Table_1_Black Perinatal Mental Health: Prioritizing Maternal Mental Health to Optimize Infant Health and Wellness.pdf

Infant mental health is interconnected with and affected by maternal mental health. A mother or birthing person's mental health before and during pregnancy and the postpartum period is essential for a child's development. During the first year of life, infants require emotional attachment and bonding to strive. Perinatal mood disorders are likely to hinder attachment and are associated with an increased risk of adverse mental health effects for children later in life. The Black community is faced with a crisis as Black mothers experience a higher prevalence of perinatal mood disorders, including postpartum depression and anxiety, compared to the United States national estimates. The aim of the research is to identify social, structural, and economic disparities of Black perinatal women and birthing people's experience to understand the impact of perinatal mental health on infants' mental health. Black mothers and birthing people may often face social and structural barriers that limit their opportunity to seek and engage with interventions and treatment that address the root causes of their perinatal mood disorder. To enhance understanding of racial disparities caused by social and structural determinants of health on Black mothers and birthing people's mental health and health care experiences that influence infant mental health, the study team conducted semi-structured interviews among self-identified cisgender Black women health professionals nationwide, who provide care to pregnant or postpartum Black women and birthing people. Our study attempted to identify themes, pathways, interventions, and strategies to promote equitable and anti-racist maternal and infant mental health care. Using a Rigorous and Accelerated Data Reduction (Radar) technique and a deductive qualitative analytic approach it was found that limited access to resources, lack of universal screening and mental health education, and the disjointed healthcare system serves as barriers, contribute to mental health issues, and put Black mothers and birthing people at a disadvantage in autonomous decision making. Our study concluded that instituting education on healthy and culturally appropriate ways to support infant development in parent education programs may support Black parents in establishing healthy attachment and bonds. Prioritizing strategies to improve maternal mental health and centering Black parents in developing these educational parenting programs may optimize parenting experiences.

婴儿心理健康与孕产妇心理健康紧密关联且受其影响。孕妇或分娩者在孕前、孕期及产后阶段的心理健康状况，对儿童发育至关重要。婴儿在生命首年需要建立情感依恋与联结以实现健康成长。围产期情绪障碍（perinatal mood disorders，包括产后抑郁与焦虑）极易阻碍情感依恋的建立，且与儿童日后出现不良心理健康结局的风险升高存在显著关联。美国黑人社区正面临一场严峻危机：相较于美国全国统计数据，黑人母亲的围产期情绪障碍患病率更高。本研究旨在明确黑人围产期女性及分娩者在相关经历中所遭遇的社会、结构与经济层面的差异，以厘清围产期心理健康对婴儿心理健康的影响机制。黑人母亲与分娩者往往会面临社会与结构性障碍，这限制了他们寻求并参与针对围产期情绪障碍根源的干预与治疗的机会。为加深对健康的社会与结构决定因素（social and structural determinants of health）所引发的种族差异的理解，以及这些差异如何通过影响黑人母亲与分娩者的心理健康及医疗照护体验进而作用于婴儿心理健康，研究团队在全美范围内，针对为黑人孕妇及产后女性提供照护的自我认同为顺性别（cisgender）的黑人女性医疗从业者开展了半结构化访谈（semi-structured interviews）。本研究旨在识别可推动公平且反种族主义式孕产妇与婴儿心理健康照护（anti-racist maternal and infant mental health care）的核心主题、作用路径、干预措施与优化策略。本研究采用严格加速数据缩减法（Rigorous and Accelerated Data Reduction, Radar）与演绎式定性分析方法（deductive qualitative analytic approach）开展分析，结果显示：资源获取受限、普遍筛查与心理健康教育的缺失、以及碎片化的医疗体系均构成障碍，加剧了心理健康问题，并使黑人母亲与分娩者在自主决策方面处于不利地位。本研究提出，在家长教育项目中纳入支持婴儿发育的健康且符合文化适配性的相关教育内容，或可帮助黑人父母建立健康的情感依恋与联结。优先制定改善孕产妇心理健康的策略，并让黑人父母主导这类育儿教育项目的开发，或可优化育儿体验。