Black Women’s Preferences for Embedding Mental Health Services in An Obstetrics Setting

Abstract

Background: Untreated perinatal depression is a significant public health issue that disproportionately affects low-income black women and may lead to higher maternal mortality rates and disparate birth outcomes. Despite the growing literature documenting prevalence and risk for perinatal depression among black women, our knowledge of patient preferences of mental health interventions in obstetrical (OB) settings among this population is limited. This study explored mental health treatment preferences among black pregnant and postpartum women in an urban OB practice, serving predominantly black women with public insurance. Subjects and Method: We employed a qualitative approach to examine Black perinatal women's mental health preferences in an OB setting. The study sample consisted of 14 perinatal women at an urban obstetrics practice in Washington, DC. Semi-structured interviews were conducted to gain insight into their emotional experiences during pregnancy and postpartum, and to obtain patient recommendations for mental health interventions within an obstetrics setting. Patient interviews were audio-recorded, transcribed, and analyzed by two coders using inductive thematic analysis and consensus procedures. Results: Participants reported several general content themes: provider-patient relationship and intervention topic feedback. Within the overall content theme of provider-patient relationship, black women noted differences in their overall levels of comfort in discussing stress and mental health issues. Subthemes of authentic connection and perceived stigma emerged. Relevant subthemes on intervention topic preferences discussed content, modality, and logistics. Conclusion:Our findings support the importance of offering integrative, culturally competent, and accessible mental health interventions in order to prevent and treat perinatal depression among low-income black women in OB settings.