Dr. Connie Omari
Hello, hello, hello and welcome to the black marriage agreement therapy matters podcast where we are breaking toxic relationship patterns and cycles in the black community. Today’s guest is Sultana Karim. Hi Sultana! Is so nice to have you here. Can we introduce you to our guests today? Of course, awesome. Sultana is the owner and psychotherapist at Corinne counseling services PLLC. She is a Licensed Clinical Professional clap counselor in the state of Maryland and a licensed professional counselor in the Commonwealth of Virginia. And she specializes in pregnancy postpartum, and the entire lifecycle of the pregnancy journey. So, it’s such an honor to have her here today. Thank you. Glad to be here. Well, let’s just jump right to it. Because right before we hit record, you know, I always like to kind of go over what we are talking about. And of course, I generically said postpartum depression, and even that is rarely talked about. But then you just educated me on the fact that there’s so many other parts of the pregnancy cycle that are very, very important. So, can you kind of explain like, what all the areas you cover are and then we’ll talk a little bit more about what you find?
Sultana Karim
first, so I cover perinatal mood and anxiety disorders. So perinatal refers the term of conception, to or after birth. And what’s people don’t look like talk a lot about is that a person can experience living anxiety during pregnancy, and postpartum. And there are different nuances that can come up for people. So, some of the people that I work with tend to be birthing parents and moms, who was either going through infertility they’re trying to conceive, they’ve had pregnancy loss. They had stillbirths or an infant loss, birth trauma or medical trauma or combination of both during the birthing experience, and then postpartum, they may have complications or just adjusting to parenthood can be difficult. No matter if there’s their first child, second, third, however many it’s still difficult time.
Dr. Connie Omari
Yeah, yeah. Oh, my goodness. Okay. So, you say that you start at the beginning of pregnancy that sounds like for people who are facing infertility, maybe even a little bit before? Can we start with that? Because, um, I think that, you know, the black community, its especially we women are so stereotyped for being these birth making machines. You know, you always hear about the black mom with multiple children and No, Father or whatever. But the point is, it’s we don’t we’re not really known for infertility. What does that look like? In your practice? What do you see with black women infertility?
Sultana Karim
A lot of it is like the emotional distress of like, wanting to be a parent.
Dr. Connie Omari
Of course, it’s a common do you get a lot of black women.
Sultana Karim
struggle with infertility? Um, not as many as where I see most of them during postpartum.
Dr. Connie Omari
Okay. Oh,
Sultana Karim
there’s a few that I do see that are experiencing infertility, and they just want to talk through the struggles because it’s impacting their self-worth. It’s also impacting their relationship with their partner, getting infertility treatments itself is a financial burden. And that it’s a lot a lot of money, especially because most insurance don’t necessarily cover for that. No. So that’s another item layer two is kind of like talking about that, then the treatments themselves is so strenuous. Lots of doctor’s appointments, and you have to kind of like plan out and be almost on edge, especially it like waiting for hopefully your period doesn’t come and if it comes then there’s another disappointment and reciting the cycle over and over again. Yeah, that’s
Dr. Connie Omari
that’s tough in vaguely familiar. Seems like ancient history, but I struggled with infertility and that was not a fun season. It really wasn’t. And yeah, but you so seem like you work with more people in postpartum. And I can also imagine that’s complicated because, first of all, it’s not socially acceptable to say, being a mother is hard. But I think yes, for our community, I mean, we have a history of being like was on a wet nurse where we’re nursing, even the slave masters, baby and nurturing and taking every that’s kind of what we’ve done. And so, to have emotional issues with that, please fill us in what is bliss give these black women an opportunity to say this, this is difficult. It’s hard.
Sultana Karim
So often with within the postpartum period, the word like postpartum depression, postpartum anxiety, all those words are not necessarily used to describe what I’ve seen and heard from my clients is like, I’m experienced postpartum, so we have to dissect what that means for them. Because what they’re really saying is I’m experiencing depression, anxiety, PTSD, etc. tends to be safer, like postpartum. First, because suppose the term postponed, it was technically a time after birth. And that time for most, for some research says one year postpartum, but others expanded out into tolerance, so like four years postpartum, because it essentially is the adjustment phase of not only being a new parent, but your physiological aspect in your body is also changed. Especially after birth, your hormones coupled several different hormones drop dramatically after birth. So that’s a small period, what’s often called like the baby blues, where your experienced tearfulness, you may be anxious, maybe on edge, but with support, you’re able to kind of overcome that. But like postpartum depression, and anxiety is on a two to three weeks, where we’re looking at some people who experience anxiety about like, leaving their baby or reinsuring, like their baby’s breathing, or constantly checking their baby to make sure they’re breathing, or they’re anxious about bed sharing with their baby, or something happening to their baby. There’s this time as intrusive thoughts kind of escalates, higher than normal, normal time periods in their lives. So, evaluating all those different nuances for them, and then normalizing like, yes, your experience is normal, in terms of like the normal transmission, your body’s response. And if it continues to resist, that’s what we need to work.
