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Our nation is facing a mental health crisis. This crisis is magnified for perinatal individuals who are pregnant or up to 1 year postpartum. Perinatal mood and anxiety disorders (PMADs) [...]

COVID-19 adversely impacted parents with substance use disorders (SUDs) as evidenced by increased overdoses. This study used a qualitative approach to examine COVID’s impact on experiences and perceptions of a parenting program designed for mothers in recovery from SUDs, “Mothering from the Inside Out” (MIO), implemented through Early Intervention (EI) home-visiting services. Four EI programs participated in training and implementation of MIO. Subjects included 10 eligible EI providers trained in August 2019 or August 2021 and 11 mothers in recovery from SUDs. More mothers completed MIO during the pandemic compared to before. We conducted inductive thematic analysis of exit interviews and field notes, along with interpretation of process measures of intervention implementation. Initially, the switch to telehealth negatively impacted the provider-parent relationship but made engagement logistically easier for some mothers. Parent and provider participants reported the need for additional psychosocial support due to increased stressors, as well as ways that MIO helped them cope during the pandemic. COVID made EI enrollment of families more difficult in general; however once enrolled, telehealth improved retention in MIO, meeting a critical need during the pandemic.

BACKGROUND: The objective of this study was to assess potential challenges, prioritize adaptations, and develop an implementation and research approach to integrate and study a parenting intervention for mothers in recovery from substance use disorders in community-based home-visiting programs. METHOD: An explanatory mixed-methods design, guided by process mapping with Failure Modes and Effects Analysis tools, and an Advisory Panel of 15 community members, identified potential implementation challenges and recommended solutions for the proposed intervention within five pre-specified domains. Thematic content analysis identified themes from detailed field notes. RESULTS: The Advisory Panel identified 44 potential challenges across all domains. They determined that the recruitment domain was most likely to create challenges. Regarding the potential challenges, two cross-domain themes emerged: (1) development of mistrust in the community and (2) difficulty initiating and sustaining engagement. Potential solutions and adaptations to protocols are reported. CONCLUSION: Mistrust in the community was cited as a potentially important challenge for the delivery and study of an evidence-based parenting intervention for mothers in recovery through home-visiting programs. Adaptations to research protocols and intervention delivery strategies are needed to prioritize the psychological safety of families, particularly for groups that have been historically stigmatized.

Objectives Few studies have elucidated the impact of work-related trauma on labor and delivery clinician or considered whether it may be a cause of burnout. This study aims to elicit labor and delivery clinician perspectives on the impact of exposure to traumatic births on their professional quality of life. Methods Labor and delivery clinicians (physicians, midwives, nurse practitioners, and nurses; n = 165) were recruited to complete an online questionnaire on experiences with traumatic births. The questionnaire contained measures from the Maslach Burnout Inventory and the professional quality of life scale version 5. Some participants completed an optional free-text prompt to recommend ways to support clinicians after traumatic births (n = 115). Others opted into a semi-structured phone interview (n = 8). Qualitative data was analyzed using a modified grounded theory approach. Results Self-reported adequate institutional support for clinicians after a traumatic birth was positively correlated with compassion satisfaction (r = 0.21, p < 0.01) and negatively correlated with secondary traumatic stress (r = - 0.27, p < 0.01), and burnout (r = - 0.26, p < 0.01). Qualitative themes included lack of system-wide and leadership support, lack of access to mental health resources, and suboptimal workplace culture as contributors toward secondary traumatic stress and burnout. Participants recommended proactive leadership, consistent debriefing protocols, trauma education, and improved access to counseling. Conclusions for Practice Multi-level barriers prevented labor and delivery clinicians from accessing needed mental health support after exposure to traumatic births. Proactive investment in healthcare system supports for clinicians may improve clinician professional quality of life., Author(s): Lulu Xu [sup.1] [sup.2] [sup.8] , Grace A. Masters [sup.1] [sup.2] , Tiffany A. Moore Simas [sup.1] [sup.2] [sup.3] [sup.4] [sup.7] , Aaron L. Bergman [sup.1] [sup.5] , Nancy [...]

Background: Various risk factors to perinatal mental health disorders have been described; however, there is a dearth of data on the perspectives of women themselves regarding what increases the risk of psychological distress. This qualitative study explores women's perceptions of factors that increase the risk of perinatal psychological distress. Aim: The aim of this study was to elucidate women's perceptions of factors that increase the risk of perinatal psychological distress. Methods: A qualitative design with an exploratory and descriptive approach is used. Women (N = 188) aged 18 to 45 years who self-report experiencing perinatal psychological distress complete an online survey. Results: Perceived causes of perinatal psychological distress include: adverse experiences with childbirth and/or breastfeeding, negative attitudes of people close to the participant, financial and social challenges, health challenges, staff behavior in a maternity hospital, a challenging baby, family circumstances, and the new role as mother. Conclusion: Women's perceived causes of perinatal psychological distress may allow for women-centered innovations in perinatal mental health care. The results highlight the need to train maternity staff regarding perinatal mental health and communication. These findings can serve as important guidelines on women-centered planning of innovations of perinatal mental health care. Interventions need to focus on the role of partners and others close to women so as to support the women during the perinatal period. [ABSTRACT FROM AUTHOR]