Shades of Blue Project Making Shift Happen for Black Maternal Mental Health

Black Maternal Mental Health Week, created by Shades of Blue Project founder Kay Matthews, is celebrated annually from July 19-25. Every year the Shades of Blue Project hosts their Black Maternal Mental Health Summit in Houston, TX during Black Maternal Mental Health Week. The theme of this year’s Black Maternal Mental Health is the Art of Motherhood Parenting Beyond Societal Norms. I was fortunate to attend this year’s summit, which offered engaging sessions on topics such addressing grief due to perinatal loss, Black fatherhood, community-based solutions to support Black maternal health and doula support.

Forty percent of Black women experience maternal mental health symptoms, but they are less likely to receive treatment. Structural racism plays a large part in diagnosing and treatment of Black birthing people. In 2021, 10 Black women stakeholders, including Kay Matthews, came up with five key pathways to equitable and antiracist maternal health care. The pathways include, education and training practitioners, investing in the Black women mental health workforce, investing in Black women led-community-based organizations, valuing, honoring, and investing in community and traditional healing practices, and promoting integrated care and shared decision making.

Medicaid not only pays for over 40 percent of births in the United States, but it also is the largest payor for behavioral health treatment. Forty-six states and Washington D.C. have taken up the 12-month postpartum extension option, but what has implementation been like?

Medicaid is critical in the discussion for improving mental health among mothers and babies in 12-month postpartum period. A CCF report on State Medicaid Opportunities to Support Mental Health of Mothers and Babies During the 12-Month Postpartum Period recommends concrete steps state Medicaid agencies can take to address mental health among mothers and infants in the postpartum year. Recommendations were vetted, revised, and prioritized during an October 2023 meeting between Medicaid policy and maternal and child health practice experts hosted by Georgetown University Center for Children and Families (CCF). State recommendations, accompanied by detailed action steps, include:

  • Enhance Primary Care to Serve More Effectively as a Care Hub for Families
  • Monitor and Reward Successful Connections to Timely Care
  • Finance and Remove Barriers to Appropriate Services
  • Support Expanded Workforce Capacity
  • Prioritize Maternal Mental Health and Infant-Early Childhood Mental Health in Medicaid

From this meeting, Kay Matthews was one of the attendees and said this powerful statement:

“The current workforce needs to be flipped (top-down to bottom-up) because doulas and community health workers are the ones that will communicate and connect with the folks that need services.”

Some risk factors that place Black women at a higher risk for perinatal depression and other mood disorders include:

  • Lack of social support
  • Perceived stress
  • Low socioeconomic status
  • Poor access to healthcare
  • Prior history of depression
  • History of sexual/physical violence
  • Poor access to education

The mental health of the mother is interconnected with the mental health of the infant. The maternal-infant dyad is important and can even impact child development.

It is imperative that state Medicaid agencies and advocates do more for the implementation of the 12-month postpartum period. Mothers need to know that they have access to mental health services. Screening is not enough. Mothers need to be able to trust behavioral health providers in order to share their mental health struggles and provide the necessary information to inform treatment plans. The Shades of Blue Project’s I.N.S.P.I.R.E. Method is a training program designed to meet the needs of women of color. We need more information like this that is culturally relevant and accessible to Black mothers focused on maternal mental health.

To learn more about the Shades of Blue Project, please visit their website.

​​Editor’s note: To maintain accuracy, Georgetown CCF uses the term “women” when referencing statute, regulations, research, or other data sources that use the term “women” to define or count people who are pregnant or give birth. Where possible, we use more inclusive terms in recognition that not all individuals who become pregnant and give birth identify as women.

Tanesha Mondestin is a Research Associate at the Georgetown University McCourt School of Public Policy’s Center for Children and Families.

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