Dr. Connie Omari
on. So how, what does that look like? How, first of all? Well, I’m imagining Now, you might have a little bit more DD, telehealth, and then you’re in the States. Okay, so do you do most of this via telehealth? Yes. Okay. Because I was like, how does it even start with a new mom coming into therapy with a with a newborn?
Sultana Karim
So pre COVID? I was in person, okay.
Dr. Connie Omari
They come in, like nursing their babies and stuff. Yeah, yeah. So you can bring your babies, okay.
Sultana Karim
It’s up to them of what they feel comfortable. Some of my clients, they will bring their babies out or some babies take care of the baby, or just like, I tell them, do what feels comfortable for you. I’m not going to sit here and say, oh, you shouldn’t do this. If you want to bring your baby, that’s fine. And that gives me some information about like, how is attachment and bonding going between the baby and helping, like if she has negative thoughts about like her as a mother, like, I’m a bad mother, because I don’t tend to my baby because like he was crying all the time. I can pinpoint our session we like when your baby cried. You picked. You pick your baby up. You bet your baby; you fed the baby. So that gives me information that like normally I wouldn’t know if they didn’t. The baby. Yeah, yeah. Um,
Dr. Connie Omari
what is it like though, like, motherhood? is the most awesome, most amazing thing ever having two children myself. I mean, but it’s hard. It’s hard work. Oh, yes. What is that like? Hearing these women that look like us being hard on themselves knowing that they’re that they’re doing the most difficult job that there is in
Sultana Karim
the world? Well, for me, I helped validate like, yes, you are doing a great job like, and also destigmatize the perfect parents or the imperfect there. Yes, to the good enough because you are doing enough with what you’re what you’re doing at this variable. Hold it because a lot of times my clients do blame themselves like, oh, I should have, or I could have done this differently. But we go back to like, at that moment you have whatever tools you have at the moment, you’ve just made the best decision for you and, and your baby and your family. Yes. Now it’s how do we do better? Next time around? Yeah.
Dr. Connie Omari
That I’m going to transition. What do you see the most in the black community with respect to postpartum?
Sultana Karim
What do you mean? I don’t know. I
Dr. Connie Omari
mean, you’re the expert. So, like, is there a common thing that you, see? Like, just more common than anything? Are there certain 12? Okay, I’m going to pinpoint stereotypes. So, check me, okay. You know, we know that black women are not getting married at the highest rates of other communities, I would just assume, again, this is not my specialty. But that might be an area of difficulty as well maybe having to do it solo, or at least having a supportive partner or even if you do outside of the realms of marriage, does that show up often? And if not, what do you see..
Sultana Karim
more of? I see a lot of the families that I work with struggle with, like support. Okay, maybe it’s just them and their partner, okay. They don’t have like family support, or they have family support. And they’re not really as supportive as they would like them to be or don’t understand what they’re going through. They will say things like, Oh, well, it’s fine. It’s normal if you have a healthy baby. But I’m struggling. I told you, I was shocked. Like, yeah, yeah. If I could do this, do this. Yes.
Dr. Connie Omari
So, I don’t want to pinpoint something. So, so you are seeing a lot of black women with their partners.
Sultana Karim
Most I’m mostly seeing that just the, the birthing person,
Dr. Connie Omari
but they have a partner to have a partner to evolve. Because I know a lot of times the research can be conflicting, you know. Now, when we’re saying partners, are we saying they’re married or in a committed long-term relationship or CO parity?
Sultana Karim
All of the above? Yeah, because sometimes their partner, they’re not married to their partner, but they’ve been with their partner for so many, so many years, or their, their, that’s their boyfriend or girlfriend, and they’re supporting them through their journey. I’m like, okay, well work with that, and still educate both you and your partner. So that you both
Dr. Connie Omari
is the partner, if they are partnered. Do they have an active role in the treatment?
