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Presentation: 5:29

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Poor mental health during pregnancy is an increasing problem for Black women within the United States, with implications for maternal and birth outcomes. Previous research has shown a strong association between race and maternal and birth outcomes, especially for Black mothers. There is also evidence within the literature of certain barriers affecting the ability to receive mental healthcare, as well as research explaining the affect barriers to healthcare can have on maternal and birth outcomes. The purpose of this systematic review was to determine if barriers to accessing mental healthcare during pregnancy can affect maternal or birth outcomes for Black women. Of the 840 results that were retrieved from PubMed and Scopus, six full-text studies were selected for a final analysis and data extraction. Studies were included if they were conducted from the year 2018 to the year 2023, performed within the United States, and published in English. Studies found that access to mental healthcare among Black women impacted the perinatal and postnatal period. Barriers such as race, poverty, unstable housing, and insurance led to adverse outcomes such as preterm birth, excessive weight loss, psychological distress, postpartum depression, and pregnancy related ER visits. The results confirmed that a lack of mental healthcare access during pregnancy does negatively impact maternal and birth outcomes for Black women within the United States. Findings suggest the need for further study into the experiences of Black women during pregnancy, especially for those with a mental health diagnosis. Future directions need to focus on finding ways to help Black women better access mental health resources to enhance maternal and birth outcomes.

Lay Summary

Mental illness has been strongly associated with adverse pregnancy outcomes, especially for Black women within the United States. Access to mental healthcare could help lessen the impacts of mental illness on maternal and birth outcomes. Black women who experience mental health problems have a greater risk of pre-term birth, low birth weight, preeclampsia, and placental abruption. Black women also face many barriers that can affect their ability to access necessary mental healthcare services. Barriers to receiving mental healthcare can come in many different forms, such as limited education, insurance, poverty, and structural racism. Researchers have shown a relationship between race, mental health, and pregnancy outcomes, yet there is limited research on the effect the inability to access mental healthcare has on pregnancy outcomes for Black women. This rapid review aimed to determine if barriers to mental healthcare access during pregnancy affected maternal or birth outcomes. Two databases, PubMed and Scopus, were searched using terms that were related to the research question such as “pregnancy,” “Black women,” “poverty,” “insurance,” “mental health care,” “pregnancy outcomes,” and “birth outcomes.” The initial search yielded 840 results, but only 6 studies met the eligibility criteria and were selected for the data extraction process. The studies indicated that barriers to obtaining mental healthcare such as poverty, insurance, unstable housing, and race can lead to excessive weight loss, postpartum depression, birth related PTSD, preterm birth, and long birth hospitalization stays. These findings show the increased need for further study into what Black women experience during pregnancy. Interventions aimed at improving mental healthcare access for Black women are needed to further prevent negative maternal or birth outcomes.