Psychological needs fulfillment and perinatal well-being among low-SES individuals: a mixed methods investigation

Poor perinatal mental health is associated with deleterious effects and individuals with low socioeconomic status (SES) are at elevated risk. Fortifying multi-level resources of low-SES pregnant individuals to boost their well-being is a crucial step toward achieving equity in perinatal health. The purpose of this project was to explore what patterns of resources supported well-being among low-SES pregnant individuals in Colorado. In a prospective mixed methods cohort study, 23 low-SES pregnant individuals completed surveys and interviews. Participants were separated into 3 subgroups based on their overall Warwick-Edinburgh Mental Well-being Scale (WEMWBS) score and interviewed to identify multi-level resources that supported their well-being. Our analysis was framed by Self-Determination Theory which contends that three universal basic psychological needs are required for individuals to function in a healthy manner: autonomy, competence, and relatedness. We extrapolated resources that promoted perinatal competence, autonomy, and relatedness from the high well-being group. Perinatal-related knowledge (construct related to competence); mindfulness and intended pregnancy (constructs related to autonomy); and emotional, informational, and friend support, social capital, and connection to nature (constructs related to relatedness) were identified as the resources more frequently endorsed in the high well-being group. Targeting interventions to fortify specific multi-level resources that support the autonomy, competence, and relatedness of pregnant individuals facing socioeconomic disadvantage is a crucial step toward achieving equity in perinatal health.

围产期心理健康状况不佳会引发诸多不良后果，而社会经济地位低下（SES）人群出现此类问题的风险显著升高。强化社会经济地位低下孕妇群体的多维度资源供给，以提升其心理健康福祉，是实现围产期健康公平的关键举措。本研究旨在探究美国科罗拉多州社会经济地位低下的孕妇群体中，哪些资源模式能够支撑其心理健康福祉。本研究采用前瞻性混合方法队列研究设计，共纳入23名社会经济地位低下的孕妇完成问卷调查与访谈。研究人员基于参与者的沃里克-爱丁堡心理健康量表（WEMWBS）总分将其划分为3个亚组，并通过访谈识别出能够支撑其心理健康福祉的多维度资源。本研究的分析框架基于自我决定理论（Self-Determination Theory），该理论指出，个体实现健康功能运转需满足三项普遍的基本心理需求：自主性、胜任感与关联性。我们从高福祉亚组中提取出了能够促进围产期胜任感、自主性与关联性的各类资源。研究发现，高福祉亚组中更常被提及的资源包括：与胜任感相关的围产期相关知识；与自主性相关的正念状态与计划内妊娠；与关联性相关的情感支持、信息支持、友人支持、社会资本以及自然联结。针对面临社会经济劣势的孕妇群体，强化能够支撑其自主性、胜任感与关联性的特定多维度资源干预措施，是实现围产期健康公平的关键路径。