAPI subgroups, both ethnic and experiential (e.g., refugees). The COVID pandemic was a considerable stressor in the AAPI community, as it both catalyzed anti-Asian hate crimes and contributed to “lumping” all Asians together without regard for the rich breadth of their heritages.
Drs. Noor and Yang define perinatal health — perinatal covers the period before, during and after pregnancy — and elaborate on the factors that can lead to mental health challenges.  While pregnancy can exacerbate pre-existing psychological vulnerabilities, other factors are contributors as well, including hormonal and psychosocial changes and disrupted sleep. Dr. Noor notes that fertility challenges and treatment can also contribute to feelings of stress and depression.
Among Asian-American women, cultural and familial norms and differing levels of acculturation can discourage these moms from acknowledging and/or speaking about the feelings they are experiencing and from seeking help.
The solution? Drs. Noor and Yang emphasize the critical importance of timely, frequent and culturally sensitive screening by a variety of health practitioners — at obstetrician/gynecologist and pediatrician visits, and also by lactation counselors, midwives and doulas. Because this is a time that their focus is on care for the baby, women may be missing out on themselves; multiple check-in points may help to identify mental health concerns early on.
They note that the American College of Obstetrics and Gynecology website offers screening resources for practitioners. Dr. Noor suggests that these screeners might be translated in a variety of languages and even administered by speakers of those languages. “What an investment that would be in women’s mental health and perinatal health, and when you’re improving that it impacts the whole family.”