Perspectives on barriers and facilitators to mental health support after a traumatic birth among a sample of primarily White and privately insured patients
Department of Psychiatry; Department of Population and Quantitative Health Sciences; Graduate School of Biomedical Sciences
Epidemiology | Female Urogenital Diseases and Pregnancy Complications | Health Services Administration | Health Services Research | Mental and Social Health | Obstetrics and Gynecology | Psychiatry and Psychology
OBJECTIVE: To elicit the perspectives of individuals with a traumatic birth experience on barriers and facilitators to receiving mental health support in the postpartum period.
METHODS: Individuals who experienced a traumatic birth within the last three years (n = 32) completed semi-structured phone interviews about their birth and postpartum experience. The Post-traumatic Stress Disorder Checklist for DSM-V (PCL-5), Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder scale (GAD-7) were administered. Qualitative data was analyzed using a modified grounded theory by three independent coders.
RESULTS: Among participants, 34.4% screened positive for PTSD, 18.8% for depression, and 34.4% for anxiety. Participants described multi-level barriers that prevented clinicians from recognizing and supporting patients' postpartum mental health needs; those involved lack of communication, education, and resources. Recommendations from participants included that 1) obstetric professionals should acknowledge birth-related trauma experienced by any individual, 2) providers of multiple disciplines need to be integrated into postpartum care, and 3) mental health support may be needed before the ambulatory postpartum visit.
CONCLUSIONS: There are multi-level barriers towards detecting and responding to individuals' mental health needs after a traumatic birth. Obstetric professionals need to use a trauma-informed approach and proactively assess mental health throughout the postpartum period.
Perinatal mental health, Trauma, Traumatic births, UMCCTS funding
DOI of Published Version
Xu L, Boama-Nyarko E, Masters GA, Moore Simas TA, Ulbricht CM, Byatt N. Perspectives on barriers and facilitators to mental health support after a traumatic birth among a sample of primarily White and privately insured patients. Gen Hosp Psychiatry. 2021 Nov-Dec;73:46-53. doi: 10.1016/j.genhosppsych.2021.08.010. Epub 2021 Aug 28. PMID: 34583284; PMCID: PMC8629868. Link to article on publisher's site
General hospital psychiatry
Xu W(, Boama-Nyarko E, Masters GA, Moore Simas TA, Ulbricht CM, Byatt N. (2021). Perspectives on barriers and facilitators to mental health support after a traumatic birth among a sample of primarily White and privately insured patients. Population and Quantitative Health Sciences Publications. https://doi.org/10.1016/j.genhosppsych.2021.08.010. Retrieved from https://escholarship.umassmed.edu/qhs_pp/1476