How migrant women in the UK are breaking the isolation around maternal mental health
- Written by Carlotta Dotto
- Edited by Ruby Russell
- Illustration by Eva Procee
Migrant women and women of color are at greater risk of post-natal depression, postpartum psychosis and other mental health disorders – and often find it harder to access support from the NHS. But networks established by women who have survived these disparities in care are helping others thrive through one of the most vulnerable times of their lives.
After a failed induction and an elective caesarean, Shaheda Akhtar sat in bed at the Birmingham Women’s Hospital, gazing at the tiny face of her newborn daughter. That moment was meant to be the happiest of her life, but she felt overwhelmed by exhaustion and utterly unprepared for what lay ahead. Her senses were on edge; every sound on the ward seemed unbearably sharp – the relentless beeping of monitors, the wails of newborns, the crash of bins being emptied – each one slicing through her mind.
When Akhtar went home days later, her behavior grew increasingly erratic. Paranoia crept in. “I was constantly worried something would happen to my daughter, that I wouldn’t be able to protect her,” she recalls. “It was unbearable.”
Her confidence with the baby unraveled; she struggled to breastfeed while her husband interacted easily with the child. “I felt like a complete failure as a mum. If I can’t feed my baby, if I can’t look after her, then I’m absolutely rubbish at this,” she remembers thinking. The weight of expectation was crushing. “Everything I wanted this to be… It just wasn’t happening for me. I was so utterly upset and devastated.”
What Akhtar didn’t know yet was that she was showing the first signs of postpartum psychosis (PP), a rare but serious mental illness that can develop in the first days after giving birth, even in someone with no prior mental health issues. Left untreated, it can have long-lasting consequences for mothers and their families.
Maternal mental health challenges can vary in severity and impact, spanning from milder depression and anxiety to less frequent illnesses, such as psychosis. Experiencing psychological distress at this critical time is common – roughly one in four mothers in England develop some form of mental health stress during pregnancy or within the first two years of their child’s life. But women of color and those from migrant communities experience both increased risk of perinatal mental health problems and reduced access to suitable care.
Roughly one in four mothers in England develop some form of mental health stress during pregnancy or within the first two years of their child’s life. But women of color and those from migrant communities experience both increased risk of perinatal mental health problems and reduced access to suitable care.
These obstacles are shaped not only by societal stigma but also by language barriers, cultural assumptions, institutional racism, and systemic neglect embedded in health and care services.
Where the system fails them, women find ways to support each other. By sharing knowledge rooted in their different cultures, creating connections across isolation, and building informal support networks, they can transform experiences of trauma into moments of empowerment.
Stigma, shame and lack of awareness
Mental health is rarely discussed in Akhtar’s Bangladeshi community – let alone psychosis. “It’s taboo, hush-hush, with a bit of stigma attached to it,” she says. When she fell ill, her family turned first to prayer and spiritual healing. “I focused so much on reciting the Quran because I felt like evil spirits were out to get me and my baby. Then it snowballed – I began to believe I had special powers, special knowledge, that I was on a mission.”
Twenty-one days after her first symptoms, Akhtar received a diagnosis and was hospitalized under the care of a mother and baby unit (MBU) – an inpatient mental health center where new mothers can be admitted with their babies.
Recovery wasn’t straightforward. She spent days praying quietly in her room, writing lists and notes in her diary, trying to make sense of her thoughts and gradually gaining confidence with her baby. Then, one day, she accepted the offer of a foot spa from a volunteer on the ward. She thought it was just a “pampering session” to help her feel better. But the meeting proved to be “far more powerful” than that.
It turned out that Katy, the pedicure therapist, had experienced postpartum psychosis herself and was now a volunteer for the charity Action on Postpartum Psychosis (APP). She told Akhtar she too had suffered stigma and isolation within her Greek community in the UK.
"When you’re completely broken down and you feel so vulnerable, you keep wondering… Am I ever going to get my strength back as a person?”
For the first time, Akhtar felt she could open up to someone and be understood. She also realized that recovery was possible. “When you’re completely broken down and you feel so vulnerable, you keep wondering… Am I ever going to get my strength back as a person?”
Inspired by the support she received, Akhtar began raising awareness and started working with APP, particularly assisting women from migrant backgrounds and Black and Asian communities. She helped APP launch a Muslim Mums Cafe group for mothers who have struggled with their mental health before or after giving birth, to get together, share their experiences, and support one another.
During Ramadan this year, she took part in an APP radio show discussing postpartum psychosis, and is currently blogging for the Muslim Women’s Network and Taahira, a muslim women’s health network. She is also collaborating with the British Board of Scholars and Imams to produce guidance on Postpartum Psychosis for community leaders: “So that if someone comes to them saying, ‘My wife, my daughter, my sister is feeling this way,’ they can point them towards medical support.”
