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Quiray J, Richards E, Navarro-Aguirre Y, Glazer D, Adachi J, Trujillo E, Perera D, Garcia EP, Bhat A. The role of doulas in supporting perinatal mental health - a qualitative study. Front Psychiatry 2024; 15:1272513. [PMID: 38487585 PMCID: PMC10937562 DOI: 10.3389/fpsyt.2024.1272513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
Objective The perinatal period presents several opportunities to identify and treat perinatal mental health and substance use disorders by integrating into existing care pathways. We aimed to examine the role of birth doulas in supporting their clients' perinatal mental health. Methods Thematic content analysis of focus groups with doulas, and interviews with doula clients was used to characterize the doula-client relationship, investigate whether and how doulas provide mental health and substance use support, and identify barriers and recommendations for doulas to support their clients' mental health. Participants were doula clients from communities underserved due to race, income, language and culture. Results Doulas and clients reported positive relationships, supported by congruence in culture, language, and lived experiences. Doulas varied in their confidence in identifying perinatal mental health problems, though most agreed that doulas could support their clients' mental health to different degrees. Barriers to engaging in perinatal mental health treatments included low perceived need and socio-economic burden. Conclusions With adequate support and training, doulas can play an important role in supporting their client's emotional well-being.
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Affiliation(s)
- Joanne Quiray
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Elizabeth Richards
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Yesenia Navarro-Aguirre
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Debra Glazer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Jamie Adachi
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Emily Trujillo
- Open Arms Perinatal Services, Seattle, WA, United States
| | - Dila Perera
- Open Arms Perinatal Services, Seattle, WA, United States
| | | | - Amritha Bhat
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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Haiman MD, Johnson KA, Horan H, Bradley LJ, Albright DL. Addressing Gaps and Saving Lives: Doulas' Role in Addressing Substance Use and Mental Health Challenges Among Pregnant and Postpartum Clients-A Scoping Review. Matern Child Health J 2024; 28:246-252. [PMID: 37948022 DOI: 10.1007/s10995-023-03832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Doulas are a potential resource for addressing substance use and mental health challenges that pregnant and postpartum individuals experience. We sought to review peer-reviewed literature that examines Doulas' role in addressing these challenges to highlight the need for more research in this area. METHODS We conducted a scoping review (2001-2021) to identify articles that examine the way in which Doulas address maternal substance use and mental health challenges in their clients. The articles were reviewed by two members of the research team. RESULTS Nine articles describing Doulas' role in addressing substance use and mental health challenges were identified. Six described Doulas' role in addressing mental health, five of which saw positive mental health outcomes due to Doula involvement. One additional article recommended Doulas be considered in the future to address mental health challenges. While the minority of articles addressed substance use (n = 2), it was reported that Doulas were a positive addition to interdisciplinary teams addressing substance use challenges with pregnant individuals. CONCLUSIONS While the literature showed that Doulas can improve substance use and mental health outcomes among pregnant or postpartum individuals, a significant gap remains in research, practice, and peer-reviewed literature addressing this issue.
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Affiliation(s)
- Madison D Haiman
- Steve Hicks School of Social Work, The University of Texas, 1925 San Jacinto Blvd, Austin, TX, 78712, USA
| | - Karen A Johnson
- School of Social Work, The University of Alabama, Box 870314, Tuscaloosa, AL, 35487-0314, USA
| | - Holly Horan
- Heersink School of Medicine, The University of Alabama at Birmingham, 619 19th ST South, Birmingham, AL, 35249, USA
| | - Lilanta Joy Bradley
- Department of Community Medicine and Population Health, The University of Alabama, 1138 NE Medical Building, 211 Peter Bryce Blvd, Tuscaloosa, AL, 35401, USA
| | - David L Albright
- Department of Political Sciences, The University of Alabama, Tuscaloosa, AL, USA.
