Perinatal Mood and Anxiety Disorder and Reproductive Justice: Examining Unmet Needs for Mental Health and Social Services in a National Cohort
Introduction: Perinatal Mood and Anxiety Disorders (PMADs) are the most common complications during the perinatal period. There is limited understanding of the gaps between need and provision of comprehensive health services for childbearing people, especially among racialized populations. Methods:...
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| Language: | English |
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Mary Ann Liebert
2024-12-01
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| Series: | Health Equity |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/heq.2022.0207 |
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| author | Tanya Khemet Taiwo Keisha Goode P. Mimi Niles Kathrin Stoll Nisha Malhotra Saraswathi Vedam |
| author_facet | Tanya Khemet Taiwo Keisha Goode P. Mimi Niles Kathrin Stoll Nisha Malhotra Saraswathi Vedam |
| author_sort | Tanya Khemet Taiwo |
| collection | DOAJ |
| description | Introduction: Perinatal Mood and Anxiety Disorders (PMADs) are the most common complications during the perinatal period. There is limited understanding of the gaps between need and provision of comprehensive health services for childbearing people, especially among racialized populations. Methods: The Giving Voice to Mothers Study (GVtM; n=2700), led by a multistakeholder, Steering Council, captured experiences of engaging with perinatal services across the United States, including access, respectful care, and health systems' responsiveness. A patient-designed survey included variables to assess relationships between race, care provider type (midwife or doctor), and needs for psychosocial health services. We calculated summary statistics and tested for significant differences across racialized groups, subsequently reporting odds ratios (ORs) for each group. Results: Among all respondents, 11% (n=274) reported unmet needs for social and mental health services. Indigenous women were three times as likely to have unmet needs for treatment for depression (OR [95% confidence interval, CI]: 3.1 [1.5–6.5]) or mental health counseling (OR [95% CI]: 2.8 [1.5–5.4]), followed by Black women (OR [95% CI]: 1.8 [1.2–2.8] and 2.4 [1.7–3.4]). Odds of postpartum screening for PMAD were significantly lower for Latina women (OR [95% CI]=0.6 [0.4–0.8]). Those with midwife providers were significantly more likely to report screening for anxiety or depression (OR [95% CI]=1.81 [1.45–2.23]) than those with physician providers. Discussion: We found significant unmet need for mental health screening and treatment in the United States. Our results confirm racial disparities in referrals to social services and highlight differences across provider types. We discuss barriers to the integration of assessments and interventions for PMAD into routine perinatal services. Implications: We propose incentivizing reimbursement schema for screening and treatment programs; for community-based organizations that provide mental health and social services; and for culture-centered midwife-led perinatal and birth centers. Addressing these gaps is essential to reproductive justice. |
| format | Article |
| id | doaj-art-129c2e6aa6f542e89c652178ef43e9b5 |
| institution | OA Journals |
| issn | 2473-1242 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Health Equity |
| spelling | doaj-art-129c2e6aa6f542e89c652178ef43e9b52025-08-20T01:49:56ZengMary Ann LiebertHealth Equity2473-12422024-12-0181768610.1089/heq.2022.0207Perinatal Mood and Anxiety Disorder and Reproductive Justice: Examining Unmet Needs for Mental Health and Social Services in a National CohortTanya Khemet Taiwo0Keisha Goode1P. Mimi Niles2Kathrin Stoll3Nisha Malhotra4Saraswathi Vedam5Birth Place Lab, Division of Midwifery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.Birth Place Lab, Division of Midwifery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.Birth Place Lab, Division of Midwifery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.Birth Place Lab, Division of Midwifery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.Birth Place Lab, Division of Midwifery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.Birth Place Lab, Division of Midwifery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.Introduction: Perinatal Mood and Anxiety Disorders (PMADs) are the most common complications during the perinatal period. There is limited understanding of the gaps between need and provision of comprehensive health services for childbearing people, especially among racialized populations. Methods: The Giving Voice to Mothers Study (GVtM; n=2700), led by a multistakeholder, Steering Council, captured experiences of engaging with perinatal services across the United States, including access, respectful care, and health systems' responsiveness. A patient-designed survey included variables to assess relationships between race, care provider type (midwife or doctor), and needs for psychosocial health services. We calculated summary statistics and tested for significant differences across racialized groups, subsequently reporting odds ratios (ORs) for each group. Results: Among all respondents, 11% (n=274) reported unmet needs for social and mental health services. Indigenous women were three times as likely to have unmet needs for treatment for depression (OR [95% confidence interval, CI]: 3.1 [1.5–6.5]) or mental health counseling (OR [95% CI]: 2.8 [1.5–5.4]), followed by Black women (OR [95% CI]: 1.8 [1.2–2.8] and 2.4 [1.7–3.4]). Odds of postpartum screening for PMAD were significantly lower for Latina women (OR [95% CI]=0.6 [0.4–0.8]). Those with midwife providers were significantly more likely to report screening for anxiety or depression (OR [95% CI]=1.81 [1.45–2.23]) than those with physician providers. Discussion: We found significant unmet need for mental health screening and treatment in the United States. Our results confirm racial disparities in referrals to social services and highlight differences across provider types. We discuss barriers to the integration of assessments and interventions for PMAD into routine perinatal services. Implications: We propose incentivizing reimbursement schema for screening and treatment programs; for community-based organizations that provide mental health and social services; and for culture-centered midwife-led perinatal and birth centers. Addressing these gaps is essential to reproductive justice.https://www.liebertpub.com/doi/10.1089/heq.2022.0207pregnancydisparitiesmaternal mental healthperson-centered carereproductive justiceperinatal mood disorders |
| spellingShingle | Tanya Khemet Taiwo Keisha Goode P. Mimi Niles Kathrin Stoll Nisha Malhotra Saraswathi Vedam Perinatal Mood and Anxiety Disorder and Reproductive Justice: Examining Unmet Needs for Mental Health and Social Services in a National Cohort Health Equity pregnancy disparities maternal mental health person-centered care reproductive justice perinatal mood disorders |
| title | Perinatal Mood and Anxiety Disorder and Reproductive Justice: Examining Unmet Needs for Mental Health and Social Services in a National Cohort |
| title_full | Perinatal Mood and Anxiety Disorder and Reproductive Justice: Examining Unmet Needs for Mental Health and Social Services in a National Cohort |
| title_fullStr | Perinatal Mood and Anxiety Disorder and Reproductive Justice: Examining Unmet Needs for Mental Health and Social Services in a National Cohort |
| title_full_unstemmed | Perinatal Mood and Anxiety Disorder and Reproductive Justice: Examining Unmet Needs for Mental Health and Social Services in a National Cohort |
| title_short | Perinatal Mood and Anxiety Disorder and Reproductive Justice: Examining Unmet Needs for Mental Health and Social Services in a National Cohort |
| title_sort | perinatal mood and anxiety disorder and reproductive justice examining unmet needs for mental health and social services in a national cohort |
| topic | pregnancy disparities maternal mental health person-centered care reproductive justice perinatal mood disorders |
| url | https://www.liebertpub.com/doi/10.1089/heq.2022.0207 |
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