Black Women's Mental Health Needs and Recommendations After Spontaneous Preterm Birth: A Qualitative Study.

Abstract

To ascertain the perspectives and recommendations of Black individuals on their experience of spontaneous preterm birth (sPTB) and its impact on maternal mental health (MMH). Qualitative interview study. One tertiary hospital in the United States of America. Self-identified Black women who experienced sPTB between 24w0d and 33w6d of gestation from July 2020 to July 2022; participants were at least 18 years old and English-speaking. Using a semi-structured interview guide grounded in the Sojourner Syndrome and the emancipatory paradigm, we explored perceptions of mental health symptoms, barriers and facilitators to MMH, and recommendations for improvement after sPTB. Data were analysed using modified grounded theory methodology, ensuring rigor through interrater reliability. Black women's experiences of mental health following sPTB, barriers and facilitators to MMH, and their recommendations for improving MMH after sPTB. Thirteen interviews were completed, averaging 1.5 years post-delivery. Interrater reliability showed almost perfect coding agreement (mean kappa 0.99 (SD 0.01)). Participants experienced self-blame, anxiety, isolation, and prolonged duration of mental health symptoms. Dismissiveness, neglect, and medical racism were mental health barriers. Person-centred care, family-centred care and racial congruency were mental health facilitators. Participants recommended transparent communication, specialised mental health providers, support groups, and culturally sensitive care to improve MMH. Black women with sPTB endured prolonged mental health sequelae heightened by neglect, dismissiveness, and medical racism. Participants recommended implementing family-centred, transparent care models with cultural sensitivity, support groups, and specialised mental health providers as ways to improve postpartum mental health.