Background
Untreated perinatal depression is common and has deleterious effects on mother, fetus/child and family Despite effective evidence-based treatment for perinatal depression, most women do not get treatment Obstetricians have not traditionally identified and/or responded to the mental health needs of perinatal women Caring and committed providers are frustrated and confused5 and mothers do not feel seen, heard or understood by their providers Implementing supports for perinatal women within the traditional medical model poses many challenges to mental health and obstetric providers
MotherWoman is a community-based grassroots organization dedicated to preventing and treating perinatal depression through an innovative organizational change approach, the Community-Based Perinatal Support Model (CPSM). This model includes: Peer-led support groups for perinatal women Organizational change interventions that include structured screening and referral, health care provider trainings and networks, and resource and referral guides
Methods
Participants
Four focus groups with MotherWoman clients, 3 months – 3 years postpartum who self-identified as having experienced perinatal depression or emotional crisis
Data collection Focus group probes targeted perceptions of the best practices to engage perinatal women in depression treatment and potential strategies for change Investigators met after each group to record observations and review verbatim notes Participants received gift cards for their participation
Data analysis Transcripts were reviewed, segmented, and coded by investigators using an iterative, constant-comparative process to identify emerging themes and recurrent patterns Inter-rater reliability of more than 90% was achieved by two investigators comparing randomly selected coded pages from focus group notes
Discussion Despite barriers, numerous facilitators to treatment were identified Supporting women’s mental health during the perinatal time period should ideally be done in both the medical setting and community Supporting the mental health of perinatal women is a fundamental challenge with multiple opportunities for intervention and education Strategies to address perinatal depression include: Offer training to OB/Gyn and mental health providers in the detection and screening of perinatal depression Prepare women for the postpartum period through psychoeducation and peer-support Create flexible treatment options that go beyond medication management and emphasize transition to motherhood
Results will Contribute to understanding the barriers and facilitators perinatal women experience when trying to access depression treatment Provide preliminary guidelines for the development of strategies to engage perinatal women in depression treatment Inform the development of interventions that aim to integrate the treatment of perinatal depression into medical setting