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Temple JA, Varshney N. Using Prevention Research to Reduce Racial Disparities in Health Through Innovative Funding Strategies: The Case of Doula Care. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:108-118. [PMID: 36757659 PMCID: PMC11303420 DOI: 10.1007/s11121-023-01497-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/10/2023]
Abstract
Racial disparities in maternal birth outcomes are substantial even when comparing women with similar levels of education. While racial differences in maternal death at birth or shortly afterward have attracted significant attention from researchers, non-fatal but potentially life-threatening pregnancy complications are 30-40 times more common than maternal deaths. Black women have the worst maternal health outcomes. Only recently have health researchers started to view structural racism rather than race as the critical factor underlying these persistent inequities. We discuss the economic framework that prevention scientists can use to convince policymakers to make sustainable investments in maternal health by expanding funding for doula care. While a few states allow Medicaid to fund doula services, most women at risk of poor maternal health outcomes arising from structural racism lack access to culturally sensitive caregivers during the pre-and post-partum periods as well as during birth. We provide a guide to how research in health services can be more readily translated to policy recommendations by describing two innovative ways that cost-benefit analysis can help direct private and public funding to support doula care for Black women and others at risk of poor birth outcomes.
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Affiliation(s)
- Judy A Temple
- Humphrey School of Public Affairs and Human Capital Research Collaborative, University of Minnesota - Twin Cities, 301-19th Avenue South, MN, 55455, Minneapolis, USA.
| | - Nishank Varshney
- Humphrey School of Public Affairs and Human Capital Research Collaborative, University of Minnesota - Twin Cities, 301-19th Avenue South, MN, 55455, Minneapolis, USA
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Promotion and Prevention of Perinatal Mood and Anxiety Disorders: Doulas’ Roles and Challenges. J Perinat Educ 2022; 31:82-93. [PMID: 35386494 PMCID: PMC8970132 DOI: 10.1891/jpe-2021-00058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Doulas are uniquely positioned to support women during birth and the postpartum period and can serve as a great asset to identify symptoms of perinatal mood and anxiety disorders (PMADs) and refer women to treatment. The goal of this study is to increase knowledge of doulas’ training on PMADs and their work with women who experienced symptoms. Results from a survey of 156 doulas and interviews with 27 doulas indicate that they felt ill-prepared to identify PMAD symptoms. They struggled in referring patients to the appropriate services and finding professional support related to supporting clients with PMADs. The study concludes that there is a need to develop a standardized model for postpartum doula care that explicitly addresses PMADs.
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Mills R, Haga SB. Qualitative user evaluation of a revised pharmacogenetic educational toolkit. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2018; 11:139-146. [PMID: 30214267 PMCID: PMC6128278 DOI: 10.2147/pgpm.s169648] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Introduction Pharmacogenetic (PGx) testing is a leading application for personalized and precision medicine; however, there are barriers, including limited provider and patient understanding, which affect its uptake. There is a need for tools that can enhance the patient and provider experience with testing and promoting the shared and informed decision-making. Materials and methods In this study, we sought to gather additional feedback on a PGx toolkit comprised of four educational tools that had been previously evaluated through an online survey by pharmacists. Specifically, we conducted semi-structured interviews with pharmacists and members of the public regarding their understanding and utility of the toolkit and its individual components. Results Participants found three of the four toolkit components, a test information sheet, flipbook, and results sheet, to be useful and important. The fourth component, results card, was viewed less favorably. Participants differed in their preference for medical jargon and detailed results nomenclature (namely star * alleles). Conclusion User input during the development of educational materials is essential for optimizing utilization, effectiveness, and comprehension.
