Student Children's Hospital of Philadelphia (CHOP) Bensalem, Pennsylvania, United States
Full Description: Postpartum depression (PPD) is the most common pregnancy complication - nearly 18% of new moms develop PPD. Left untreated, PPD can impede optimal maternal functioning and hamper the cognitive, emotional, and behavioral development of children. Recent work shows PPD is also the leading cause of self-harm and suicide among new moms. Still, one in five new moms is not screened for PPD. This figure is even higher for Non-Latinx Black women who face a higher risk of developing PPD then non-Latinx White women due to psychosocial and economic factors, but are less likely to use inpatient, outpatient, and emergency department mental health services for treatment. Feelings of isolation are one major predictor for the development of PPD, yet public health measures taken to stem the spread of SARS-CoV-19 have inadvertently created conditions that foster poor mental health. Despite widespread psychological effects of COVID-19, media focus has centered on the economic and physiological ramifications of the pandemic. Scholars have explored the psychosocial toll of COVID-19 on vulnerable populations, but few investigators have applied a mixed methods approach to define the psychosocial experience of non-Latinx Black birthing and the trends that present in their acquisition of mental health therapy. This exploratory sequential mixed methods study leverages a phenomenological approach to obtain deeper understanding of the association between social support and self-reported symptoms of depression among non-Latinx Black birthing persons (N=150), and qualitatively explore inequitable trends in care acquisition that persist against the backdrop of a harrowing global health crisis. Our data analysis process is iterative, with both quantitative and qualitative arms performed within social constructivist and critical race theory frameworks. Themes ascertained from sample interviews inform the statistical model we use to perform regression analysis defining the effects of relationship status, maternal support system and perceived social support on Edinburgh Postnatal Depressive Scale (EPDS) scores at 12 months postpartum. Qualitative and quantitative emphasis is placed on the unique psychosocial experience of non-Latinx Black birthing persons, who studies have shown faced disproportionate mental health consequences of COVID-19. In the last few decades, public health discourse surrounding maternal mental health has increased. Initiatives such as the Bringing Postpartum Out of the Shadows Act have been launched to improve mental health outcomes nationwide. Despite screening recommendations from the United States Preventive Services Task Force, and the American Academy of Pediatrics, many cases of postpartum depression still go undetected. By elevating maternal mental health awareness, this study strengthens the case for standardized PPD screening and calls for accessible pathways to therapy for medically underserved Black birthing people at increased risk for PPD.
Abbreviated Description: Postpartum depression (PPD) is the leading cause of suicide among new moms. Despite the severity of untreated PPD, nearly 15% of women are not screened for symptoms. Non-Latinx Blacks face higher risk for PPD than non-Latinx Whites due to psychosocial and economic factors but are less likely to receive appropriate treatment. This phenomenological mixed methods study elevates disparate mental health outcomes between non-Hispanic Black and White birthing persons and strengthens the case for standardized PPD screening in the U.S. by first, defining the association between social support and self-reported depression symptoms of non-Latinx Black birthing persons ~12 months postpartum (N=150), and qualitatively investigating inequitable trends in care acquisition that persist amid COVID-19.
