A qualitative study of minority ethnic women's experiences of access to and engagement with perinatal mental health care

TY - JOUR

T1 - A qualitative study of minority ethnic women's experiences of access to and engagement with perinatal mental health care

AU - Pilav, Sabrina

AU - De Backer, Kaat

AU - Easter, Abigail

AU - Silverio, Sergio A.

AU - Sundaresh, Sushma

AU - Roberts, Sara

AU - Howard, Louise

N1 - Funding Information: Sabrina Pilav, Kaat De Backer, Dr. Abigail Easter, Prof. Louise M. Howard, and Sergio A. Silverio (King’s College London) are currently supported by the National Institute for Health Research Applied Research Collaboration South London [NIHR ARC South London] at King’s College Hospital NHS Foundation Trust. Kaat De Backer (King’s College London) was supported by NIHR East of England Applied Research Collaboration [NIHR ARC East of England] at Cambridgeshire and Peterborough NHS Foundation Trust. The views expressed are those of the author[s] and not necessarily those of the NIHR or the Department of Health and Social Care. Sabrina Pilav and the wider service evaluation were funded through the NHSE/ the NHS perinatal service we worked with. Publisher Copyright: © 2022, The Author(s).

PY - 2022/5/18

Y1 - 2022/5/18

N2 - BACKGROUND: Approximately one in five women will experience mental health difficulties in the perinatal period. However, for a large group of women, symptoms of adverse perinatal mental health remain undetected and untreated. This is even more so for women of ethnic minority background, who face a variety of barriers which prevents them from accessing appropriate perinatal mental health care.AIMS: To explore minority ethnic women's experiences of access to and engagement with perinatal mental health care.METHODS: Semi-structured interviews were conducted with 18 women who had been diagnosed with perinatal mental health difficulties and who were supported in the community by a specialist perinatal mental health service in South London, United Kingdom. Women who self-identified as being from a minority ethnic group were purposefully selected. Data were transcribed verbatim, uploaded into NVivo for management and analysis, which was conducted using reflective thematic analysis.RESULTS: Three distinct overarching themes were identified, each with two or three subthemes: 'Expectations and Experiences of Womanhood as an Ethnic Minority' (Shame and Guilt in Motherhood; Women as Caregivers; Perceived to Be Strong and Often Dismissed), 'Family and Community Influences' (Blind Faith in the Medical Profession; Family and Community Beliefs about Mental Health and Care; Intergenerational Trauma and Family Dynamics) and 'Cultural Understanding, Empowerment, and Validation' (The Importance of Understanding Cultural Differences; The Power of Validation, Reassurance, and Support).CONCLUSION: Women of ethnic minority background identified barriers to accessing and engaging with perinatal mental health support on an individual, familial, community and societal level. Perinatal mental health services should be aware ethnic minority women might present with mental health difficulties in different ways and embrace principles of cultural humility and co-production to fully meet these women's perinatal mental health needs.

AB - BACKGROUND: Approximately one in five women will experience mental health difficulties in the perinatal period. However, for a large group of women, symptoms of adverse perinatal mental health remain undetected and untreated. This is even more so for women of ethnic minority background, who face a variety of barriers which prevents them from accessing appropriate perinatal mental health care.AIMS: To explore minority ethnic women's experiences of access to and engagement with perinatal mental health care.METHODS: Semi-structured interviews were conducted with 18 women who had been diagnosed with perinatal mental health difficulties and who were supported in the community by a specialist perinatal mental health service in South London, United Kingdom. Women who self-identified as being from a minority ethnic group were purposefully selected. Data were transcribed verbatim, uploaded into NVivo for management and analysis, which was conducted using reflective thematic analysis.RESULTS: Three distinct overarching themes were identified, each with two or three subthemes: 'Expectations and Experiences of Womanhood as an Ethnic Minority' (Shame and Guilt in Motherhood; Women as Caregivers; Perceived to Be Strong and Often Dismissed), 'Family and Community Influences' (Blind Faith in the Medical Profession; Family and Community Beliefs about Mental Health and Care; Intergenerational Trauma and Family Dynamics) and 'Cultural Understanding, Empowerment, and Validation' (The Importance of Understanding Cultural Differences; The Power of Validation, Reassurance, and Support).CONCLUSION: Women of ethnic minority background identified barriers to accessing and engaging with perinatal mental health support on an individual, familial, community and societal level. Perinatal mental health services should be aware ethnic minority women might present with mental health difficulties in different ways and embrace principles of cultural humility and co-production to fully meet these women's perinatal mental health needs.

KW - perinatal mental health

KW - minority ethnic women

KW - maternity services

KW - qualitative analysis

UR - http://www.scopus.com/inward/record.url?scp=85130246194&partnerID=8YFLogxK

U2 - 10.1186/s12884-022-04698-9

DO - 10.1186/s12884-022-04698-9

M3 - Article

C2 - 35585579

SN - 1471-2393

VL - 22

SP - 1

EP - 13

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

IS - 1

M1 - 421

ER -