Sultana Karim
Yeah, it depends on what the client wants. Sometimes they just want that time to be for them. And if I feel like there’s some information that they need to share with their partner, I’ll give them handouts or like, Hey, give this to your partner, and have a discussion about what we talked about, so that you both are on the same page, because oftentimes, some of the moms tell me about like, oh, well, I’m experiencing postpartum rage, because he or they don’t do what I tell them to do, or how they should be doing it. Little things just set them off about what their partner does. We have a conversation about, well, let’s have a postpartum rage. And how can we regulate ourselves so that we can be the best parents for our children and our family? Hmm,
Dr. Connie Omari
nice. Nice. You mentioned a couple of things that I don’t think I’ve known much about all stillbirths. Just what is it like working with a family who’s gone through something like that?
Sultana Karim
It’s difficult just to kind of have like, for me to be present with them and hold that space for them. I just feel like so sad for their experience. And the fact that they reached out for help. I’m like, yeah. But it is, it’s a lot of education about grieving. Because the idea of like, some people have the idea of like, oh, well, you’re just supposed to get over.
Dr. Connie Omari
it. That’s what I was going to say, Oh, what about miscarriage and chemical pregnancies and stuff? Like? How they I mean, what do you say? What do you say to someone? Let me just be honest, because, you know, if someone had an 18-year-old child that died, you know, I think that that will be so like, the responses to that grieving parent will be so different than someone who was pregnant, you know, and had a stillborn or heaven forbid, didn’t even have I had a chemical pregnancy. I believe it was just there for a second and it was gone. And it’s just like, okay, you Like, What? What? How do we comfort? Those people that are going through that? And what can we say to, you know, a grieving mother who’s in pain?
Sultana Karim
For a lot of times I talked, I asked them, what do they want to talk about in terms of their loss? And what is that impact? So, some people, it’s the loss of what could have been, or loss of being a parent, if it’s so early in their pregnancy, or even later on when they have a stillbirth, like, what my life could have been, what the life of their baby could have been. So, we talk and process that. And then we talked about how do we honor their loss, and honor their feelings that are coming up? Because oftentimes, it’s like, oh, I have to bury it down deep. Because other people and Rao me don’t understand. It’s like, no, don’t bury a deep because it’s going to, it’s going to come up, and then it’s going to come back to hold. It’s how do we knowledge, what feelings are coming up for you? And how do we process that out and in a healthy way and honoring your loss. So, for some people, they’ve done like little books about their baby, they’ve had like little ultrasounds and a story about their experience, their pregnancy, if they had a stillbirth there, if the baby had a specific outfit on, or they had office that was for their baby, they’ll create like little dongles, little stuffed little animal dolls and stuff like that, to honor their laws. And that’s it. And we just continue to process until they’re at a point where they’re okay, and they can manage the intense feelings that are coming up for them, and also build their support system, and helping that that support system understand that this is loss, regardless of any stereotypes and anything they’re taught, like anything that comes up for them, or even the Un comfortability of it. It’s how do we just sit there and listen to what the person needs? an empathetic way? Yes, it’s also that they need us need support for you to listen, they don’t need psi comments are like, some people will have said like, their family members are oh, well, you have you’ll get pregnant again. It’s okay. Just minimize that person’s feelings.
Dr. Connie Omari
Yeah, as a therapist, I’ve learned that sometimes the most important thing is just said nothing. Just, you know, I remember, my speaking of a good friend of mine lost her daughter, who was 21. And, I mean, I wasn’t even going to try to me, mostly pretend like I had any earthly idea of what that could feel like. And I knock on wood I never do. So, I think I said something like, I’m sorry, because that was truthful. I’m sorry that you’ve, I am so sorry. And I wish you weren’t going through this.
Sultana Karim
I mean, you know what I mean? Like, the best you could do is like, say, like, I know, this is hard. How can I support you? And
Dr. Connie Omari
I think that’s what I said. Yeah, that sounds better. But it was it. Yeah. Yeah. So, for those of you who are listening, and you’re going through this, it’s so what can we say?
To check people kind of like, do you? Like what Okay, so somebody says, okay, well, you’ll have a baby soon, you know, don’t worry about it. What’s a good response to that?
Sultana Karim
Depends on someone’s because some people can shoot like, I’ve had clients just choose not to have a relationship with that person who said those things for that period of time until they’re ready to address it. Or if they’re ready to address it’d be like, what you said was rude. And you minimize my feelings. I am struggling right now. And I rather you support me than to say anything. If you can’t support me, please don’t be in my space.
Dr. Connie Omari
need that? Okay, gosh, I wonder as to Hey, see when it’s cool to just get so good. It’s like, I get distracted, and I forget. Um, oh, this is what it was. I’m just curious what got what got you into doing this, this type of specialty?
