For a staggering number of women, pregnancy is not a time of joy. Women often struggle with stress, depression and anxiety during pregnancy, and this maternal mental health distress can persist a year after giving birth. According to the Centers for Disease Control and Prevention, rates of depression among new moms increased seven-fold from 2000 to 2015. Twice as many low-income African American women experience maternal mental distress (stress, depression anxiety), and the health disparity has been magnified by the COVID-19 pandemic. Experiencing mental health concerns can lead to negative effects on health for both mother and her baby and changes the infant’s developing brain in worrisome ways.
Yet low-income Black women are less likely to receive screening or have available treatment during this critical period - especially in the District of Columbia. Even when stress, anxiety or depression are identified, many women are not adequately treated because they face obstacles daily in life and distrust healthcare providers or the system. Fortunately, we have the tools to effectively find and treat these women, and intervening early can help D.C. babies enjoy the strongest start at life.
We’ll track health - including mental health - of moms starting during pregnancy and will monitor how their newborns develop.
Our overall goal is to partner with former patients, moms with experience giving birth in D.C., and other members of low-income Black communities to develop and test different approaches to overcome obstacles and achieve health equity by providing effective mental health screening and care. We have two major aims. First, we want to personalize plans that combine patient navigation and a culturally adapted cognitive-behavioral intervention for low-income Black pregnant women designed to boost recruitment and retention within the healthcare system.
Second, our prospective randomized controlled study design will help women in two ways, comparing usual care with care guided by a patient navigator that includes culturally adapted cognitive-behavioral interventions and peer support. Women get to choose the type of support that best fits their lifestyle, virtual or in person.
Our patient partners spoke loudly and clearly: It’s too difficult to get mental health care in D.C., and it ends too quickly. So, participants will remain in the study up to 12 months after delivery. And our study also will include women who do not yet meet criteria for being diagnosed with major depression or anxiety. #NoMotherLeftBehind.
Our diverse team will include patients; community leaders; midwives and doctors who treat women during pregnancy and their infants after birth; psychologists; and advisers skilled at transforming health care to better meet patient’s unique needs, ensuring insurance covers it and ramping up software so it can be used by more people nationwide.