For Akhtar, this is a way to ensure that women like her no longer have to navigate the confusion, fear and stigma alone. Confronting other women, she realized that shame and the pressure to hide struggles are widespread – but they are compounded by barriers to care. “A lot of the challenge comes down to access. Women may not know where to go for help, how to recognize symptoms, or even that help exists,” she explains.
Migrant women in maternity care
“The people who face the most barriers are often those who need our care the most – and yet their voices are not the ones we hear in maternity care."
Women from Black and ethnic minority (BAME) backgrounds and lower socioeconomic groups are at greater risk of physical and psychiatric complications of pregnancy compared to white British women, according to an MBRRACE UK report published in September 2025. Yet many BAME women in the UK face delays in accessing care, several studies have shown – and migrant women are particularly at risk.
“The people who face the most barriers are often those who need our care the most – and yet their voices are not the ones we hear in maternity care,” says Amina Hatia, a London-based midwife who works supporting refugees and asylum seekers with mental health needs.
She recalls meeting a woman who had fled Afghanistan while nine months pregnant. Sitting with her husband, children and an interpreter, the woman was asked deeply personal medical questions by a stranger. The experience taught Hatia that building trust requires focusing on individual experience. “She didn’t want to be here. She hadn’t chosen it. And to her, I was just a nosy stranger asking painful questions in a language she didn’t understand,” Hatia recalls.
Every migrant woman’s story is different. “Fleeing Kabul in chaos is a different experience from getting pregnant in the UK or after years in a refugee camp,” she says. “How people arrive – and why they arrive – has the biggest impact on how they approach maternity.” Pregnancy can feel like “hope and a new start” for some, but for others, it can feel like “trauma replayed.” Both need care, but “the care has to look different.”
For many, language is a major barrier: words like ‘induction’ or ‘consent’ can be hard to navigate, interpreters are not always available, and AI-driven language tools fail to capture the nuance of pain, fear or mental distress – especially in cases like postpartum depression or psychosis.
Compounded by isolation, this can leave a woman in crisis unable to express her suffering. “It’s heartbreaking to see a woman in so much pain and not be able to communicate with her,” says Rowenna Wilcox, a mental health support worker in Birmingham who has personal experience of severe postpartum mental distress.
Even fluent speakers revert to their first language when frightened. “If they can’t do that safely in labor, we’re failing them,” Hatia says.
Racialized care in the NHS
“Supporting migrants, refugees, asylum-seeking communities – whatever label we’re using for them, we need to remember that this is a label we’ve assigned to them,” Hatia says. “That is not who they are. This is the situation they have found themselves in.”
Yet inadequate resources to tackle the specific – and often complex – needs of migrant women are not the only problem – and it is not only migrant mothers who face barriers to adequate care. Black women are more than twice as likely to die during pregnancy or shortly after childbirth than white women, and women from Asian and mixed ethnic backgrounds also face slightly higher risks. This is partly due to socioeconomic factors, but widespread racism in maternity care is also a factor.
According to Five X More’s 2025 report, Black women often experience a lack of empathy from health providers and denial of basic rights. Many feel dismissed, unsafe and unheard. These outcomes can lead to further anxiety, post-traumatic stress and fear of future pregnancies – which is particularly worrying considering that mental health-related issues are the leading cause of maternal death between six weeks and one year postpartum.
Caroline Bazambanza, who researches racialized reproductive health at the London School of Economics, recounts stories of Black women who disclosed troubling thoughts, such as harming their child, and asked for therapy – only to be referred to social services. As a result, they often withdraw their plea, fearing that asking for help could paint them as an unfit mother. “If the institution is not going to work for us, then we’re not going to engage with the institution,” Bazambanza says.
Bias also extends to clinical practice. Until last year, jaundice in black and brown babies was assessed using white skin as the baseline, according to a review by the NHS Race and Health Observatory. Terms like “pink” were still being used to describe a well-perfused baby. “That’s colonial medicine reproduced worldwide,” Hatia says.
Black women also report being denied pain relief or having their pain minimized, reflecting racist assumptions such as that Black women feel less pain – which stem from historical experiments conducted on enslaved women in the United States, such as those performed without anesthesia by J. Marion Sims, the so-called “father of gynecology.”
Bazambanza emphasizes the “significant” importance of group support as contexts in which women of color can speak freely without having to prove their case. “They could simply say, ‘As soon as I walked into the room, I noticed from the way he looked at me…’ and everyone in the group understood.”
The National Health Service, often called “the closest thing the English have to a religion,” is built on English traditions of colonialism, immigration and racism. Founded in 1948 with a vision of free health care for all, the NHS demanded a huge workforce – in a country still reeling from the Second World War.
In June of the same year, the Empire Windrush docked on the Thames, bringing hundreds of people from the Caribbean to fill Britain’s labor gap – and particularly jobs in the new NHS. Over the following decades, thousands more people from British colonies and former colonies joined them. By 1960, nearly 40% of junior NHS doctors were from India, Pakistan, Bangladesh and Sri Lanka, and in 1965 some 5,000 Jamaican women were working in British hospitals.