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Affiliation(s)
- Rachel Mills
- Duke Center for Applied Genomics and Precision Medicine, Duke University Medical Center, Durham, NC, USA,
| | - Susanne B Haga
- Duke Center for Applied Genomics and Precision Medicine, Duke University Medical Center, Durham, NC, USA,
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Karaçam Z, Çoban A, Akbaş B, Karabulut E. Status of postpartum depression in Turkey: A meta-analysis. Health Care Women Int 2018; 39:821-841. [DOI: 10.1080/07399332.2018.1466144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Zekiye Karaçam
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Ayden Çoban
- Department of Midwifery, Faculty of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Burcu Akbaş
- Department of Midwifery, Institute of Health Sciences, Adnan Menderes University, Aydın, Turkey
| | - Erdem Karabulut
- Medical Faculty Department of Biostatistics, Hacettepe University, Ankara, Turkey
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Top ED, Karaçam Z. Effectiveness of Structured Education in Reduction of Postpartum Depression Scores: A Quasi-Experimental Study. Arch Psychiatr Nurs 2016; 30:356-62. [PMID: 27256941 DOI: 10.1016/j.apnu.2015.12.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 09/16/2015] [Accepted: 12/17/2015] [Indexed: 12/21/2022]
Abstract
The aim of this study was to evaluate effectiveness of structured education in reduction of postpartum depression scores among women. This was a quasi-experimental study with a pre-post tests and a control group. Non-random sampling was used and the study included a total of 103 Turkish women, 52 of whom were in the intervention group and 51 were in the control group. The women in the intervention group were offered structured education for postpartum depression and given structured education material. Effectiveness of the education given was evaluated by comparing scores for Edinburg Postpartum Depression Scale obtained before and after delivery between the intervention and the control groups. Before education, median score (8.0±4.8) for Edinburg Postpartum Depression Scale of the intervention group were significantly higher the than the control group (6.0±6.0, p=0.010), but the groups were statistically similar in terms of having depression (intervention: 17.3%, control: 11.8%, p=0.425). After education, the median score for Edinburg Postpartum Depression Scale and the ratio of the women having depression in the intervention group were significantly lower than in the control group (respectively intervention: 4.0±3.0, control: 10.0±4.0, p=0.000; intervention: 7.7%, control: 25.5%, p=0.015). Besides, the median score (8.0±4.8) of the intervention group before education were significantly higher than the score (4.0±3.0) obtained after education (p=0.000), while the median score (6.0±6.0) of the control group before education were lower than the score (10.0±4.0) obtained after education (p=0.000). This study revealed that structured education offered to women by nurses was effective in reducing the postpartum depression scores and the numbers of women having depression.
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Affiliation(s)
- Ekin Dila Top
- İzmir Katip Çelebi University Faculty of Health Sciences, Division of Nursing, İzmir, Turkey
| | - Zekiye Karaçam
- Adnan Menderes University Aydın School of Health, Division of Midwifery, Aydın, Turkey.
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Ryu KH, Shin HS, Yang EY. Effects of Laughter Therapy on Immune Responses in Postpartum Women. J Altern Complement Med 2015; 21:781-8. [PMID: 26496141 DOI: 10.1089/acm.2015.0053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To examine the effects of laughter therapy on secretory IgA (sIgA) in postpartum women. METHODS The study used a nonequivalent control group with nonsynchronized design. The participants were 76 postpartum women who agreed to participate in this study and were selected by convenience sampling (experimental group, n = 38; control group, n = 38). The data were collected from December 15, 2009, to April 8, 2010. The experimental group participated in a postpartum laughter program from a laughter therapy expert for 60 minutes per session, twice a week for 2 weeks, for a total of four sessions. To evaluate the effects of the postpartum laughter program, sIgA levels in breast milk were measured. The data were analyzed using SPSS WIN 20.0 software. RESULTS Immune response (sIgA) significantly differed between the experimental and control groups. CONCLUSION A postpartum laughter program can be applied as a complementary and alternative intervention to postpartum women in a transitional mother-infant care center.
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Affiliation(s)
- Kyung Hee Ryu
- 1 Department of Nursing, Seojeong College at Korea , Gyeonggi Province, Korea
| | - Hye Sook Shin
- 2 College of Nursing Science, Kyung Hee University at Korea , Seoul, Korea
| | - Eun Young Yang
- 3 Department of Nursing, Sahmyook Health College at Korea , Seoul, Korea
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Improvement in Depressive Symptoms Among Hispanic/Latinos Receiving a Culturally Tailored IMPACT and Problem-Solving Intervention in a Community Health Center. Community Ment Health J 2015; 51:385-92. [PMID: 25107309 PMCID: PMC4321971 DOI: 10.1007/s10597-014-9750-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 06/17/2014] [Indexed: 01/08/2023]
Abstract
The present study investigated whether a culturally-tailored problem-solving intervention delivered by a trained depression care specialist (DCS) would improve depressive symptoms over a 6 month period among Hispanic/Latino patients in a federally-qualified community health center by the California-Mexico border. Participants included 189 low income Hispanic/Latino patients of Mexican heritage. Based on the improving mood-promoting access to collaborative treatment (IMPACT) evidence-based treatment, patients received evidence-based problem-solving therapy. The Patient Health Questionnaire-9 (PHQ-9) was administered to assess changes in self-reported depressive symptoms between baseline and monthly for a 6-month follow up period. The majority of participants were female (72.5%) with a mean age of 52.5 (SD = 11.7). The mean PHQ-9 at baseline was 16.9 (SD = 4.0) and at the 6-month follow-up, the average PHQ-9 decreased to 9.9 (SD = 5.7). A linear mixed model analysis showed significant improvement in PHQ-9 scores over a 6 month period (F = 124.1; p < 0.001) after controlling for age, gender, smoking and diabetes. There was a significant three way interaction between time, gender and smoking (p = 0.01) showing that the depressive symptoms among male smokers did not improve as much as non-smoking males and females. Results suggest that a culturally-tailored problem solving approach can significantly reduce depressive symptoms among Hispanic/Latino low-income patients.
