(642) Coping mechanisms and support systems of Black women after preterm birth: a qualitative study

Objective: Spontaneous preterm birth (sPTB) can have lasting impacts on the birthing person and the delivered child.  Black women endure a higher prevalence of sPTB; however, there is a lack of data on how they cope with having a sPTB and the support symptoms they rely on to recover. Our study aimed to reveal the perspectives of Black women on coping mechanisms and their support systems after sPTB. 

Study Design: We conducted a qualitative interview study of self-identified Black women who had a sPTB at a large teaching hospital. We enrolled participants who had a sPTB between 24w0d and 33w6d from July 2020 to July 2022, spoke English, and were at least 18 years old. Interview participants were interviewed until thematic saturation was achieved. Data were analyzed using an inductive coding approach. Interrater reliability testing was performed. Standardized questions captured participants’ perceptions of mental health symptoms, coping mechanisms, and support structures leveraged after sPTB.

Results: Of 47 eligible participants, 13 (27.7%) completed the screening and interview process. Inter-rater reliability scores showed almost perfect coding agreement (mean kappa 0.99 (SD 0.01)). Participants found that psychological and spiritual connections helped them cope with the mental impact of sPTB; significant themes are noted in Table 1. Support from partners, family members, and community members aided in participants building resiliency. However, participants perceived a lack of understanding of the sPTB from their partners and family members as less support, which negatively impacted their mental health.

Conclusion: Black women who had a sPTB coped through psychological and spiritual connections with support networks aiding in the development of resiliency. However, the lack of understanding of the sPTB within their support network, made participants feel unsupported. Interventions geared towards including patients’ spiritual preferences and support networks in their pregnancy and postpartum management could increase perceived support after sPTB and improve mental health.