Taxonomy of access to mental healthcare for economically marginalized women during a public health crisis: a qualitative study of obstetric professionals and perinatal women during the COVID-19 pandemic

Information from the abstract

Background Mood and anxiety disorders are the most common pregnancy complications in the United States. Global public health crises increase the risk of these disorders, impact obstetric professionals that serve perinatal women, and introduce new challenges to accessing mental healthcare, particularly for economically marginalized perinatal women. Accordingly, the study purpose is to develop a taxonomy of mental healthcare access during public health crises for economically marginalized perinatal women. Methods In-depth interviews were conducted with obstetric professionals (n=14) serving economically marginalized perinatal women during the COVID-19 pandemic. Our research team employed a modified grounded theory to develop a taxonomy comprising dimensions, components and factors for perinatal mental healthcare access. Results from obstetric professionals were then triangulated with data from economically marginalized perinatal women (n=24) who attempted to access mental healthcare during the COVID-19 pandemic. Results Obstetric professionals enumerated factors related to a six dimension taxonomy of access, including approachability, availability, affordability, accessibility, accommodation, and acceptability. Dimensions were triangulated and found to align with experiences of perinatal women. Each dimension included multiple components and factors influential to the respective component. For example, the dimension of affordability included direct mental healthcare costs (the component) which reportedly increased for patients due to a rise in un- and under-employment and loss of employer-sponsored health insurance (the factors). Conclusion Findings highlight opportunities for policymakers and healthcare professionals to identify components impacted across the six dimensions of access for economically marginalized perinatal women and respond to the factors influential. Interventions could include ongoing support to normalize mental healthcare, collaborations with community-based organizations, prioritization of patient-centered and collaborative care models.

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Related topics: Maternal Mental Health During Pregnancy and Postpartum · COVID-19 Impact on Reproduction · COVID-19 and Mental Health