BackgroundThe perinatal period, which we here define as pregnancy and the first year postpartum, is a time in women’s lives that involves significant physiological and psychosocial change and adjustment, including changes in their social status and decision-making power. Supporting women’s empowerment at this particular time in their lives may be an attractive opportunity to create benefits for maternal and infant health outcomes such as reductions in perinatal depressive symptoms and premature birth rates. Thus, we here systematically review and critically discuss the literature that investigates the effects of empowerment, empowerment-related concepts and empowerment interventions on reductions in perinatal depressive symptoms, preterm birth (PTB), and low birthweight (LBW).MethodsFor this systematic review, we conducted a literature search in PsychInfo, PubMed, and CINAHL without setting limits for date of publication, language, study design, or maternal age. The search resulted in 27 articles reporting on 25 independent studies including a total of 17,795 women.ResultsThe majority of studies found that, for the most part, measures of empowerment and interventions supporting empowerment are associated with reduced perinatal depressive symptoms and PTB/LBW rates. However, findings are equivocal and a small portion of studies found no significant association between empowerment-related concepts and perinatal depressive symptoms and PTB or LBW.ConclusionThis small body of work suggests, for the most part, that empowerment-related concepts may be protective for perinatal depressive symptoms and PTB/LBW. We recommend that future theory-driven and integrative work should include an assessment of different facets of empowerment, obtain direct measures of empowerment, and address the relevance of important confounders, including for example, ethnicity and socioeconomic status.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1495-1) contains supplementary material, which is available to authorized users.

Intimate partner violence (IPV) affects one in three women and can have long-lasting psychological effects, with abuse survivors typically exhibiting elevated stress and depressive symptoms. However, women with greater personal empowerment resources (i.e., self-care, agency, self-efficacy) and who practice relaxation techniques generally exhibit lower stress and depressive symptoms. The present study investigated the effectiveness of Personal Empowerment Programs (PEP) and practicing relaxation techniques in promoting empowerment and lowering stress and depressive symptoms. Ninety women were recruited from PEP classes conducted at domestic violence agencies in Orange County, California. Salivary cortisol and affect were assessed before and after one PEP class. Perceived stress, depressive symptoms, empowerment, and relaxation techniques were also assessed. Practicing relaxation techniques correlated with more empowerment. For women without sexual abuse experiences only, having completed more classes (>5 classes) in the program was associated with greater empowerment, less stress, and fewer depressive symptoms. Implications extend to future studies and interventions for IPV survivors.

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Purpose Greater acculturation is associated with adverse perinatal outcomes in Mexican-American women, but the mechanisms by which acculturation influences perinatal outcomes are unclear. Pregnant acculturated Mexican-American women are more likely to engage in unhealthy prenatal behaviors relative to those less acculturated, including poor sleep. As sleep disruptions are associated with acculturation and negative perinatal outcomes, particularly maternal depression, alterations in sleep may adversely affect pregnant Mexican-American women. Methods Sixty pregnant women of Mexican descent completed surveys about sleep, acculturation, depressive symptoms and potential protective factor of social support. Results Acculturation, but not social support, significantly predicted increased sleep disruptions as well as overall feeling less refreshed upon waking across pregnancy. Moderation analysis indicated that more acculturated women who took longer to fall asleep reported increased depressive symptoms. Feeling refreshed upon waking also mediated the relationship between increased acculturation and elevated maternal depressive symptoms. Conclusions Acculturation and altered sleep contribute to greater risk in Mexican-American women for maternal depressive symptoms in the perinatal period. These findings have implications for prevention and treatment of maternal mental health disorders, which may adversely affect perinatal outcomes in the vulnerable Mexican-American population.