This May, during Asian Pacific American Heritage Month, Maven is shining a light on the specific joys and challenges that the Asian American and Pacific Islander (AAPI) community experience on their family-building journey. Asian Pacific American Heritage Month celebrates the incredibly diverse population categorized as AAPI, reflecting on the stories and culture of 75 countries from Asia, as well as the Pacific Islands of Melanesia, Micronesia, and Polynesia.
We sat down with Maven Nurse Practitioner, Fidela Chiang, to talk about her experience helping AAPI Maven members as they start and build their families.
The role of family in the AAPI community
Many people who identify as AAPI prioritize the role of family in their lives. Pew Research found that about a quarter of Asian-Americans live in multigenerational households and are more likely to prioritize being a good parent over their career, owning a home, or having lots of free time. “For many Asian-Americans, their identities can be tied to their families and what their parents have done,” explains Chiang. “I personally am a second-generation child of immigrants. My parents worked hard to come here and build their lives. So some of us feel that we should be just as diligent to honor what our parents did for our families.”
Chiang explains that in her personal and professional experience, AAPI people tend to have a lot of respect for their elders and a more collectivist than individualistic way of thinking. “There’s an idea that it’s not just about me and my path. Much of what I do reflects my family and cultural identity.” But she’s clear that her experience can’t define what the 20.6 million people in the U.S. who identify as Asian, Native Hawaiian, or Pacific Islander have gone through. “There are so many different ethnic groups within the terms ‘Asian.’ Everyone has a unique journey.”
Navigating mental health challenges
One of the most common challenges Chiang sees in AAPI patients, friends, and family is a lack of mental healthcare. This need for more comprehensive mental health support is an issue for AAPI people through the entirety of the family-building process, from preconception to postpartum. Research shows that between one fifth and one quarter of women freezing their eggs are Asian-American, and the few studies that exist on AAPI fertility show that Asian-American patients may have greater difficulty conceiving, wait longer to seek infertility treatment, and have less success in fertility treatments. “There can be a high mental toll with infertility,” says Chiang. “It is common for many people to the pressure to conceive ‘naturally.’” It’s important to note that this is typical for everyone, not within the AAPI community. Struggles with infertility can cause emotional and financial stress—the American Psychiatric Association recently noted that the “psychological impact of being unable to conceive is a profound loss and significant life crisis.”
However, mental health struggles may not end after a person gets pregnant. A 2020 study shows that in the postpartum period, AAPI women are almost nine times as likely as their white counterparts to report suicidal ideation and depressive symptoms. But they are also less likely to report their symptoms and seek help. “It can often be culturally stigmatized to seek mental health care,” explains Chiang. “There can also be an element of shame for many Asian-Americans to seek care or admit that they need help.”
That’s why it’s so important to make mental health care easily accessible and affordable for the AAPI community on their family-building journeys. In her experience as a Nurse Practitioner with Maven, Chiang has found that many members who seek her out tend to be Asian or Asian-American. “Many people who seek care from me often want that connection,” Chiang explains. “ I think there’s a comfort in that I might better understand some things that they’re going through, especially as it relates to mental health while building a family.”
The value of care matching
Cultural heritage and identity can run deep. Especially in the vulnerable moments of fertility treatments, pregnancy, postpartum, and parenting, it can be comforting to know that your provider fundamentally understands your experience. “Provider representation can be important for patients because there can often be a mutual understanding of shared values and common lived experiences,” explains Chiang. “For example, I’ve also navigated through society as an Asian person. I’ve also been discriminated against or experienced microaggressions, and I've also tried to find meaning in my own cultural identity as a parent.”
Chiang works to be able to relate to all her patients’ experiences but has found that it can be helpful for many patients to share a foundation of cultural understanding with their providers. “You don’t have to explain certain concepts, perspectives, or values. It’s just there.”
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