Exploring the Feasibility of Adapting and Implementing an Effective Postpartum Depression Evidence-based Intervention for Black Mothers

Abstract

maternal health. African American women are 5.2 times more likely to die from pregnancy related causes and 1 out of 3 are impacted by postpartum depression, as compared to 1 out of 7 White women. Scholarly research supports the lived experiences and prolonged exposure to chronic stress due to racism, sexism, discrimination, and oppression impact African American women’s overall health and maternal health. Despite these risks, there are no evidence-based treatment interventions specific to Black women with postpartum depression. This project addresses this gap. Guided by the first 4 phases of the ADAPT-ITT intervention adaptation framework, community based participatory research approach, intersection theory, Black feminist thought and ecological systems theory, this project describes the formative work done in collaboration with Black mothers with recent histories of postpartum depression (n=6) to culturally tailor an existing evidence based perinatal treatment intervention for use with Black mothers specifically. The Mothers and Babies course, the intervention in question, is an 8-week, facilitator led, group course grounded in cognitive behavioral therapy, attachment theory and the Reality Management approach. In the current study, two focus groups were conducted virtually with the same participants (n=6). Participants were college educated, middle-class African American women ranging in age from 30-44 years old who self-identified as having postpartum depression within the last 3 years. Topics that pertained to Black women, motherhood, and postpartum depression such as the Superwoman schema, systemic discrimination and the influence of maternal figures were introduced and discussed during the focus groups. Focus groups were recorded, transcribed, thematically coded, and the emergent used to guide and introduce cultural congruent themes to the intervention. The findings from this project suggest most interventions of this sort pilot studies with populations of low-income women, leaving middle class women unaccounted for while they are also greatly impacted by postpartum depression. Policy change recommendations include expanding funding for group focused research efforts, organizations, and programs to implement culturally tailored interventions for all women experiencing postpartum depression to make services more accessible. Implications for social workers and researchers include conducting more group focused research, addressing implicit bias, and culturally tailoring current interventions and theoretical frameworks to speak to Black women’s experiences using an ecological systems theory lens.