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Q&A

Health Equity/Community Health

Poster Session 3

(673) Mental health needs after preterm birth: A qualitative assessment of Black women’s experiences

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Foundation Awardee

    Primary & Presenting Author(s)

  • Arthurine Zakama, MD

    Fellow
    University of Pennsylvania
    San Francisco, CA, United States

    • Coauthor(s)

  • MM

    Mlka Mengesha, BS

    Research Coordinator
    University of Pennsylvania
    Philadelphia, PA, United States

  • FM

    Florence Momplaisir, MD, MSPH

    Assistant Professor
    University of Pennsylvania School of Medicine
    Philadelphia, PA, United States

  • Michal A. Elovitz, MD

    Hilarie L. Morgan and Mitchell L. Morgan President’s Distinguished Professor in Women’s Health
    Women’s Biomedical Research Institute, Icahn School of Medicine at Mount Sinai
    New York, NY, United States

  • Jennifer Lewey, MD, MPH (she/her/hers)

    Cardiologist, Assistant Professor of Medicine
    University of Pennsylvania
    Philadelphia, PA, United States

  • Michelle P. Debbink, MD,PhD

    Assistant Professor
    University of Utah
    Salt Lake City, UT, United States

Objective: Black women (BW) face higher rates of spontaneous preterm birth (sPTB) than their White counterparts. BW endure a higher prevalence of perinatal mental health conditions with more debilitating symptoms; however, these often go unaddressed. Our study sought to reveal the perspectives of BW on the impact of sPTB on their mental health and their desired interventions.

Study Design: We conducted a qualitative interview study of self-identified BW who delivered at one teaching hospital, 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 recruited and interviewed until thematic saturation was achieved. Data were analyzed through inductive coding. Interrater reliability testing was performed. Standardized questions captured participants’ perceptions of mental health symptoms, barriers and facilitators to care seeking, and recommendations for improving mental health after sPTB.

Results: Of 47 eligible participants, 13 (27.7%) completed screening and interviews. Interrater reliability scores showed almost perfect coding agreement (mean kappa 0.99 (SD 0.01)). Participants experienced self-blame, isolation, and prolonged duration of mental health symptoms (Table 1). Participants noted disrespectful communication and a lack of mental health resources. They felt dismissed and neglected while seeking care and experienced medical racism. These barriers negatively impacted their mental health and decreased their desire to re-engage with the healthcare system. Personalized care, family-centered communication, and racial representation facilitated care. Participants recommended improved patient-provider communication, specialized mental health providers, support groups, and culturally sensitive care.

Conclusion: Black women with a sPTB endured prolonged mental health sequelae, worsened by neglect, dismissiveness, and medical racism. Implementing explanatory communication models, providing culturally responsive care, support groups, and sPTB-trained mental health providers are needed.