Perinatal Behavioral Health, the COVID-19 Pandemic, and a Social Determinants of Health Framework

Abstract

The United States has greater prevalence of mental illness and substance use disorders than other developed countries, and pregnant women are disproportionately affected. The current global COVID-19 pandemic, through the exacerbation of psychological distress, unevenly affects the vulnerable population of pregnant women. Social distancing measures and widespread closures of businesses secondary to COVID-19 are likely to continue for the foreseeable future and to further magnify psychosocial risk factors. We propose the use of a social determinants of health framework to integrate behavioral health considerations into prenatal care and to guide the implementation of universal and comprehensive psychosocial assessment in pregnancy. As the most numerous and well-trusted health care professionals, nurses are ideally positioned to influence program and policy decisions at the community and regional levels and to advocate for the full integration of psychosocial screening and behavioral health into prenatal and postpartum care as core components.

Integrating Mental Health Care in Ambulatory Obstetrical Practices: Strategies and Models

“…26,27 HEALTH EQUITY Race and ethnicity impact pregnancy experiences and birth outcomes, and there are known racial/ethnic health inequalities among BIPOC individuals. 28 Poor maternal health outcomes are more common in black women, including higher infant mortality rates and a 3 to 4 times higher maternal death rate. 28 While depression and anxiety disorders are the most common pregnancy complications, studies suggest higher prevalence rates in black and Hispanic women.…”

“…28 Poor maternal health outcomes are more common in black women, including higher infant mortality rates and a 3 to 4 times higher maternal death rate. 28 While depression and anxiety disorders are the most common pregnancy complications, studies suggest higher prevalence rates in black and Hispanic women. 28 However, BIPOC patients are less likely to seek outpatient mental health care and more likely to disclose BH concerns to primary care or OB/Gyn providers.…”

Context Matters: Assessing the Association Between Area Deprivation and the Severity of Injury and Types of Domestic Violence Victimization Among Women

“…Fourth, resources to promote women’s emotional health and healthy coping with the wide range of pandemic-related experiences are needed. Nurses are uniquely positioned to influence program and policy decisions at the local and regional levels (Ruyak & Kivlighan, 2021), as well as advocate for the full integration of psychosocial screening and behavioral health as core components. We advocate for interventions such as telemedicine services that focus on ensuring the continuity of essential services and strengthening support systems for vulnerable groups, including male perpetrators, in order to reduce the collateral impact of domestic violence in low-income communities.…”

experience of midwife in delivering the midwifery care of mental illness of pregnant women and post-partum during the pandemic of COVID-19

“…It is estimated that half of postpartum depression cases are started during pregnancy. The most trusted health care professionals, nurses and midwives are idealistically positioned in influencing program and policy decisions at the community and regional levels and to improve integration of psychosocial screening and attitude health into prenatal and postpartum care as the focus pursued by health workers (Ruyak and Kivlighan, 2021). The incidence of perinatal depression occurs in about 13 percent of women, although some studies show that perinatal anxiety is about 22% percent of women.…”