Sultana Karim
Oh, so I’ve been working with pregnancy, pregnant and postpartum people throughout my career in different ways. So, like, I’ve worked with them in domestic violence situations. Yeah, but like within the past five years, I’ve kind of shift from doing domestic violence sexual assault stuff to perinatal, because my own experience. And pregnancy is like in pregnancy, I struggled with a bit of depression and anxiety. And then it currents aside, it was like really initially, like the first trimester was really hard. As we all know, like there’s nausea. A lot. I was just struggling. It wasn’t so second trimester when I was feeling a lot better. Everything kind of like felt clearer for me. But then I had a traumatic birth, where I was afraid that I was going to die, say hemorrhage. And then afraid of my daughter, she was going to die because she experienced respiratory issues and had to be in the NICU. Wow. Yes. And so postpartum, I struggled with postpartum, PTSD, depression and anxiety.
Dr. Connie Omari
Hmm. Wow. And How old’s your daughter now?
Sultana Karim
Just 4. And a couple of months.
Dr. Connie Omari
My daughter would say I’m four and three quarters.
Unknown Speaker
I’m five now.
Dr. Connie Omari
So amazing. Wow. You know, you, you’re just saying that brought back. It’s amazing how you can when my daughter, I don’t know, gosh, I can’t remember how old she was. She was still in in me. But she had something on her heart. And I just remember in gosh, it was only I think the next week, I had to come back and it was gone. But that week was like the most oh my god,
like, heavy. Oh my gosh, like,
it’s amazing, because I forgot all about it. Because clearly, she didn’t have it, you know, never heard of it again, never came up again. But that so I can’t imagine, you know, going through what you’re talking about and that’s just something I guess we take for granted. You have, I guess pregnancy privilege, in terms of not having to
go through that. But also, I want to ask you this.
I believe that black women are desensitized to pain. So, when we do experience discomfort and depression, and whether we’re pregnant after pregnancy, trying to get pregnant. Do we Do you think that we can accurately identify like I know we’re not saying well, this is a pyramid? Oh, you know, postpartum depression? I know we’re not using that terminology. But are we recognizing that it’s an issue? Because sometimes we just have so used to being unhappy and uncomfortable that we just accept it?
Sultana Karim
Yeah, I think so. Given that, while we have the stereotype of being the strong black woman, and at the same time, being a human being who is struggling with just the physical of the whole Chase, I feel like when we were pregnant and postpartum, we changed dramatically, from physiologically to physically. So emotionally. It’s how do we know when? When do we need help? When is it too much? When is your thoughts going? Spiraling and you losing time it’s impacting work is impacting your relationship with others? Those are the times where we need to come back and like, is this because I have to be strong? Or is this where I can get help? And also, there’s a still stereotype about seeking mental health treatment and within the black community is how do we it’s not necessarily like that mental health is bad. It’s how do we work towards our own wellness? And that’s the approach I tend to kind of go with my clients like when we talk about wellness is not just one thing, like mental health is a piece of your overall wellness and it impacts all of us. We don’t have it and if we don’t get the help and support that we need.
Dr. Connie Omari
Absolutely, absolutely. Um Are there is there any myths? Are there any myths about pregnancy perinatal loss, you can see stuff that you’d like to debunk.
Sultana Karim
We feel pain if you are, so we feel pain, okay, because There is a myth within the healthcare profession that brown and black people do not feel pain, right? Yes, no, we feel pain. Oh yeah, I’ve seen you to advocate for yourself. And if you need additional support, whether it be your partner or family member, whoever supporting it in the room, in, either they’re coming to your prenatal or they’re with your childbirth, advocate for yourself, have them to also advocate on your behalf. Even maybe want to hire a doula or be there to support you left as they will stay with you. And whatever your wishes are, they will be there with you to support you and help you advocate for yourself. And that’s essentially advocate on your behalf depending on the circumstances and some hospitals have some rules and all that, but they will work with you. And
Dr. Connie Omari
love it. Love it. Love it. Do you work with a doula just curiously like in terms of your clients? Do you have like, yeah, yeah, I’m a big fan. Can you just explain what a doula is because a lot of people don’t know that this service exists.