Today, one in five NHS workers is not a UK national, with Indians, Filipinos and Nigerians accounting for 20% of nurses and health visitors. Nearly 30% of the NHS workforce are Black and minority ethnic (BAME) – including half its doctors – despite a 2022 report finding that most BAME NHS staff had considered quitting due to racism at work. Over 85% of NHS management is white.
The NHS is also failing to uphold the principle of free and equal access to health care for all. In one survey, 25% of primary care patients reported being discriminated against based on their ethnicity, with BAME patients having significantly lower levels of trust in the service than white patients.
Nurturing cultural practices
Harm also stems from forcing mothers to adhere to cultural norms that may be detrimental. At the MBU where Akhtar was admitted, Wilcox explains that some practices such as “co-sleeping” are prohibited, even though they are the norm in many cultures.
Wilcox recalls a Nigerian mother on the ward who carried her baby on her back, wrapped in fabric. “It looked like the most cosy, secure and comfortable way for the baby to be carried. As soon as she was on her back, she just relaxed and drifted off to sleep.” But because it’s considered unsafe by Western professionals, the practice was discouraged on the ward. “I can see why – insurance reasons, mainly – but positive cultural traditions often get lost in the process,” Wilcox says.
In sharp contrast with white British practices that often leave mothers relatively isolated after birth, in the Bangladeshi community where Akhtar grew up, extended family mobilizes around new mothers. They cook, help with household chores, and take care of the other children, if there are any, she says.
“My mother was there for me in the early days after I came home. And then, when I got sick, my brothers took turns staying at my house. My sisters-in-law were also there for me, especially taking care of my daughter,” Akhtar recalls.
Between isolation and support
Amina Hatia was lucky – her own experience of giving birth was not just positive but transformative. She says she came to midwifery after being “bewitched” by two midwives who attended her own labor 18 years ago. “They changed my entire birth experience and supported me in such a way that I went on to have one of the most empowering experiences of my life.” She remembers the shock of giving birth: “I had not only survived but thrived in it.”
She thought: “What a way to live your life – to support women like this.” Two years later, she began her midwifery training, and in 2016 she joined Doulas Without Borders. A grassroots network across the UK comprising over a hundred voluntary doulas, the NGO was created in response to the urgent need to support vulnerable pregnant women, including refugees, asylum seekers and those facing hardship, to address disparities in maternal health outcomes.
“A mother who has arrived in the UK fleeing violence or terror should also be entitled to an empowering birth like I [had]. It will make a much bigger difference to her life to regain some control.”
The doulas, who are often refugees or women from ethnic minorities themselves, are trained to support people through pregnancy, labor, birth and postnatal care. There to ‘mother the mothers,’ they act as a trusted presence for women at their most vulnerable time – listening, advocating, helping them to feel safe. Operating through WhatsApp groups across the UK, they can intervene based on needs – be they overcoming language barriers, protection from violence, or simply being there. According to one doula in the network, their mere presence in a medical setting can help mitigate microaggressions, for example, against a woman of color.
Hatia firmly believes in the role of a doula as complementary to that of a midwife. “Our roles are different, but together we can ensure women and birthing people feel heard and supported,” she says. Among others, Doulas Without Borders’ Mother Tongue project trains the additional figure of a “birth companion” who shares the first language of newly arrived mothers, helping them navigate the system with culturally sensitive support.
“A mother who has arrived in the UK fleeing violence or terror should also be entitled to an empowering birth like I [had],” Hatia says. “It will make a much bigger difference to her life to regain some control.”
That universal sense of pressure
Beyond cultural and economic differences, and differences in care, experiences of some form of physical or psychological trauma are common to many women at this fragile moment in their lives.
Pregnancy, childbirth and motherhood transform a woman’s entire reality in radical ways: from physical and hormonal changes to taking on a new role in her family, in her relationship and in society. The transition can have a profound emotional impact – and sometimes lead to severe psychological distress. Added to this is the weight of collective idealizations and habitual gender bias, suggesting that motherhood should be the most natural thing for a woman to do.
“People make it look so easy. Why is it so hard for me? Why can’t I just do the things I’m supposed to do?” Shaheda Akhtar wondered when she was still struggling. “I think talking to others is really important because you realize you’re not alone,” she says, urging anyone who has suffered from postpartum depression not to struggle in silence.
Because that sense of pressure, explains Akhtar, is universal. “There’s this pressure on new mothers to do all the things they’re supposed to do… when you fail or struggle, you automatically feel like a failure, because no one tells you how hard it can be.”
Correction: This article has been updated to correct the name and role of the volunteer who offered Shaheda Akhtar a pedicure.
About the author:
Carlotta Dotto is an award-winning investigative journalist and editor, covering topics such as gender inequality, digital violence, migration, human trafficking and mental health. Additionally, she is a trainer and public speaker, teaching data-driven journalism, information design and OSINT tools.
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