Raising a child is equal parts rewarding and difficult. Actress, singer, and television personality Keke Palmer honored the hardships of new motherhood in an Instagram video earlier this month. “If you are a single parent, pull out your cape. As a matter of fact, unclip your angel wings because I don’t know how else you did it.” 

Palmer welcomed her first child with boyfriend Darius Jackson to the world last month. At some point in the supportive video, Palmer aptly honored a truth that unveils an unsettling reality. “But when it comes to raising a kid, I’ve already learned in these short few days that it takes a village and sometimes that’s a privilege.” It only took a few days for Palmer to learn that the transition to motherhood can be a tumultuous experience. Equally as glaring is the understanding that a number of new mothers are deprived of the tools necessary to adequately manage this experience. Among them are low-income mothers, who must manage the conditions of their economic status in addition to the conditions of the postpartum period.

Lack of social support is a known risk factor for postpartum depression. It is important to note that social support does not start and end with a partner. In one study on the association between social support and postpartum depression, mothers who had no social support from a partner or others, had social support from a partner only, or had social support from others only, were 7.22 times more likely to experience symptoms of postpartum depression than those who had support from all spheres. While this is likely to impact mothers of all backgrounds, low-income postpartum mothers are uniquely vulnerable. Belonging to low income communities, the members of their social networks may be struggling to manage their own family and work responsibilities, which limits their ability to show up. 

Additionally, social support is described as a three-dimensional construct that covers emotional support, instrumental support (money, time, and tangible acts of service), and informational support. Like the dimensions of social support mentioned above, these three dimensions all work in conjunction to shape the postpartum experience for new mothers. 

A number of structural factors prevent low-income mothers from accessing these modes of care. The United States does not have a national standard for paid parental leave. This disproportionately affects low-income birthing people, who must focus on making enough money to support their families, rather than managing the changes that came with the birth of their children. Unfortunately, while they are out working to provide for themselves and their newborn baby, they are also missing out on the emotional and informational support that could reduce the feelings of loneliness often associated with the postpartum period. Furthermore, the structure of low-income communities ultimately limits the extent of instrumental support for low-income mothers. With other responsibilities to manage, it is difficult for others to offer material support.

Like the foundation that creates these conditions, the consequences of this phenomenon are far-reaching. Postpartum depression has been shown to significantly stress infants. With this stress comes less secure maternal–child attachment, increased fussiness, and lower intellectual and motor development scores, poorer academic performance, and impaired development trajectories. What’s worse, infants with mothers experiencing higher depressive symptoms are more likely to experience minor health problems, gain significantly less weight, and have more nighttime awakenings at 9 months of age.

Luckily, there exist a number of frameworks that model adequate support and care for postpartum mothers. In many East Asian countries, traditional confinement practices allow newly postpartum mothers to recover from pregnancy and childbirth. For thirty days, the birthing person avoids physical work while living with their family to focus on the recovery of their physical and emotional strength. In Taiwan, newly postpartum birthing people have the option to remain in hotel-like maternity care centers. In Western and Northern European countries, healthcare professionals conduct home visits soon after childbirth. 

Much like these nations, the United States must set up a structure for maternal care that is customary before anything else. While the care of newly postpartum low-income people will be highly individualized, a key solution is the development of a system of support that is accessible to all mothers. In the meantime, heightening our awareness of the ways current structures of support fall short will ensure that our most vulnerable birth givers do not fall through the cracks.