Lulu Xu1, Esther Boama-Nyarko2, Grace A Masters3, Tiffany A Moore Simas4, Christine M Ulbricht5, Nancy Byatt6. 1. Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States. Electronic address: wanlu.xu@umassmed.edu. 2. Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States. Electronic address: Esther.Boama-Nyarko@umassmed.edu. 3. Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States. Electronic address: Grace.Masters@umassmed.edu. 4. Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Obstetrics & Gynecology, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Pediatrics, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Obstetrics & Gynecology, UMass Memorial Health Care, Worcester, MA 01655, United States. Electronic address: TiffanyA.MooreSimas@umassmemorial.org. 5. Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States. Electronic address: christine.ulbricht@nih.gov. 6. Department of Psychiatry, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Obstetrics & Gynecology, University of Massachusetts Chan Medical School, 55 Lake Avenue, Worcester, MA 01655, United States; Department of Psychiatry, UMass Memorial Health Care, Worcester, MA 01655, United States. Electronic address: Nancy.Byatt@umassmemorial.org.
Abstract
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.
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.
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