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Martin A, Horowitz C, Balbierz A, Howell EA. Views of women and clinicians on postpartum preparation and recovery. Matern Child Health J 2015; 18:707-13. [PMID: 23775250 DOI: 10.1007/s10995-013-1297-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To explore important domains of women's postpartum experiences as perceived by postpartum mothers and obstetricians/midwives, and to investigate how postpartum care could enhance patient preparation for the postpartum period. Qualitative research study was conducted to explore women's and clinicians' perceptions of the postpartum experience. Four focus groups of postpartum women (n = 45) and two focus groups of obstetric clinicians (n = 13) were held at a large urban teaching hospital in New York City. All focus groups were audio recorded, transcribed, and analyzed using grounded theory. Four main themes were identified: lack of women's knowledge about postpartum health and lack of preparation for the postpartum experience, lack of continuity of care and absence of maternal care during the early postpartum period, disconnect between providers and postpartum mothers, and suggestions for improvement. Mothers did not expect many of the symptoms they experienced after childbirth and were disappointed with the lack of support by providers during this critical time in their recovery. Differences existed in the major postpartum concerns of mothers and clinicians. However, both mothers and clinicians agreed that preparation during the antepartum period could be beneficial for postpartum recovery. Results from this study indicate that many mothers do not feel prepared for the postpartum experience. Study findings raise the hypothesis that capturing patient-centered domains that define the postpartum experience and integrating these domains into patient care may enhance patient preparation for postpartum recovery and improve postpartum outcomes.
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Affiliation(s)
- Anika Martin
- Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA
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Corrigan CP, Kwasky AN, Groh CJ. Social Support, Postpartum Depression, and Professional Assistance: A Survey of Mothers in the Midwestern United States. J Perinat Educ 2015; 24:48-60. [PMID: 26937161 PMCID: PMC4720860 DOI: 10.1891/1058-1243.24.1.48] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Transition into motherhood is generally a joyful life event; for some women, however, it is marked by emotional turmoil. Lack of support can be associated with postpartum depression and can compromise both the mother and infant. A descriptive, cross-sectional study (N = 61) was conducted to explore the relationship between social support and postpartum depression and to determine whether mothers overwhelmed with childcare, or overwhelmed with life in general since becoming a mother, sought professional help. The results revealed that screening for depression alone may not be sufficient, that mothers are willing to contact a professional for help in the postpartum period, and that assessments after birth should include a broader assessment of life's difficulties rather than focusing on childcare responsibilities alone.
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Bocknek EL, Hossain Z, Roggman L. Forward progress of scientific inquiry into the early father-child relationship: introduction to the special issue on very young children and their fathers. Infant Ment Health J 2014; 35:389-93. [PMID: 25798490 DOI: 10.1002/imhj.21475] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Research on fathering and the father-child relationship has made substantial progress in the most recent 15 years since the last special issue of the Infant Mental Health Journal on fathers and young children. This special issue on fathers and young children contains a series of papers exemplifying this progress, including advances in methodology-more direct assessment and more observational measures-in addition to the increasing dynamic complexity of the conceptual models used to study fathers, the diversity of fathers studied, and the growth of programs to support early father involvement. In assessing the current state of the field, special attention is given to contributions made by the papers contained in this special issue, and two critical areas for continued progress are addressed: (1) methodological and measurement development that specifically address fathers and fathering relationships and (2) cross-cultural and ecologically valid research examining the diversity of models of fathering.
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