Sultana Karim
So, there’s different types of doulas. So, I’m goanna call this talk about the whole spectrum. doula in pregnancy can help you kind of advocate for yourself and with your medical appointments with your doctor, sometimes they can be with you at your prenatal appointments. So during childbirth, they can help with positioning to make sure that you’re feeling comfortable, they may make some suggestions on depending on their level of skills, and what their training, but they can give us they can offer different types of like positions the baby asks you to do like sit on a ball versus sitting on a bed. For child birthing positions, they may recommend instead of kind of like having yourself on your back and your legs up. Maybe you’re on all fours or maybe on your side to help progress pregnancy, the birthing experience, and then postpartum, they provide like support in the home. So whether it’s postpartum you struggle with getting some sleep, maybe you have your postpartum doula come by, and they will take baby for a couple of hours while you get sleep. Or maybe you need help preparing for a meal and you haven’t eaten all day. They will help you in that kind of doing those tangible things that you need support. And then we’ll find out other additional supports as deemed appropriate.
Dr. Connie Omari
Got it? Got it, love it. Do you encouraging this might be a little bit delish. But for us, what about eating like the placenta stuff? Do you ever have those types of conversations with your kids?
Sultana Karim
Not necessarily. No,
Dr. Connie Omari
I haven’t had yet.
Weird thing that I that I’ve been to, but you can be this, I
found research this. You can, I would have the placenta encapsulated in it. Because you know, it takes nine months for all those hormones to be coming here. But what usually they come pretty quickly. But still, they leave abruptly. So, there’s that maybe out there. And that’s where I believe a lot of the postpartum comes from because you just kind of balance all that. And so, when you’re eating your placenta, you’re consuming the placenta, it’s like it’s a way to just kind of, you know, make it a little bit more gradual and not as abrupt.
Sultana Karim
Yeah, there’s different cultures that do like they will cook the placenta and eat it throughout the postpartum period. So, people won’t capsulate it. It just depends. It’s not a lot of evidence, but it’s not a lot of research on that here. Some like it’s a preventative for society sorter. And that’s only one factor, like the birthing experience. We also have to consider like the other risk factors, their own history of mental health struggle, their trauma history, and generational trauma. Like there’s so many aspects to consider.
Dr. Connie Omari
Support so they have now Yeah, reports. Yep,
Sultana Karim
yes. Yeah.
Dr. Connie Omari
Oh, cool. Cool. Well, gosh,
this has been a pleasure. Just kind of picking your brain and getting into this. Are there any final words or two that you want to make sure that you leave with our audience today?
Sultana Karim
Yes, so two, one. If you’re not getting straight screens, and your prenatal and postnatal appointments or mood and anxiety disorder, please advocate on your behalf and be like a I didn’t. You didn’t ask me questions about my experience. So that because most so Some research suggests that at black and brown people are not screened as often, or mood and anxiety disorders in pregnancy and postpartum as their white counterparts. Unfortunately, however, there is still a slow shift to make sure that everyone is getting that assessment. But it’s not. It’s not happening as fast as I would like it’s. And then if they are being screen, there might not be getting resources or know what that’s like what the results were that screening tool is. So, talking with your healthcare provider, and I know postpartum you only have that six-week appointment, depending on where you’re where you’re delivering. It’s either a six-week appointment or a two-week appointment. Still have that conversation with your provider. And you will also be seeing the pediatrician a lot this year, and they should be screening every single visit. Okay, yeah.
Dr. Connie Omari
You were telling me that I was I really? I don’t recall any type of screening like that. So, Wow. Yeah. Um, you said there were two things, did you cover both of them?
Sultana Karim
And then oh, the second one. No. And the second one is mental health is something that helps elevate you and to help you feel better, and to be the best person that you can be for yourself and your children. So, if you are struggling, please reach out.
Dr. Connie Omari
Love it. Well, listen, it has been a pleasure having you today. You are a wealth of information. You are so wise and so knowledgeable about this. And we are honored that you took the time to have this conversation with us today. Where can our listeners find you? So you’re in Virginia and Maryland? Correct? Yes. serve anybody in those in that state? And how can they find you to get services?
Sultana Karim
So you can access my website@www.kr IMCOUU AMG? Counseling,
Dr. Connie Omari
I will link in the comments so you can just you just click it. Well, thank you again, so much. Okay. This has been a pleasure to have you today. And to our audience. Listen, she’s here if you’re having issues or if you know someone who was having issues and you’re also on Instagram, right?
Sultana Karim
Yes, I’m an Instagram and Facebook actor in counseling. So I put lots of like, information on there as well a ways that can help you feel better, but also information about perinatal mood anxiety disorder, and just the whole perinatal period.
Dr. Connie Omari
Absolutely. That’s how I found her. So look her up. She knows what she’s doing. All right. Thank you so much, everybody. Thanks for joining us peace and blessings. All right. That’s it.
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