Structural Factors in Health Care Associated With the Mental Health Needs of Black Women in California During the Perinatal Period

Objective: To identify structural factors associated with the receipt of mental health care treatment among Black women in California during pregnancy and after childbirth. Design: Secondary analysis of data from the population-based Listening to Mothers in California survey. Participants: The sample included 194 non-Latina Black women in the postpartum period. Methods: We used descriptive statistics, including differences between means and logistic regression, to conduct a series of bivariate analyses. Results: Most respondents (84.4%, n = 163) reported symptoms of perinatal mood and anxiety disorders prenatally, and half (50% n = 97) reported symptoms of perinatal mood and anxiety disorders in the postpartum period. Only 12.3% to 14.6% of those who reported symptoms received mental health care treatment. Furthermore, 21.2% (n = 38) of respondents were not screened for postpartum depression. Respondents with private insurance coverage were more likely to report receipt of mental health care after childbirth (OR = 4.6; 95% confidence interval [1.5, 13.5]) compared to respondents with public insurance coverage. Conclusion: Our results suggest a high prevalence of unmet mental health needs among non-Latina Black women who lived in California during the perinatal period. Practitioners in clinical settings may be more likely to make referrals to mental health care for women with private insurance coverage in the postpartum period. JOGNN, 52, 481-490; 2023. https://doi.org/10.1016/j.jogn.2023.08.002